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Parental feeding practices play a significant role in children's health behaviors. Given the high prevalence of childhood obesity, it is important to examine factors that may influence parental feeding practices. This study examined the role of family functioning on the relationship between child behavior problems and parent feeding practices. We hypothesized that higher problematic child behavior would correlate with lower parental engagement in healthy parent feeding practices, with greater family dysfunction mediating that relationship. Participants (n = 220) were rural-dwelling parents of school-aged children with overweight or obesity. Participants completed the McMaster Family Assessment Device, Child Behavior Checklist (CBCL), and Child Feeding Questionnaire at baseline. Mediation models were used with youth behavioral problems (CBCL) as the independent variable, parental feeding practices as the dependent variable, and family functioning as the mediator. Two significant mediation models revealed (a) family functioning mediated the relationship between child behavior problems and parental perception of responsibility taking for child eating, and (b) family functioning mediated the relationship between child behavior problems and parental monitoring of their child's eating. More child behavior problems were associated with unhealthier family functioning, which was associated with less parental monitoring of children's unhealthy food intake and reduced responsibility taking for feeding and meal planning of their children. These findings suggest the synergistic effect of child behavior problems with poorer family functioning may be a risk factor for unhealthy parent feeding practices in children with overweight or obesity. If these relationships are supported by longitudinal research, behavior interventions for children with obesity should consider poor family functioning and child behavior as potential barriers to parental monitoring and responsibility of children's feeding practices.

Family functioning mediates the relationship between child behavior problems and parent feeding practices in youth with overweight or obesity