Adolescent eating autonomy survey development and exploratory factor analysis

The development of autonomy over eating may impact nutrition-related disease risk, such as obesity and diabetes. Little is known about how eating autonomy develops throughout childhood and adolescence perhaps due to the absence of survey tools to measure adolescents eating autonomy behavioral engagement. This study developed and validated a comprehensive survey to evaluate adolescent eating autonomy using an iterative item development with content validity, expert review, and exploratory factor analysis (EFA). A sample of United States adolescents (n = 355; 12-17 years) completed surveys, including the newly developed eating autonomy survey, adolescent-reported parental autonomy support, and Comprehensive Feeding Practices (CFPQ), demographics and food insecurity. Maximum Likelihood EFA tested the factor structure of survey items, with estimated factor associations examined by age, sex, BMI, and food insecurity risk. Spearman Correlations examined discriminant and convergent validity of newly identified factors against previously established parental-constructs related to adolescents' eating autonomy; parental autonomy support and food-related parenting practices. Eating autonomy survey factors were found to be sufficiently distinct from previously established constructs; with final 28-item survey loading onto 5 factors: Snack Autonomy, Breakfast and Lunch Autonomy, Food Purchasing and Independence, Parent-granted Autonomy, Contextual control in eating. Initial demographic exploration of eating autonomy factors found that females had more autonomy in most areas, while only select areas of autonomy were associated with adolescent age (3 factors), household food insecurity (2 factors) and adolescent BMI (1 factor). This work begins to delineate and quantify dimensions of adolescents' autonomous eating behaviors yet further scale analyses are needed before the scale can be adopted more widely. Better understanding this unique developmental feature of adolescent eating behavior may reveal associations with a variety of behavioral concerns and health outcomes.