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Journal of Community Health

, Volume 41, Issue 3, pp 593–602 | Cite as

Perceived Parental Barriers to and Strategies for Supporting Physical Activity and Healthy Eating among Head Start Children

  • Jiying LingEmail author
  • Lorraine B. Robbins
  • Vicki Hines-Martin
Original Paper

Abstract

Despite the need for parents to support their children’s healthy behaviors, knowledge of factors preventing parents from doing so is still rudimentary. This study primarily aimed to explore perceived parental barriers to and strategies for supporting physical activity and healthy eating among Head Start children. A semi-structured interview format was used with four focus groups conducted at two urban Head Start centers in the Midwestern U.S. A qualitative content analysis of audio-recorded sessions was facilitated using ATLAS.ti7. A convenience sample of 32 parents (Mage = 34.97 years) participated. Over half were female (78.1 %), African Americans (65.6 %), and single (65.6 %). About 61.3 % reported an annual family income <$20,000, and 43.8 % were unemployed. Three themes reflected the barriers: (1) intrapersonal (child): short attention span and limited eating preferences; (2) interpersonal (parent): lack of time and cooking skills and a tight family budget; and (3) environmental: inaccessible programs, lack of age-appropriate education, electronic media use, and unsafe environment. Parents across all groups expressed high interest in enrolling in a program with their children. Recommendations included: parents’ support team; family outings at parks; taking a walk or enrolling in a class with children; and planting a garden. Many parents showed their preference for face-to-face meetings and a support group, but repulsion of counseling. To promote parental support in future interventions with Head Start children, their perceived intrapersonal, interpersonal, and environmental barriers should be considered as intervention targets. Involving parents through a support group and face-to-face meetings is recommended.

Keywords

Barriers Parental involvement Childhood obesity Head start children Qualitative 

Notes

Acknowledgment

This study was funded by Michigan State University College of Nursing. The authors thank Emily Roth, Jordyn Roberts, Ashley Triplett, and Fujun Wen for their assistance on conducting the focus groups and transcribing the audiotaped interviews.

