Evaluating the face validity of early eats: A consumer‐focused educational website to enhance practical skills in complementary feeding and early allergen introduction

To the Editor,

Despite growing evidence supporting the early introduction of food allergens beginning at approximately 4–6 months of age, ¹ parents and caregivers in the United States have been slow to adopt this practice. ² , ³ This reluctance, as reported from existing literature, is attributed to limited guidance from pediatricians, ⁴ , ⁵ fear of allergic reactions, ³ infant refusal, ³ practical problems such as taste dislikes, ³ or conflicting cultural or religious practices. ³ Unfortunately, this parental hesitancy can delay the timely introduction of allergenic foods, which is particularly detrimental for high‐risk infants—those with eczema or an existing egg allergy ⁶ —who may benefit the most from the early introduction. ⁷ Studies conducted outside of the United States have reported higher rates of early allergen inclusion among young children in countries such as Australia, ⁸ New Zealand, ⁹ and the United Kingdom, ¹⁰ where detailed infant feeding guidance is more widely available, ¹¹ , ¹² , ¹³ and with strong community support and updates. ¹⁴

A review of current U.S.‐based educational resources on complementary feeding and early allergen introduction ¹⁵ , ¹⁶ , ¹⁷ , ¹⁸ reveals a lack of consumer‐focused, age‐specific, in‐depth practical tools that provide parents and caregivers with up‐to‐date guidelines and actionable solutions to common barriers. These barriers include challenges with complementary feeding, preparation of age‐appropriate food textures, integration of family or cultural feeding practices, foundational nutrition knowledge, and hands‐on cooking guidance. In collaboration with dietetic interns at Bowling Green State University (BGSU) from 2023 to 2025, we developed a consumer‐focused educational website designed to provide visual, practical, and culturally inclusive guidance for parents and caregivers of young children: www.earlyeats.org. The website covers five key topics: (1) the timing of nutritional transition, (2) preparing age‐appropriate complementary foods at home, (3) addressing common feeding challenges, (4) working with allergy risks and (5) cultural and personal food choices. In addition, the site features age‐specific recipes incorporating the top nine allergens, accompanied by cooking demonstration videos, nutrient information, portion guidance, and suggested recipe variations. The overall aim of this study was to evaluate the face validity of a newly developed, consumer‐focused educational website designed to support caregivers in complementary feeding and early allergen introduction.

The content was developed through a comprehensive literature review and reviewed by the study's principal investigators—a registered dietitian trained by FARE and actively engaged in pediatric food allergy education and research. Parents and caregivers of at least one child aged 2 years or younger were then recruited between September and November 2024 to evaluate the website's clarity, usability, and perceived usefulness as part of a face validity assessment. The study was approved by the university's Institutional Review Board and recruitment was conducted through flyers posted on campus and community locations. After providing informed consent, participants were invited to review the website and completed an online survey assessing the website's clarity, ease of navigation, organization, literacy level, and overall acceptability (Table 1). Participants also completed knowledge‐check items to assess comprehension and responded to an open‐ended question regarding what they benefited most from the website. An attention‐check question was included in the survey. Participants who completed the survey were entered into a raffle for one of the twenty $25 Amazon e‐gift cards.

TABLE 1.

Quantitative results of the website satisfaction.

