Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review

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Johnson" }, { "@type": "Person", "name": "Rebecca K. Golley" }, { "@type": "Person", "name": "Marian McBride" }, { "@type": "Person", "name": "Patricia Kearney" }, { "@type": "Person", "name": "Jamie Krikham" }, { "@type": "Person", "name": "Anna Lene Seidler" }, { "@type": "Person", "name": "Helen Skouteris" }, { "@type": "Person", "name": "Caroline B. Terwee" }, { "@type": "Person", "name": "Sarah Redsell" } ], "publisher": { "@type": "Organization", "name": "HRB Open Research", "logo": { "@type": "ImageObject", "url": "https://hrbopenresearch.org/img/AMP/HRB_image.png", "height": 566, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://hrbopenresearch.org/img/AMP/HRB_image.png", "height": 1200, "width": 127 }, "description": " Background How, what and when infants are fed in the first year of life influences their health and development. Interventions to improve infant feeding demonstrate inconsistent findings, highlighting a need for standardisation of what and how outcomes are measured. A core outcome set of infant feeding outcomes for use in childhood obesity prevention interventions has previously been developed, and scoping reviews have been conducted to identify what outcome measurement instruments are currently used to measure these outcomes. The aim of this review is to evaluate the measurement properties of the identified outcome measurement instruments that measure outcomes included in the infant feeding core outcome set. Methods A systematic review will be conducted following the COSMIN Initiative guidance. PubMed, EMBASE, CINAHL and PsycINFO databases will be searched from inception to present. To be eligible for inclusion studies must include infants ≤ 1 year of age. Studies must also report the development and/or evaluation of one or more measurement property of the outcome measurement instruments identified in our previous reviews, or other relevant outcome measurement instruments identified by the study team. Study screening and selection will be conducted independently in duplicate. The COSMIN Risk of Bias checklist will be used to evaluate the methodological quality of each study, and measurement properties will be evaluated one-by-one based on the COSMIN Initiative guidance. Confidence in the final ratings will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach. Results will be presented in narrative and tabular format. Discussion Evaluating measurement properties of outcome measurement instruments to measure outcomes included in the infant feeding core outcome set will inform development of a core outcome measurement set. This will standardise measurement in trials of infant feeding interventions to prevent childhood obesity, thus improving evidence synthesis and reducing research waste. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/8-43", "name": "Measurement properties of outcome measurement instruments used to..." } } ] } Home Browse Measurement properties of outcome measurement instruments used to... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Matvienko-Sikar K, Dutch D, Duffy M et al. Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :43 ( https://doi.org/10.12688/hrbopenres.14108.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review [version 1; peer review: 1 approved] Karen Matvienko-Sikar https://orcid.org/0000-0003-2777-6581 1 , Dimity Dutch https://orcid.org/0000-0002-8139-0068 1 , Moira Duffy https://orcid.org/0009-0006-2156-9599 1 , [...] Eibhlín Looney https://orcid.org/0009-0001-8832-360X 1 , Victoria Brown 2 , John Browne https://orcid.org/0000-0003-3494-4336 1 , Darren Dahly 1,3 , Declan Devane 4,5 , Janas Harrington https://orcid.org/0000-0002-6238-7031 1 , Brittany J. Johnson 6 , Rebecca K. Golley 6 , Marian McBride 7 , Patricia Kearney https://orcid.org/0000-0001-9599-3540 1 , Jamie Krikham 8 , Anna Lene Seidler 9 , Helen Skouteris 10 , Caroline B. Terwee 11,12 , Sarah Redsell https://orcid.org/0000-0002-2176-2325 13 Karen Matvienko-Sikar https://orcid.org/0000-0003-2777-6581 1 , Dimity Dutch https://orcid.org/0000-0002-8139-0068 1 , [...] Moira Duffy https://orcid.org/0009-0006-2156-9599 1 , Eibhlín Looney https://orcid.org/0009-0001-8832-360X 1 , Victoria Brown 2 , John Browne https://orcid.org/0000-0003-3494-4336 1 , Darren Dahly 1,3 , Declan Devane 4,5 , Janas Harrington https://orcid.org/0000-0002-6238-7031 1 , Brittany J. Johnson 6 , Rebecca K. Golley 6 , Marian McBride 7 , Patricia Kearney https://orcid.org/0000-0001-9599-3540 1 , Jamie Krikham 8 , Anna Lene Seidler 9 , Helen Skouteris 10 , Caroline B. Terwee 11,12 , Sarah Redsell https://orcid.org/0000-0002-2176-2325 13 PUBLISHED 21 Mar 2025 Author details Author details 1 University College Cork School of Public Health, Cork, County Cork, Ireland 2 Deakin Health Economics, Deakin University Institute for Health Transformation, Burwood, Victoria, Australia 3 HRB Clinical Research Facility, Cork, County Cork, Ireland 4 School of Nursing and Midwifery, University of Galway, Galway, County Galway, Ireland 5 HRB Trials Methodology Research Network, University of Galway, Galway, County Galway, Ireland 6 Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, South Australia, Australia 7 Health & Wellbeing, Strategy & Research, Healthcare Strategy, Health Service Executive, Dublin, County Dublin, Ireland 8 Centre for Biostatistics, Manchester Academic Health Service Centre, The University of Manchester, Manchester, England, UK 9 German Center for Child and Adolescent Health, Universitatsmedizin Rostock, Rostock, Germany 10 Health and Social Care Unit, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia 11 Amsterdam UMC Location VUmc Department of Epidemiology and Biostatistics, Amsterdam, North Holland, The Netherlands 12 Methodology, Amsterdam Public Health Research Institute, Amsterdam, North Holland, The Netherlands 13 University of Nottingham School of Health Sciences, Nottingham, England, UK Karen Matvienko-Sikar Roles: Conceptualization, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Dimity Dutch Roles: Methodology, Writing – Review & Editing Moira Duffy Roles: Methodology, Writing – Review & Editing Eibhlín Looney Roles: Methodology, Writing – Review & Editing Victoria Brown Roles: Conceptualization, Methodology, Writing – Review & Editing John Browne Roles: Conceptualization, Methodology, Writing – Review & Editing Darren Dahly Roles: Conceptualization, Methodology, Writing – Review & Editing Declan Devane Roles: Conceptualization, Methodology, Writing – Review & Editing Janas Harrington Roles: Conceptualization, Methodology, Writing – Review & Editing Brittany J. Johnson Roles: Methodology, Writing – Review & Editing Rebecca K. Golley Roles: Conceptualization, Methodology, Writing – Review & Editing Marian McBride Roles: Conceptualization, Methodology, Writing – Review & Editing Patricia Kearney Roles: Conceptualization, Methodology, Writing – Review & Editing Jamie Krikham Roles: Conceptualization, Methodology, Writing – Review & Editing Anna Lene Seidler Roles: Methodology, Writing – Review & Editing Helen Skouteris Roles: Conceptualization, Methodology, Writing – Review & Editing Caroline B. Terwee Roles: Conceptualization, Methodology, Writing – Review & Editing Sarah Redsell Roles: Conceptualization, Methodology, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Maternal and Child Health collection. Abstract Background How, what and when infants are fed in the first year of life influences their health and development. Interventions to improve infant feeding demonstrate inconsistent findings, highlighting a need for standardisation of what and how outcomes are measured. A core outcome set of infant feeding outcomes for use in childhood obesity prevention interventions has previously been developed, and scoping reviews have been conducted to identify what outcome measurement instruments are currently used to measure these outcomes. The aim of this review is to evaluate the measurement properties of the identified outcome measurement instruments that measure outcomes included in the infant feeding core outcome set. Methods A systematic review will be conducted following the COSMIN Initiative guidance. PubMed, EMBASE, CINAHL and PsycINFO databases will be searched from inception to present. To be eligible for inclusion studies must include infants ≤ 1 year of age. Studies must also report the development and/or evaluation of one or more measurement property of the outcome measurement instruments identified in our previous reviews, or other relevant outcome measurement instruments identified by the study team. Study screening and selection will be conducted independently in duplicate. The COSMIN Risk of Bias checklist will be used to evaluate the methodological quality of each study, and measurement properties will be evaluated one-by-one based on the COSMIN Initiative guidance. Confidence in the final ratings will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach. Results will be presented in narrative and tabular format. Discussion Evaluating measurement properties of outcome measurement instruments to measure outcomes included in the infant feeding core