References

  1. 1.
    Aikens, N., Hulsey, L. K., Moiduddin, E., et al. (2011). Data tables for FACES 2009 head start children, families, and programs: Present and past data from FACES report. OPRE Report 2011-33b. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.Google Scholar
  2. 2.
    Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2011). Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA, 311(8), 806–814.CrossRefGoogle Scholar
  3. 3.
    Cunningham, S. A., Kramer, M. R., & Narayan, K. M. (2014). Incidence of childhood obesity in the United States. New England Journal of Medicine, 370(5), 403–411.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Te Velde, S. J., Van Nassau, F., Uijtdewilligen, L., et al. (2012). Energy balance-related behaviours associated with overweight and obesity in preschool children: A systematic review of prospective studies. Obesity Reviews, 13(Suppl 1), 56–74.CrossRefGoogle Scholar
  5. 5.
    Gubbels, J. S., Kremers, S. P., Stafleu, A., Goldbohm, R. A., de Vries, N. K., & Thijs, C. (2012). Clustering of energy balance-related behaviors in 5-year-old children: Lifestyle patterns and their longitudinal association with weight status development in early childhood. International Journal of Behavioral Nutrition and Physical Activity, 9(77), 1–10.Google Scholar
  6. 6.
    Reinehr, T., Kleber, M., Lass, N., & Toschke, A. M. (2010). Body mass index patterns over 5 y in obese children motivated to participate in a 1-y lifestyle intervention: age as a predictor of long-term success. American Journal of Clinical Nutrition, 91(5), 1165–1171.CrossRefPubMedGoogle Scholar
  7. 7.
    Goldfield, G. S., Harvey, A., Grattan, K., & Adamo, K. B. (2012). Physical activity promotion in the preschool years: A critical period to intervene. International Journal of Environmental Research and Public Health, 9(4), 1326–1342.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Gahagan, S. (2012). Development of eating behavior: Biology and context. Journal of Developmental and Behavioral Pediatrics, 33(3), 261–271.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Monasta, L., Batty, G. D., Macaluso, A., et al. (2011). Interventions for the prevention of overweight and obesity in preschool children: A systematic review of randomized controlled trials. Obesity Reviews, 12(501), e107–e118.CrossRefPubMedGoogle Scholar
  10. 10.
    Ling, J., Robbins, L. B., & Wen, F. (2016). Interventions to prevent and manage overweight or obesity in preschool children: A systematic review. International Journal of Nursing Studies, 53, 270–289.CrossRefPubMedGoogle Scholar
  11. 11.
    Hudson, C. E., Cherry, D. J., Ratcliffe, S. J., & McClellan, L. C. (2009). Head Start children’s lifestyle behaviors, parental perceptions of weight, and body mass index. Journal of Pediatric Nursing, 24(4), 292–301.CrossRefPubMedGoogle Scholar
  12. 12.
    Brogan, K., Danford, C., Yeh, Y., & Jen, K. L. C. (2014). Cardiovascular disease risk factors are elevated in urban minority children enrolled in head start. Childhood Obesity, 10(3), 207–213.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Bellows, L. L., Davies, P. L., Anderson, J., & Kennedy, C. (2013). Effectiveness of a physical activity intervention for Head Start preschoolers: A randomized intervention study. American Journal of Occupational Therapy, 67(1), 28–36.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Fitzgibbon, M. L., Stolley, M. R., Schiffer, L., Horn, L., KauferChristoffel, K., & Dyer, A. (2006). Hip-Hop to Health Jr. for Latino preschool children. Obesity, 14(9), 1616–1625.CrossRefPubMedGoogle Scholar
  15. 15.
    Bond, M., Wyatt, K., Lloyd, J., & Taylor, R. (2011). Systematic review of the effectiveness of weight management schemes for the under fives. Obesity Reviews, 12(4), 242–253.CrossRefPubMedGoogle Scholar
  16. 16.
    Nixon, C. A., Moore, H. J., Douthwaite, W., et al. (2012). Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4–6-year-olds: A systematic review. Obesity Reviews, 13(Suppl 1), 106–117.CrossRefPubMedGoogle Scholar
  17. 17.
    Fitzgibbon, M. L., Stolley, M. R., Schiffer, L., et al. (2013). Family-based hip-hop to health: Outcome results. Obesity, 21(2), 274–283.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    De Bock, F., Genser, B., Raat, H., Fischer, J. E., & Renz-Polster, H. (2013). A participatory physical activity intervention in preschools: A cluster randomized controlled trial. American Journal of Preventive Medicine, 45(1), 64–74.CrossRefPubMedGoogle Scholar
  19. 19.
    Krueger, R. A., & Casey, M. A. (2010). Focus group interviewing in Handbook of practical program evaluation (pp. 378–403). San Francisco (CA): Jossey-Bass.Google Scholar
  20. 20.
    Morgan, D. L., & Krueger, R. A. (1998). The focus group kit. California: Sage Publications Inc.Google Scholar
  21. 21.
    Rabiee, F. (2004). Focus-group interview and data analysis. Proceedings of the Nutrition Society, 63(4), 655–660.CrossRefPubMedGoogle Scholar
  22. 22.
    Fylan, F. (2005). Semi structured interviewing. A handbook of research methods for clinical and health psychology. New York: Oxford University Press Inc.Google Scholar
  23. 23.
    Wengraf, T. (2011). Qualitative research interviewing: Biographic narrative and semi-structured methods. London: Sage.Google Scholar
  24. 24.
    Krippendorff, K. (2013). Content analysis: An introduction to its methodology. London: Sage Publications Inc.Google Scholar
  25. 25.
    Glaser, B. G. (1965). The constant comparative method of qualitative analysis. Social Problems, 12(4), 436–445.CrossRefGoogle Scholar
  26. 26.
    McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15, 351–377.CrossRefPubMedGoogle Scholar
  27. 27.
    Skouteris, H., McCabe, M., Swinburn, B., Newgreen, V., Sacher, P., & Chadwick, P. (2011). Parental influence and obesity prevention in pre-schoolers: A systematic review of interventions. Obesity Reviews, 12(5), 315–328.CrossRefPubMedGoogle Scholar
  28. 28.
