Obesity is a pandemic affecting all age groups (1) and is one of the most significant health issues today (2). Obesity has increased rapidly worldwide in recent decades, with a growing increase among adolescents (3). In Latin America, obesity rates have reached worrisome levels (4), with an increasing rate since 2016 estimated to reach 19.8% in 2030 (5). The prevalence of overweight and obesity is even more concerning in Chile (2), Ávila-Alpirez et al. (3) report that four out of every 10 adolescents between 12 and 19 years are overweight or obese.

Adolescence is characterized by complex transitions due to important physical but also psycho-social and dietary changes (6, 7). During adolescence, maladaptive eating behaviors (8) and disorganized eating habits can occur (9), which lead to a reduction in eating quality (6, 10, 11), and which are associated with weight gain (12–14) and obesity, which generally persists into adulthood (9, 15–18). Papamichael et al. (19) showed that adolescents adopt diets characterized by high levels of sugar, fats, processed meats, and salt, which have been linked to an increased risk of developing non-transmissible diseases sooner than usual (14, 17). This is a significant public health issue in all parts of the world (7, 20) given the associated negative consequences, which lead to a reduction in quality of life in the subsequent developmental stages (17, 21–24).

Negative eating behaviors during adolescence can be explained partly by the greater autonomy and independence acquired at this life stage (7, 23). However, although children acquire greater autonomy in adolescence (9), parents continue to be responsible for meal preparation and eating at home (7). Therefore, parents continue to play an important role in their children’s development of eating habits during this period (25, 26). This influence is supported by Family Systems Theory, which states that individuals involved in reciprocal relationships (such as parents and their children) can influence each other’s thoughts, emotions, behaviors (27), and eating habits [e.g., (28, 29)].

To instill healthy eating habits and avoid weight gain, parents can use different Food Parental Practices (FPP), i.e., specific feeding habits that parents use to influence what, when, and how much their children eat (30), both during and between family meals (31). Vaughn et al. (32) propose a classification of FPP into three categories: coercive control (e.g., restriction, pressure to eat, threats, and bribes), structure (e.g., modeling, monitoring, availability, and accessibility of foods, unstructured practices), and autonomy support (e.g., nutritional education, stimuli, reasoning, and negotiation). Studies on FPP have focused mainly on preschool children and early childhood (20, 33, 34), likely due to the evidence indicating that unhealthy eating habits in early childhood could lead to complex eating disorders in more advanced life stages (35) and that in 90% of cases, obesity in childhood remains in adolescence (36). However, this focus on early childhood has led to a paucity of studies on FPP in adolescence, particularly in Latin America (7, 37).

Nevertheless, the sparse evidence available had showed that FPP strongly influence eating preferences, food choice, and intake during adolescence (38, 39). In addition, recent studies have shown that different FPP applied to adolescents can have different impact, with modeling having a positive impact on healthy eating habits (23, 40), while other FPP such as restriction are associated with negative results, such as weight gain (30).

Several instruments are currently used to measure FPP in different age groups. One frequently used measure is the Comprehensive Feeding Practices Questionnaire (CFPQ), initially developed by Musher-Eizenman and Holub (41), which consists originally of 49 items representing 12 factors to measure child FPP. Later, Melbye et al. (42) adapted this instrument to be applied to parents of adolescents.

The psychometric properties of the CFPQ have been widely evaluated in different studies, which has led to proposals to reduce the number of factors (7, 42–48). For instance, studies conducted with the CFPQ (41), in Brazil in samples of parents of school-aged children (45, 48), and in Greece with a sample of parents with children between 2 and 12 years (46), reported a model of only six of the 12 original factors. The factors that have shown greater stability in previous studies with parents are Monitoring [e.g., (13, 30, 43)], Control [e.g., (43)], Restriction for weight control [e.g., (43, 49–51)], Modeling [e.g., (43, 52, 53)], and Environment [e.g., (13, 51)].

