BACKGROUND: Effective treatment of childhood obesity requires a multi-factorial approach and should target factors impacting on a child's environment. OBJECTIVE: To explore the impact of three treatment programs on parental child-feeding practices at 6, 12 and 24 months post-program. SUBJECTS/INTERVENTION: Overweight children (n = 159) aged 5 to 7 years, recruited to the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS) randomized controlled trial with three treatment arms; a dietary modification program, a physical activity skill development program or a combination of both programs. MAIN OUTCOME MEASURES: The Child Feeding Questionnaire (CFQ), a validated 31-item questionnaire measuring child-feeding practices, completed by parents. STATISTICAL ANALYSIS: Linear mixed models were used to assess change over time and to determine differences by intervention group. RESULTS: A significant decrease (p < 0.01) in CFQ domain scores were reported and sustained at 24 months for all groups, in the domain of pressure to eat (mean +/- SEM, 1.8 +/- 0.06, 1.6 +/- 0.06) with increases in degree of monitoring (4.0 +/- 0.07, 4.2 +/- 0.06). The domain of restriction showed significant decreases in dietary intervention groups only (baseline 3.9 +/- 0.05, 24 months 3.7 +/- 0.06), the domain scores for concern were found to be strongly associated with child BMI z-score (r = 0.73, p < 0.001) at baseline only. CONCLUSIONS: This study provides evidence that specific child-feeding domains are modifiable in the context of a targeted obesity intervention and further that changes can be sustained over time.

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