    Chapman, S. (2014). Attention problem in children. Accessed on November 13, 2015 from http://www.abilitypath.org/areas-of-development/learning–schools/problem-solving-skills/articles/attention-problems-03.html
  29. 29.
    Berge, J. M., Arikian, A., Doherty, W. J., & Neumark-Sztainer, D. (2012). Healthful eating and physical activity in the home environment: Results from multifamily focus groups. Journal of Nutrition Education and Behavior, 44(2), 123–131.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Dwyer, J., Needham, L., Simpson, J. R., & Heeney, E. S. (2008). Parents report intrapersonal, interpersonal, and environmental barriers to supporting healthy eating and physical activity among their preschoolers. Applied Physiology, Nutrition and Metabolism, 33(2), 338–346.CrossRefGoogle Scholar
  31. 31.
    Scaglioni, S., Arrizza, C., Vecchi, F., & Tedeschi, S. (2011). Determinants of children’s eating behavior. American Journal of Clinical Nutrition, 94(6 Suppl), 2006S–2011S.CrossRefPubMedGoogle Scholar
  32. 32.
    Ventura, A. K., & Worobey, J. (2013). Early influences on the development of food preferences. Current Biology, 23(9), R401–R408.CrossRefPubMedGoogle Scholar
  33. 33.
    Irwin, J. D., He, M., Bouck, L. M. S., Tucker, P., & Pollett, G. L. (2005). Preschoolers’ physical activity behaviours—Parents’ perspectives. Canadian Journal of Public Health-Revue Canadienne De Sante Publique, 96(4), 299–303.PubMedGoogle Scholar
  34. 34.
    Larson, N., Ward, D. S., Neelon, S. B., & Story, M. (2011). What role can child-care settings play in obesity prevention? A review of the evidence and call for research efforts. Journal of the American Dietetic Association, 111(9), 1343–1362.CrossRefPubMedGoogle Scholar
  35. 35.
    Hey, D. W., Kelly, K. M., Teaford, S., & McDermott, A. Y. (2015). Barriers to physical activity and healthy eating in children as perceived by low-income parents: A case study. International Journal of Nutrition, 1(2), 75–87.Google Scholar
  36. 36.
    Hendrickson, D., Smith, C., & Eikenberry, N. (2006). Fruit and vegetable access in four low-income food deserts communities in Minnesota. Agriculture and Human Values, 23(3), 371–383.CrossRefGoogle Scholar
  37. 37.
    Ruelas, V., Iverson, E., Kiekel, P., & Peters, A. (2012). The role of farmers’ markets in two low income, urban communities. Journal of Community Health, 37(3), 554–562.CrossRefPubMedGoogle Scholar
  38. 38.
    Yeh, M. C., Ickes, S. B., Lowenstein, L. M., et al. (2008). Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA. Health Promotion International, 23(1), 42–51.CrossRefPubMedGoogle Scholar
  39. 39.
    Summerbell, C. D., Moore, H. J., Vögele, C., et al. (2012). Evidence-based recommendations for the development of obesity prevention programs targeted at preschool children. Obesity Reviews, 13, 129–132.CrossRefPubMedGoogle Scholar
  40. 40.
    Reynolds, A. J., Temple, J. A., Ou, S. R., et al. (2007). Effects of a school-based, early childhood intervention on adult health and well-being—A 19-year follow-up of low-income families. Archives of Pediatrics and Adolescent Medicine, 161(8), 730–739.CrossRefPubMedGoogle Scholar
  41. 41.
    Sallis, J. F., & Glanz, K. (2006). The role of built environments in physical activity, eating, and obesity in childhood. Future of Children, 16(1), 89–108.CrossRefPubMedGoogle Scholar
  42. 42.
    Burdette, H. L., & Whitaker, R. C. (2005). A national study of neighborhood safety, outdoor play, television viewing, and obesity in preschool children. Pediatrics, 116(3), 657–662.CrossRefPubMedGoogle Scholar
  43. 43.
    Strasburger, V. C., Jordan, A. B., & Donnerstein, E. (2010). Health effects of media on children and adolescents. Pediatrics, 125(4), 756–767.CrossRefPubMedGoogle Scholar
  44. 44.
    Mendoza, J. A., Zimmerman, F. J., & Christakis, D. A. (2007). Television viewing, computer use, obesity, and adiposity in US preschool children. International Journal of Behavioral Nutrition and Physical Activity, 4(44), 1–10.Google Scholar
  45. 45.
    Foltz, J. L., May, A. L., Belay, B., Nihiser, A. J., Dooyema, C. A., & Blanck, H. M. (2012). Population-level intervention strategies and examples for obesity prevention in children. Annual Review of Nutrition, 32, 391–415.CrossRefPubMedGoogle Scholar
  46. 46.
    Jurkowski, J. M., Mills, L. L. G., Lawson, H. A., Bovenzi, M. C., Quartimon, R., & Davison, K. K. (2013). Engaging low-income parents in childhood obesity prevention from start to finish: A case study. Journal of Community Health, 38(1), 1–11.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Van Lippevelde, W., Verloigne, M., De Bourdeaudhuij, I., et al. (2012). Does parental involvement make a difference in school-based nutrition and physical activity interventions? A systematic review of randomized controlled trials. International Journal of Public Health, 57(4), 673–678.CrossRefPubMedGoogle Scholar
  48. 48.
    O’Connor, T. M., Jago, R., & Baranowski, T. (2009). Engaging parents to increase youth physical activity: A systematic review. American Journal of Preventive Medicine, 37(2), 141–149.CrossRefPubMedGoogle Scholar
  49. 49.
    Eysenbach, G., Powell, J., Englesakis, M., Rizo, C., & Stern, A. (2004). Health related virtual communities and electronic support groups: Systematic review of the effects of online peer to peer interactions. BMJ, 328(7449), 1166.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Resnicow, K., Davis, R., & Rollnick, S. (2006). Motivational interviewing for pediatric obesity: Conceptual issues and evidence review. Journal of the American Dietetic Association, 106(12), 2024–2033.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jiying Ling
    • 1
    Email author
  • Lorraine B. Robbins
    • 2
  • Vicki Hines-Martin
    • 3
  1. 1.Michigan State University College of NursingEast LansingUSA
  2. 2.Michigan State University College of NursingEast LansingUSA
  3. 3.Office of Health Disparities and Community EngagementUniversity of Louisville School of NursingLouisvilleUSA

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