Piccoli et al. (7) then adapted this instrument to measure the perception that adolescents have of FPP exerted by their parents in a sample of Brazilian adolescents. These authors thus proposed a 10-factor model for the CFPQ-Teen, validating the CFPQ-Teen using factorial analysis. Nevertheless, there remain research gaps regarding the CFPQ that this study seeks to fulfill. Namely, this scale has not been adapted to Spanish, and its psychometric properties have not been assessed in other contexts. Therefore, the focus of this study was to adapt the CFPQ-Teen to Spanish and to evaluate the psychometric properties of a five-factor model of the CFPQ-Teen, considering those factors that have shown greater stability in previous studies with samples of parents.

Having a validated instrument that measures the perceptions of adolescents about the application of the FPP is relevant because of the discrepancies found in the reports of parents and adolescents. Adolescents provide a different account of what their parents do to influence their eating habits, compared to what the parent’s report, especially in the Latin American Spanish-speaking context, which presents significant increases in the rate of overweight and obesity in adolescents (3–5). Furthermore, adolescence represents the last life stage in which parents have the possibility of a greater influence on their children’s eating habits through FPP (54).

Another aspect little studied in Latin America is the differences in adolescents’ perceptions of FPP according to gender (55). Making comparisons between the perceptions of samples of female and male adolescents is relevant because the evidence indicates that females have healthier eating habits than males, which suggests that gender is an important factor in food choices (55). It has been shown that, in particular, male adolescents consume more meat and fewer vegetables, and female adolescents select healthier foods like fruits and vegetables (56).

According to Cortez et al. (57), the differences in eating habits according to gender in adolescence are associated with the ideal body stereotypes that society imposes. Adolescent females place excessive significance on being thin, viewing it as a sign of perfection and attractiveness and adopting a thin esthetic model that places enormous societal pressure on girls as they develop their body image and self-esteem. Conversely, males seek an ideal muscular mesomorph body (58). However, to the best of the authors’ knowledge, there are no studies available that have assessed measurement invariance of the CFPQ-Teen according to the gender of the adolescents, which enable a correct comparison of the perceptions that female and male adolescents have of the FPP their parents exercise to promote adequate nutrition and prevent weight gain. Therefore, it is necessary to verify the equivalence of the perceptions of female and male adolescents regarding the FPP exercised by their parents.

In summary, the novelty of this study lies in the adaptation of the CFPQ-Teen to Spanish, validate it, assess its psychometric properties, and estimate the measurement invariance according to the adolescents’ gender in a Latin American country. It should be highlighted that the CFPQ-Teen measure the adolescent’s perception of their parents’ FPP, which allows to broaden the vision of studies that only consider the perspective of parents. Having both the parents’ and adolescents’ perspectives would allow for the development of better intervention strategies to improve how parents exercise FPP with the goal of improving adolescents’ eating habits and health.

Based on this background, the aims of this study were: (1) to adapt and validate a five-factor model version of the CFPQ-Teen in Spanish; (2) to examine the psychometric properties, (3) to evaluate the measurement invariance according to the adolescents’ gender, and (4) to compare the scores of each factor between female and male adolescents.

Previous studies have focused mainly on measuring FPP in parents of preschoolers (20). In addition, there is a small number of studies that measure FPP in adolescents, particularly in Latin America (28, 29). One of the most frequently used instruments to measure FPP is the CFPQ (41), which is answered by parents. The need to validate this instrument cross-culturally led to Ángel et al. (90) adapting the CFPQ to Spanish in a sample of Mexican mothers. Meanwhile, Del Valle et al. (43) adapted and validated a Spanish five-factor model version of the CFPQ (42) to be answered by parents of adolescents in Chile, in addition to considering measurement invariance according to the parent’s gender. However, given the differences between what the parents and children state regarding FPP that the parent offer (91), it is necessary to consider the adolescents’ responded perceptions of the FPP that their parents exercise in the home. In response, Piccoli et al. (7) adapted the CFPQ to Portuguese and measured the perception of FPP in adolescents (CFPQ-Teen) with a sample of adolescents from 12 to 18 years of age in Brazil. These authors validated a model comprised of 43 items representing 10 factors.