outcome set will inform development of a core outcome measurement set. This will standardise measurement in trials of infant feeding interventions to prevent childhood obesity, thus improving evidence synthesis and reducing research waste. READ ALL READ LESS Keywords outcome measurement instruments, measurement properties, feeding practices, diet, anthropometry, childhood obesity Corresponding Author(s) Karen Matvienko-Sikar ( [email protected] ) Close Corresponding author: Karen Matvienko-Sikar Competing interests: No competing interests were disclosed. Grant information: Health Research Board [HRB-EIA-2022-005]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Matvienko-Sikar K et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Matvienko-Sikar K, Dutch D, Duffy M et al. Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :43 ( https://doi.org/10.12688/hrbopenres.14108.1 ) First published: 21 Mar 2025, 8 :43 ( https://doi.org/10.12688/hrbopenres.14108.1 ) Latest published: 21 Mar 2025, 8 :43 ( https://doi.org/10.12688/hrbopenres.14108.1 ) Introduction Infant feeding, in terms of how, what and when infants are fed in the first year of life, has important implications for child health and development. Infant feeding includes aspects such as the duration of breastfeeding, timing of introduction of solids, the feeding environment, and parent/caregiver feeding practices and styles 1 – 6 . Infant feeding has been associated with development of diabetes 7 , 8 , respiratory illnesses 7 , 8 , allergic rhinitis 9 , cardiovascular diseases 8 , neurodevelopment 7 , and parent-child bonding and interactions 8 . Infant feeding is also suggested to be an important factor in the development and prevention of childhood obesity 6 , 10 – 13 , which is a public health challenge with approximately 37 million children under the age of 5 years estimated to have overweight or obesity in 2022 14 . Childhood obesity is associated with significant adverse outcomes for the individual, including Type 2 diabetes, autoimmune diseases, cardiovascular disease, increased risk of premature mortality, and impaired mental health 15 , 16 . Infant feeding behaviours, knowledge and attitudes have been targeted in childhood obesity prevention interventions 6 , 10 , 17 – 19 . However, evidence of effectiveness of such interventions is inconsistent and it remains unclear what interventions work, for whom, and in what contexts 10 , 18 , 20 , 21 . One potential reason for inconsistency in existing findings is heterogeneity in the outcomes that are measured and reported 10 , 20 , 22 – 24 . For instance, in a previous review examining what outcomes are measured in infant feeding studies, 236 individual outcomes were identified across 126 studies 23 . Such heterogeneity limits evidence synthesis and contributes to research waste 10 , 25 , 26 . To address this, two core outcome sets (COS) for childhood obesity prevention have been developed: an infant feeding COS for childhood obesity prevention, which includes 26 outcomes across nine outcome domains 24 ; and a complementary Early Prevention of Childhood Obesity (EPOCH) COS for children up to 5 years of age 22 . A COS represent the minimum set of outcomes that should be measured and reported in trials, and other research, in specific health areas 26 . While these COS provide invaluable resources for what to measure, it is essential to provide guidance on how best to measure these outcomes 27 . This is because the quality, feasibility, and availability of outcome measurement instruments (OMIs) have been cited as barriers to COS use by trialists 28 . Further, the use of poor-quality OMIs can bias trial findings 29 . To provide recommendations on what OMIs should be used to measure core outcomes for childhood obesity prevention, core outcome measurement sets (COMS) are being developed for both previously developed COS 27 , 30 , 31 . Three scoping reviews have been conducted to date to identify what OMIs have been used to measure the 26 outcomes included in the infant feeding COS 27 . These scoping reviews form part of the Standardised measurement for Childhood Obesity Prevention (SCOPE) study 31 , and were conducted for outcomes related to caregiver feeding practices and feeding environment, infant diet, and infant anthropometric outcomes 27 . Findings of the reviews identified over 200 OMIs currently used to measure 23 infant feeding COS outcomes. OMIs for three outcomes (knowing how to offer solid foods, caregiver modelling of eating behaviours, offering healthy foods) were not identified in the reviews, which focused on trials conducted in infancy; it is