Construct measured	Questions	Mean (SD) or percentage	Scale range or explanation
Reading accessibility	Where there any words used on the website that you were unfamiliar with?	1.06 (0.24)	1 = no words that I am unfamiliar with, 2 = 1–2 words, 3 = 3–4 words, 4 = 5 or more words
Usability	On a scale of 1–5 how easy was it to navigate the website?	1.59 (1.33)	On a Likert scale, 1 = very easy, and 5 = very hard
Clarity	On a scale 1–5 did the material on the website flow well and was it easy to understand?	1.59 (1.33)	On a Likert scale, 1 = very easy, and 5 = very difficulty
Practicality	After viewing this website are you going to implement what you learned into feeding practice with your child?	1.12 (0.33)	On a Likert scale, 1 = very willing, and 5 = unwilling
	On a scale of 1–5 how willing would you be to try the recipes found on the website with you infant?	1.76 (1.2)	On a Likert scale, 1 = very willing, and 5 = unwilling
Website organization	On a Scale of 1–5 how was the overall flow and appearance of the website?	4.71 (0.77)	On a Likert scale, 1 = looked unsightly and disorganized, and 5 = looked professional and organized
Perceived usefulness	On a scale 1 to 5 please rate if the knowledge presented on this website was beneficial to you?	4.41 (0.94)	On a Likert scale, 1 = not beneficial at all, and 5 = extremely beneficial
Knowledge retention	How easy was it for you to retain the knowledge that you learned from the website on a scale of 1–5?	4.82 (0.39)	On a Likert scale, 1 = I forgot the content, and 5 = still remember important concepts and key points
Knowledge check	Based on what you learned from this website at what age should you introduce allergenic foods?	100%	17/17 answered correct on this question
	Based on what you learned from the website where on a packaged item would you look to see if it had any potential food allergens in it?	94%	16/17 answered correct on this question

Seventeen parents or caregivers completed the evaluation. Participant demographics are summarized in Table 2, with most respondents reporting at least some college education. All participants passed the attention‐check question. Participants reported that the literacy level was appropriate (mean = 1.06 ± 0.24, where 1 = no unfamiliar words and 4 = five or more unfamiliar words), navigation was easy (mean = 1.59 ± 1.33, where 1 = very easy and 5 = very hard), and the information was beneficial (mean = 4.41 ± 0.94, where 1 = not beneficial and 5 = extremely beneficial). Caregivers also expressed strong willingness to apply the information to feeding practices (mean = 1.12 ± 0.33, where 1 = very willing and 5 = unwilling).

TABLE 2.

Participant demographic characteristics (N = 17).

Variable	Category	n (%)
Child age eligibility	Has at least one child aged ≤2 years	17 (100)
	Does not have a child aged ≤2 years	0 (0)
Highest education level of respondent	High school diploma	1 (5.9)
	Some college	6 (35.3)
	College degree or higher	8 (47.1)
	Prefer not to answer	2 (11.8)
Primary grocery shopping location	Food pantry	0 (0)
	Grocery store	17 (100)
	Other	0 (0)
Frequency of home meal preparation	1–2 times per week	0 (0)
	3–4 times per week	13 (76.5)
	5–6 times per week	2 (11.8)
	Daily	2 (11.8)

Qualitative feedback further supported website acceptability. For example, one caregiver noted that the website clarified “when to start introducing foods like eggs and peanuts”, while another highlighted learning “learned some great new recipes”. Participants also acknowledged the value of the website's nutritional guidance for infants, noting that it helped them understand “what food I have to give to my child to get a specific vitamin.” Participants consistently emphasized the value of clear timelines, practical recipes, and allergen‐specific guidance. All participants indicated they would recommend the website to others and planned to revisit it.

In summary, the responses suggest that the website is accessible, practical, and engaging. Strengths of this study include the use of mixed quantitative and qualitative methods and the focus on consumer‐perceived face validity, an important early step in intervention development. Limitations include the small sample size, limited demographic diversity, and recruitment from a single geographic region, which may limit generalizability. Moving forward, the website will be refined based on user feedback and evaluated in larger and more diverse populations to assess its impact on caregiver knowledge, confidence, and infant feeding practices. The website is currently public available, and ongoing updates through collaborating with dietetic interns, faculties and experts will help ensure it remains responsive to caregiver needs, supports evidence‐based practice, and advances public health goals in food allergy prevention.

AUTHOR CONTRIBUTIONS

Ashley Wheeler: Methodology; data curation; writing – review and editing. Cecilia Record: Methodology; data curation; writing – review and editing. Wan Shen: Conceptualization; investigation; funding acquisition; writing – original draft; methodology; writing – review and editing; formal analysis; data curation; supervision.

CONFLICT OF INTEREST STATEMENT

None.