In light of the considerable increase in the prevalence of overweight and obesity in Spanish-speaking Latin American adolescents (5) and the need to conduct research with a gender perspective (55), the present study focused on adapting and validating the version of CFPQ-Teen (7) in a Spanish-speaking Latin American country considering possible differences between female and male adolescents. Thus, to the best of the authors’ knowledge, this is the first study to integrate the adaptation of the CFPQ-Teen to Spanish, validate it, assess its psychometric properties, estimate the measurement invariance according to the adolescents’ gender, and compare the scores of the factors, in a reduced four-factor model selected based on the factor stability reported in previous studies (43–47).

The psychometric analysis of the four factors model of the CFPQ-Teen using the EFA led to the elimination of the factor Environment, because two of its items had high loadings with the factor Parental Modeling, such that only two inverse items were left. In other studies, this factor has also been shown to have problems with internal consistency and homogeneity (7, 42–45, 47, 48). Eliminating this factor is in accordance with the criterion of Fabrigar et al. (92), which recommends keeping a minimum of three to four items per factor evaluated and the general EFA criteria recommended by Streiner (93). As a result of the EFA, a reduced measurement model was reported with four factors: Monitoring with four items, Adolescent Control with five items, Restriction for weight control with eight items, and Parental Modeling with four items.

In the CFA, item 12 of the factor Adolescent Control, which had a loading <0.40: “Do your parents allow you to leave the table when you are satisfied even if others have not finished eating?,” was removed from the instrument. The removal of this item is in line with recent studies (42, 43, 46), because this item primarily reflects the rupture of social norms related to meals rather than the control of the child about what and when to eat (42).

An adapted and validated Spanish 20-item version was finally obtained, with four factors on the CFPQ-Teen to be answered by adolescents: Monitoring with four items, Adolescent Control with four items, Restriction for weight control with eight items, and Parental Modeling with four items. The evaluation of the psychometric properties of the resulting measurement model from the CFA showed acceptable to good goodness-of-fit levels and good convergent, discriminant, external concurrent validity and reliability, demonstrating that it is a valid instrument to assess adolescents’ perception of the factors studied here. Concerning external concurrent validity, the positive association between dietary quality and monitoring and modeling confirms previous studies, which indicate that monitoring and modeling promote healthier eating habits in adolescents (28, 29). Moreover, the negative relation between restriction and dietary quality confirms previous studies associating this FPP with negative results in adolescents’ eating habits (30). The negative association between the factor control and dietary quality confirms that parents controlling less what adolescents eat in response to their search for autonomy in food choices (23) leads to adolescents having reduced dietary quality (13). Therefore, it may be concluded that the adapted and validated Spanish version of the reduced CFPQ-Teen constitutes a valid and reliable instrument to evaluate the four factors studied in Chilean adolescents. Obtaining a reduced CFPQ-Teen in this study contributes to a better understanding and interpretation of FPP in adolescents.

Furthermore, the model showed measurement equivalence of the initial factor structure up to the levels of communality and uniqueness of the items. The results obtained in the measurement invariance analysis verified the fulfillment of the configural, metric, scalar, and partial strict invariance. This means that the CFPQ-Teen measures the perceptions of female and male adolescents of the FPP included in this investigation equally well.

