Valid and Reliable Measure of Adherence to Satter Division of Responsibility in Feeding

Objective: To examine the validity and psychometrics of sDOR.2-6y, a 12-item measure of adherence to the Satter Division of Responsibility in Feeding (sDOR). Design: Cross-sectional survey. Setting: Online respondents in central Pennsylvania. Participants: 117 parents (94% female, 77% White, 62% in ≥1 income-based assistance program) of preschoolers aged 2–6 years (28% moderate/high nutrition risk). Main Outcome Measures: The sDOR.2-6y and Nutrition Screening Tool for Every Preschooler (NutriSTEP), a measure of child nutrition risk and other validated measures of eating behavior and parent feeding practices. Analysis: Relationships were evaluated with Pearson r, t tests, ANOVA, or chi-square. Factor structure was investigated using principal components analysis with varimax rotation. Binary logistic regression and general linear model controlling for low-income status compared with sDOR.2-6y and NutriSTEP scores. Linear regression predicted NutriSTEP and Satter Eating Competence Inventory 2.0 scores from sDOR.2-6y. Results: The sDOR.2-6y ranged from 16–32 (mean, 25.9 ± 3.3; n = 114). Parents of youth at nutrition risk had lower sDOR.2–6y scores (P = 0.004). Each 1 point sDOR.2-6y increase decreased nutrition risk odds by 21% (95% confidence interval, 0.675–0.918; P = 0.002). The sDOR.2-6y scores were higher with less restriction and pressure to eat (both P < 0.001) and were associated with feeding style. Specificity was 87% with sDOR.2-6y cutoff ≥24; sensitivity was 66% with cutoff ≥26. Conclusions and Implications: The sDOR.2-6y accurately and reliably indicated adherence of low-income mothers to sDOR. Larger, diverse samples for future studies are recommended.