likely these outcomes have been measured in older children and/or in non-trial designs and work is ongoing to identify OMIs for these outcomes. In addition, OMIs identified in the reviews differ by type such as questionnaires, individual questions, dietary recall, food diaries/records, weighing scales, and callipers. Given the volume and inconsistencies in OMIs used to measure the COS outcomes, evaluation of the measurement properties and other characteristics of these OMIs (e.g., feasibility) is necessary to develop the SCOPE COMS. The COnsensus-based Standards for health Measurement INstruments (COSMIN) Initiative provide guidance on the evaluation of OMIs 32 – 34 . Following COSMIN Initiative guidance, systematic reviews of the literature on the development and validation of OMIs are an important tool to determine if the OMIs are valid, reliable, feasible and interpretable 33 , 35 . The COSMIN Initiative provides criteria to evaluate measurement properties identified in development and validation studies 33 . It also provides guidance on summarising and grading available evidence to make recommendations/suggestions about potentially suitable OMIs for use in future research 33 . As such, the aim of this review is to systematically review the measurement properties and feasibility of the OMIs for infant (≤ 1 year) caregiver feeding practices and feeding environment, diet and anthropometric outcomes included in an infant feeding core outcome set for childhood obesity prevention. Methods The evaluation of measurement properties of OMIs identified in our previously conducted scoping reviews 27 will follow COSMIN Initiative guidelines 33 . We will conduct a systematic review to identify evidence on measurement properties for established OMIs that have undergone measurement property testing. This protocol is reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 36 . See Supplementary File 1 for PRISMA-P checklist 37 . The review protocol is registered in the PROSPERO systematic review database (CRD420250650995). Preliminary OMI screening Over 200 OMIs were identified in our three scoping reviews 27 , which is not a feasible number to examine for measurement properties. Therefore, a systematic approach will be taken to screen OMIs for inclusion in the current review. OMIs identified in our scoping reviews 27 will be sourced, if possible, including obtaining copies of questionnaires and details of objective measurements. Where OMIs are not found in the published papers identified in the previous reviews 27 , study authors will be contacted and requested to provide the OMI used, with reminders sent if no reply is received. OMIs that cannot be obtained through literature searches or via contact with study authors will not be included in the screening and review stages. Screening of OMIs will be conducted using prespecified criteria including: 1) whether a recent review was conducted for the OMI following COSMIN guidelines 33 , 38 or rated as moderate to high quality using the AMSTAR 2 tool 39 ; 2) whether the OMI is fit for purpose (e.g., sufficient face and content validity); 3) whether the OMI is relevant for the population of interest; 4) whether the OMI is affordable to use; and 5) whether the OMI is practical to use. For this review, a 6 th criterion is related to whether the OMI could be used in both the infant feeding COMS 31 and the EPOCH COMS 30 . The EPOCH COMS is designed to be a complementary COMS for use beyond 12 months of age to measure outcomes included in a COS for early intervention trials to prevent obesity in childhood 30 . Preliminary screening of OMIs will be done independently in duplicate, with any disagreements resolved by consensus or brought to a third reviewer. To ensure the needs and preferences of parents/caregivers are considered in the preliminary screening, Patient and Public Involvement (PPI) representatives pilot-tested the screening criteria with seven OMIs and will contribute to screening 20% of the OMIs in this review, in addition to the duplicate screeners. PPI representatives include mothers of infants ≤ 1 year old, with a range of infant feeding experiences. See Supplementary File 2 for full preliminary screening criteria and details. Study eligibility. Study eligibility in the systematic reviews is determined by the constructs of interest, population, instrument type and measurement instruments (see Table 1 ). The constructs of interest are predetermined by those included in an infant feeding COS for childhood obesity prevention 24 . See Supplementary File 3 for details of outcomes and their definitions. The population is infants ≤ 1 year of age. The instrument types are also predetermined by our previous scoping reviews 27 and the results of preliminary screening stage. Table 1. Study eligibility criteria. Construct of interest The OMI should measure one of the 26 outcomes included in an infant feeding core outcome set for childhood obesity prevention 24 . The outcomes and their definitions are included in Supplementary File 3. Population Infants ≤ 1 year of age, born at full-term and not less than 37 weeks’ gestation; as per COSMIN Initiative guidelines, this should consist of at least 50% of the study population. Where it is unclear if at least 50% of infants were born at full term, study authors will be contacted for this information. Instrument type OMIs identified in our previous reviews 27 , and any other relevant OMIs identified by the study team, including additional OMIs provided by contacted study authors, will be eligible for inclusion. These OMIs include, for example, questionnaires, single survey items, food diaries, dietary recall, weighing scales, callipers, air displacement plethysmography. Measurement properties Eligible papers must report on development and/or evaluation of one or more measurement property of the previously identified OMIs 27 : content validity, structural validity, cross-cultural validity, internal consistency, reliability, measurement error, construct validity, criterion validity, responsiveness. Inclusion criteria: Studies must report on the development and/or evaluation of one or more measurement properties of previously identified OMIs that are used to measure an outcome included in the infant feeding core outcome set 24 . At least 50% of the study population must include infants ≤ 1 year of age, born at full-term. Only published full-text papers will be included as the likelihood of identifying comprehensive information on measurement properties in other types of publications (e.g. abstracts or reviews) is considered small 33 . English-language only publications will be eligible for inclusion but will be no restrictions on location or date of publication. Exclusion criteria: Studies that do not meet the inclusion criteria, that report on development and evaluation of an OMI that is not included in the review search, or that report using an OMI as a comparison tool for validation of another OMI will also be excluded. Search strategy. PubMed, EMBASE, CINAHL and PsycINFO databases will be searched from inception to present. Summary search blocks are presented in Table 2 , full search terms are presented in Supplementary File 4. Reference lists of identified papers will also be searched to ensure all studies are identified. Table 2. Summary search blocks. Population Terms related to infancy [AND] Measurement properties COSMIN sensitive search filter for measurement properties, which includes terms related to all measurement properties 40 [AND] Instrument names Pre-identified caregiver infant-feeding practices and feeding environment OMI names (Search 1) Pre-identified diet OMI names (Search 2) Anthropometric OMI names (search 3) [NOT] COSMIN Exclusion filter to remove irrelevant studies, e.g., animal studies and case reports 40 Study screening and selection. Identified studies from each search will be downloaded and deduplicated using Covidence software. Covidence software will also be used for study screening. All titles and abstracts of identified studies will be independently screened in duplicate against inclusion/exclusion criteria. Full texts of potentially eligible studies will then be screened independently and in duplicate. Any discrepancies at either screening stage will be resolved through consensus discussion or recourse to a third reviewer if needed. Data extraction. Data extraction is informed by COSMIN Initiative guidance 33 and the COSMIN taxonomy of measurement properties 29 , 33 . Extracted data will include: study and participant characteristics (title, author, year of publication, country, language, setting, participant type (e.g., child, caregiver, healthcare professional), age, gender, and sample size); OMI characteristics (name, version, OMI language, construct measured, target population, intended context of use, number of items, response options, possible range of scoring, scoring algorithm, measurement model, recall period, measurement properties, and how well the scope of the OMI has been described); feasibility characteristics (time to administer, OMI openly available, licensing information, costs, available translations; interpretability characteristics (percentage of patients with lowest and highest scores, number of items