The fulfillment of configural invariance showed that the number of factors and location of the items in the measurement model is equivalent in the female and male adolescent samples. The fulfillment of metric invariance showed that the instrument is equivalent in measuring the perception of the meaning of the factors in the female and male samples as evidenced by identical factor loadings. The fulfillment of scalar invariance verified that the instrument is equivalent in the levels of the five-point response possibilities of the Likert-type scale. When evaluating strict invariance, which measures the proximity between the values predicted by the measurement model and the data collected in the sample, two residuals had to be released to obtain its confirmation. First, the residual of item 38 from the Parental Modeling, “My parents eat healthy food to give me an example of healthy eating habits,” was released because it presented a different goodness-of-fit between the predictions and the empirical values of the correlation matrices. Eliminating the equivalence restriction between the two samples in item 38 confirmed partial strict invariance 1. Next, it was necessary to release the estimation of a second residual in item 29 of the factor Restriction for weight control, “If I eat more than normally at one meal, my parents reduce the quantity of food at the next meal,” because it presented a different goodness-of-fit between the residuals of the empirical correlation matrices and was reproduced by the measurement model between the two samples. The elimination of the equivalence restriction in item 29 confirmed partial strict invariance 2. These results can be associated with male adolescents presenting a greater frequency of high scores on the Likert-type response scale in both items, indicating that unlike females, males perceive that parents show them a greater consumption of healthy food and unlike females, males perceive receiving less food when their parents consider they have eaten more than normal at a previous meal. These results may be associated with parents employing more restrictive FPP with their children (94), which vary according to the perception of risk against diseases such as obesity (31).

Among the limitations of this study, it must be considered that the adolescents who participated belong to families in which both parents work, and they might have less time to worry about their adolescent children’s eating. A cross-sectional design and a medium-sized non-probability sample were used (n = 473). Furthermore, our sample is not representative of the Chilean population of adolescents because the sample only include adolescents between the ages of 12 and 16. In addition, this study was developed in a single Spanish-speaking Latin American country. Although the AHEI may be a useful tool to measure diet quality, this measure does not include all possible food groups and the quantity of food consumed is not assessed.

Future research should take into account probability samples of the population, cross-cultural studies, and longitudinal designs. In this regard, it would be feasible to gauge how FPP has changed over time, and it might be possible to achieve external validity by comparing this measure to a gold standard or external predictive validation using data observed in longitudinal studies. Future studies should also consider performing a profile transition analysis to examine latent heterogeneity over time. Future studies may also evaluate the measurement invariance according to another relevant characteristics of the adolescents, such as different levels of education or household income.

This is the first study to adapt a final model of the four-factor version of the CFPQ-Teen into Spanish, verifying the psychometric properties of reliability, validity. Moreover, to our knowledge, this is the only study to date that has assessed the measurement equivalency of the perception of male and female adolescents through multigroup invariance analysis of a measurement model. This analysis made it possible to measure and compare the scores of the factors on the CFPQ-Teen between female and male adolescent samples in a Spanish-speaking context. This study provides a unique, valid and reliable questionnaire to measure and assess the understanding of how female and male adolescents perceive and internalize four FPP exercised by their parents in the family context, making it possible to establish other associations with characteristics of the parents and the adolescents, such as age and socioeconomic level, among other sociodemographic variables.

Although adolescents show differences in eating habits, theoretically our results suggest that male and female adolescents have similar perceptions of their parents’ control, monitoring, modeling, and restriction for weight control. The findings from this study also have practical implications. The results allow to identify the FPP that require greater emphasis on the part of parents, as well as those FPP in which a higher level of mastery is present, from the perspective of their adolescent children. This research contributes to the construction of scenarios based on FPP factors for their application in research on eating behavior and its implications in the orientation and production of the food industry, as well as in health and educational organizations and institutions through different intervention programs applied to adolescents and their parents. This is relevant to promote an improvement in the eating habits of families with adolescent children.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving humans were approved by the Universidad de La Frontera Ethics Committee (Protocol Number 007/2019). The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent to participate in this study was obtained from the participants’ legal guardian/next of kin. The adolescents also provided their own written informed consent.

CV: Data curation, Formal analysis, Methodology, Software, Writing – original draft, Writing – review & editing. HM: Data curation, Formal analysis, Methodology, Software, Writing – review & editing. LO: Investigation, Writing – review & editing. KG: Supervision, Writing – review & editing. CA-B: Supervision, Writing – review & editing. BS: Conceptualization, Funding acquisition, Investigation, Project administration, Resources, Supervision, Writing – review & editing.