with missing values, minimal important change/minimal important difference, credibility score). Measurement property data to be extracted, if reported, include data on face and content validity, structural validity, internal consistency, cross-cultural validity/measurement invariance, reliability, measurement error, criterion validity (e.g., doubly labelled water as a gold standard for energy intake), construct validity (e.g., associations between breastfeeding duration and child anthropometric outcomes), and responsiveness. Different data will be extracted depending on the OMIs used, e.g., data on a number of items, recall period, and internal consistency may not be applicable to objective anthropometric OMIs. Data extraction will be conducted using the COSMIN review management file ( https://www.cosmin.nl/tools/guideline-conducting-systematic-review-outcomemeasures/ ). Pilot data extraction will be conducted independently by two reviewers with a subset of studies to ensure the data extraction form is fit for purpose. All subsequent data extraction will be conducted by a single reviewer, and all extracted data will be checked by a second reviewer. Quality assessment. The COSMIN Risk of Bias checklist 41 will be used to evaluate the methodological quality of each study, with studies evaluated as very good, adequate, doubtful or inadequate. The COSMIN Risk of Bias tool includes standards referring to design requirements and preferred statistical methods. It adopts a “worst score counts” principle whereby the lowest rating for any quality standard determines the overall rating 41 . Quality assessment will be conducted by two reviewers independently and in duplicate, with any disagreements resolved by consensus discussion or recourse to a third reviewer as needed. The COSMIN criteria for good measurement properties 33 will be applied by two reviewers independently in duplicate, with results rated as sufficient (+), insufficient (-) or indeterminate (?). Evaluating measurement properties of the OMIs. Measurement properties of identified OMIs will be evaluated one-by-one, starting with content validity, based on the COSMIN Initiative guidance 33 . Reliability, measurement error, criterion validity, hypotheses testing for construct validity and responsiveness will be examined as appropriate. The review team will define hypotheses for evaluating construct validity and responsiveness as recommended in the COSMIN guidance 33 . The measurement properties for each OMI will then be summarised as per COSMIN Initiative guidance for consistent and inconsistent study results 33 . Results will be summarised by one reviewer and checked by a second reviewer. Summarised results will then be rated independently by two reviewers using the COSMIN criteria for good measurement properties, with summarised results rated as sufficient (+), insufficient (-), or indeterminate (?). Certainty assessment. Confidence in the final ratings will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach to grading the quality of the evidence 33 , 42 . Four factors are considered when grading the quality of the evidence for OMIs, namely the risk of bias, inconsistency of results, imprecision (e.g., total sample size), and indirectness (e.g., evidence from different populations) 33 . Following the GRADE approach, evidence is downgraded to moderate, low, or very low evidence when there is a risk of bias, unexplained inconsistency, indirect results, or imprecision. The evidence can be downgraded to very low when the evidence is based on one inadequate study only 33 . Grading the quality of the evidence will be done by two reviewers independently, with any discrepancies resolved by consensus discussion or recourse to a third reviewer. Reporting. The summary of the evidence, based on the results of reviewed studies and the graded quality of the evidence on the measurement properties of OMIs, will be presented in the three respective review papers: 1) caregiver infant-feeding practices and feeding environment outcomes, 2) diet outcomes, and 3) anthropometric outcomes. The summary of the results, overall rating of the summarised result (sufficient, insufficient or indeterminate), and the quality of the evidence will be presented narratively and in tabular format. OMIs will be categorised as: a) suggested for use; b) potentially suggested for use; and c) not suggested for use. Findings will be reported following the PRISMA-COSMIN guideline for reporting of systematic reviews of OMI 32 . Discussion Evaluation of the measurement properties of OMIs that are currently used to measure core feeding practices and environment, diet, and anthropometric outcomes is essential to inform the development of a COMS. Following the evaluation of measurement properties, the next step is to conduct prioritisation and consensus processes with key stakeholders through an e-Delphi and consensus meeting, respectively. These processes will be conducted following the evaluation of OMI measurement properties as outlined here by bringing those OMIs categorised as suggested for use and potentially suggested for use forward to the e-Delphi survey, with the results of the e-Delphi survey informing the consensus meeting. The findings of these reviews and the subsequent consensus processes will, therefore, lead to the finalisation of the infant feeding COMS for childhood obesity prevention. Developing and using a COMS can standardise OMIs used in trials of infant feeding interventions to prevent childhood obesity, which will improve evidence synthesis and reduce research waste in this area. Ethical considerations As this is a systematic review, there are no potential ethical issues. As such, ethical approval is not required. Dissemination Findings from this study will be disseminated as three review publications based on the following groupings: caregiver feeding practices and environment OMIs, child diet OMIs, and child anthropometric OMIs. Findings will also be disseminated as presentations at academic conferences. Data availability Underlying data No data are associated with this article. Extended data Open Science Framework: Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes, https://doi.org/10.17605/OSF.IO/UAXGK 37 . This project contains the following extended data: - Supplementary file 1: PRISMA-P checklist - Supplementary file 2: Screening criteria - Supplementary file 3: COS outcomes and definitions - Supplementary file 4: Search strategy Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgements We would like to thank the members of the PPI group who have kindly contributed to pilot-testing the preliminary screening criteria for use in this review and their continued involvement in screening OMIs. Faculty Opinions recommended References 1. Hurley KM, Cross MB, Hughes SO: A systematic review of responsive feeding and child obesity in high-income countries. J Nutr. 2011; 141 (3): 495–501. PubMed Abstract | Publisher Full Text | Free Full Text 2. Modrek S, Basu S, Harding M, et al. : Does breastfeeding duration decrease child obesity? An instrumental variables analysis. Pediatr Obes. 2017; 12 (4): 304–311. 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PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 21 Mar 2025 ADD YOUR COMMENT Comment Author details Author details 1 University College Cork School of Public Health, Cork, County Cork, Ireland 2 Deakin Health Economics, Deakin University Institute for Health Transformation, Burwood, Victoria, Australia 3 HRB Clinical Research Facility, Cork, County Cork, Ireland 4 School of Nursing and Midwifery, University of Galway, Galway, County Galway, Ireland 5 HRB Trials Methodology Research Network, University of Galway, Galway, County Galway, Ireland 6 Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, South Australia, Australia 7 Health & Wellbeing, Strategy & Research, Healthcare Strategy, Health Service Executive, Dublin, County Dublin, Ireland 8 Centre for Biostatistics, Manchester Academic Health Service Centre, The University of Manchester, Manchester, England, UK 9 German Center for Child and Adolescent Health, Universitatsmedizin Rostock, Rostock, Germany 10 Health and Social Care Unit, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia 11 Amsterdam UMC Location VUmc Department of Epidemiology and Biostatistics, Amsterdam, North Holland, The Netherlands 12 Methodology, Amsterdam Public Health Research Institute, Amsterdam, North Holland, The Netherlands 13 University of Nottingham School of Health Sciences, Nottingham, England, UK Karen Matvienko-Sikar Roles: Conceptualization, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Dimity Dutch Roles: Methodology, Writing – Review & Editing Moira Duffy Roles: Methodology, Writing – Review & Editing Eibhlín Looney Roles: Methodology, Writing – Review & Editing Victoria Brown Roles: Conceptualization, Methodology, Writing – Review & Editing John Browne Roles: Conceptualization, Methodology, Writing – Review & Editing Darren Dahly Roles: Conceptualization, Methodology, Writing – Review & Editing Declan Devane Roles: Conceptualization, Methodology, Writing – Review & Editing Janas Harrington Roles: Conceptualization, Methodology, Writing – Review & Editing Brittany J. Johnson Roles: Methodology, Writing – Review & Editing Rebecca K. Golley Roles: Conceptualization, Methodology, Writing – Review & Editing Marian McBride Roles: Conceptualization, Methodology, Writing – Review & Editing Patricia Kearney Roles: Conceptualization, Methodology, Writing – Review & Editing Jamie Krikham Roles: Conceptualization, Methodology, Writing – Review & Editing Anna Lene Seidler Roles: Methodology, Writing – Review & Editing Helen Skouteris Roles: Conceptualization, Methodology, Writing – Review & Editing Caroline B. Terwee Roles: Conceptualization, Methodology, Writing – Review & Editing Sarah Redsell Roles: Conceptualization, Methodology, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information Health Research Board [HRB-EIA-2022-005]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 21 Mar 2025, 8:43 https://doi.org/10.12688/hrbopenres.14108.1 Copyright © 2025 Matvienko-Sikar K et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Matvienko-Sikar K, Dutch D, Duffy M et al. Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :43 ( https://doi.org/10.12688/hrbopenres.14108.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 21 Mar 2025 Views 0 Cite How to cite this report: Lanigan J. Reviewer Report For: Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :43 ( https://doi.org/10.21956/hrbopenres.15505.r46660 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-43/v1#referee-response-46660 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 28 Apr 2025 Julie Lanigan , University College London Great Ormond Street Institute of Child Health, London, UK Approved VIEWS 0 https://doi.org/10.21956/hrbopenres.15505.r46660 The protocol is very detailed, explains all procedures well and is supported by relevant and current references. I have one comment that relates to the title. In my opinion, the title does not accurately describe the work ... Continue reading READ ALL The protocol is very detailed, explains all procedures well and is supported by relevant and current references. I have one comment that relates to the title. In my opinion, the title does not accurately describe the work to be undertaken. The title should clearly state that outcomes of interest relate to childhood obesity only and not to other outcomes described in the introduction. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Infant and child nutrition, childhood obesity, clinical nutrition, interventions to improve short and long-term health in infants and young children, dietary intake assessment I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Lanigan J. Reviewer Report For: Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :43 ( https://doi.org/10.21956/hrbopenres.15505.r46660 ) The direct URL for this report is: https://hrbopenresearch.org/articles/8-43/v1#referee-response-46660 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 21 Mar 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 21 Mar 25 read Julie Lanigan , University College London Great Ormond Street Institute of Child Health, London, UK Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Lanigan J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 28 Apr 2025 | for Version 1 Julie Lanigan , University College London Great Ormond Street Institute of Child Health, London, UK 0 Views copyright © 2025 Lanigan J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The protocol is very detailed, explains all procedures well and is supported by relevant and current references. I have one comment that relates to the title. In my opinion, the title does not accurately describe the work to be undertaken. The title should clearly state that outcomes of interest relate to childhood obesity only and not to other outcomes described in the introduction. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Infant and child nutrition, childhood obesity, clinical nutrition, interventions to improve short and long-term health in infants and young children, dietary intake assessment I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Lanigan J. Peer Review Report For: Measurement properties of outcome measurement instruments used to measure caregiver feeding practices and feeding environment, infant diet, and infant anthropometry outcomes: Protocol for a systematic review [version 1; peer review: 1 approved] . HRB Open Res 2025, 8 :43 ( https://doi.org/10.21956/hrbopenres.15505.r46660) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://hrbopenresearch.org/articles/8-43/v1#referee-response-46660 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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