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Maternal and Child Health Journal

, Volume 22, Issue 7, pp 958–967 | Cite as

Challenges and Facilitators to Promoting a Healthy Food Environment and Communicating Effectively with Parents to Improve Food Behaviors of School Children

  • Hiershenee B. Luesse
  • Rachel Paul
  • Heewon L. Gray
  • Pamela Koch
  • Isobel Contento
  • Victoria Marsick
Article

Abstract

Background Childhood obesity is a major public health concern and families play an important role. Improving strategies to reach parents and directing tailored nutrition education to them is needed. Purpose To investigate the challenges and facilitators to promoting a healthy environment at home and to identify communication preferences to inform intervention strategies for effectively reaching low-income urban minority families. Procedure Semi-structured focus group interviews were conducted with four groups involving 16 low-income urban parents (94% female; 88% Hispanic/Latino, 12% African American) of elementary school children. Interviews were transcribed and analyzed applying Social Cognitive Theory and using in-vivo coding. Main Findings The most common barriers to parents providing healthy foods to their children were accommodating child preferences and familial opposition. Parents showed intentionality to engage in healthy behaviors, and often shared procedural knowledge for reaching health goals. The analyses of desired communication channels yielded major preferences: tailored information, information provided through multiple mediums, appropriate duration/frequency of messages, and presented from a voice of authority. Conclusion and Implication While parents expressed desires to be healthy, the home food environment presented substantial challenges. Multi-media supports such as workshops, flyers, and text messaging may be useful to facilitate the sharing of information to minimize the tensions between intentionality and reaching desired goals to be healthy. Some parents thought that information received through text messaging could be easily shared and would act as a voice of authority to support child behavior change.

Keywords

Home environment Childhood obesity Social cognitive theory Qualitative study 

Notes

Acknowledgements

The authors thank parent coordinators for their technical assistance with this study. A portion of this study has been presented in abstract form at the Society for Nutrition Education and Behavior conference in Wisconsin, 2015.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Ball, K., Jeffery, R. W., Abbott, G., McNaughton, S. A., & Crawford, D. (2010). Is healthy behavior contagious: Associations of social norms with physical activity and healthy eating. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 86.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory: Englewood Cliffs: Prentice-Hall, Inc.Google Scholar
  3. Baranowski, T., Domel, S., Gould, R., Baranowski, J., Leonard, S., Treiber, F., & Mullis, R. (1993). Increasing fruit and vegetable consumption among 4th and 5th grade students: Results from focus groups using reciprocal determinism. Journal of Nutrition Education, 25(3), 114–120.CrossRefGoogle Scholar
  4. Birch, L., Savage, J. S., & Ventura, A. (2007). Influences on the development of children’s eating behaviours: from infancy to adolescence. Canadian Journal of Dietetic Practice and Research: A Publication of Dietitians of Canada, 68(1), s1.Google Scholar
  5. Brown, R., & Ogden, J. (2004). Children’s eating attitudes and behaviour: A study of the modelling and control theories of parental influence. Health Education Research, 19(3), 261–271.CrossRefPubMedGoogle Scholar
  6. Carlson, A., Kinsey, J., & Nadav, C. (2002). Consumers’ retail source of food: A cluster analysis. Family Economics and Nutrition Review, 14(2), 11.Google Scholar
  7. Carruth, B. R., & Skinner, J. D. (2000). Revisiting the picky eater phenomenon: Neophobic behaviors of young children. Journal of American College of Nutrition, 19(6), 771–780.CrossRefGoogle Scholar
  8. Contento, I. (2015). Nutrition education. Linking research, theory, and practice. Burlington: Jones & Bartlett Learning.Google Scholar
  9. Cullen, K. W., Baranowski, T., Rittenberry, L., & Olvera, N. (2000). Social–environmental influences on children’s diets: results from focus groups with African-, Euro-and Mexican-American children and their parents. Health Education Research, 15(5), 581–590.CrossRefPubMedGoogle Scholar
  10. CDC Health Disparities & Inequalities Report (CHDIR). (2013). Retrieved from https://www.cdc.gov/minorityhealth/chdireport.html.
  11. Daniel-White, K. (2002). Reassessing Parent Involvement: Involving Language Minority Parents in School Work at Home. Working Papers in Educational Linguistics, 18(1), n1.Google Scholar
  12. Duggan, M., & Rainie, L. (2013). Cell phone activities 2013. Washington: Pew Research Center’s Internet & American Life Project.Google Scholar
  13. Duncanson, K., Burrows, T., & Collins, C. (2014). Peer education is a feasible method of disseminating information related to child nutrition and feeding between new mothers. BMC Public Health, 14(1), 1.CrossRefGoogle Scholar
  14. Fjeldsoe, B. S., Marshall, A. L., & Miller, Y. D. (2009). Behavior change interventions delivered by mobile telephone short-message service. American Journal of Preventive Medicine, 36(2), 165–173.CrossRefPubMedGoogle Scholar
  15. Galloway, A. T., Lee, Y., & Birch, L. L. (2003). Predictors and consequences of food neophobia and pickiness in young girls. Journal of the American Dietetic Association, 103(6), 692–698.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Gruber, K. J., & Haldeman, L. A. (2009). Peer reviewed: Using the family to combat childhood and adult obesity. Preventing Chronic Disease, 6(3), A106.PubMedPubMedCentralGoogle Scholar
  17. Herman, K. M., Craig, C. L., Gauvin, L., & Katzmarzyk, P. T. (2009). Tracking of obesity and physical activity from childhood to adulthood: The Physical Activity Longitudinal Study. International Journal of Pediatric Obesity, 4(4), 281–288.  https://doi.org/10.3109/17477160802596171.CrossRefPubMedGoogle Scholar
  18. Hoover-Dempsey, K. V., Walker, J. M., Sandler, H. M., Whetsel, D., Green, C. L., Wilkins, A. S., & Closson, K. (2005). Why do parents become involved? Research findings and implications. The Elementary School Journal, 106(2), 105–130.CrossRefGoogle Scholar
  19. Hyun, K. B., & Glanz, K. (2013). Text messaging to motivate walking in older African Americans: A randomized controlled trial. American Journal of Preventive Medicine, 44(1), 71–75.CrossRefGoogle Scholar
  20. Kharbanda, E. O., Stockwell, M. S., Fox, H. W., & Rickert, V. I. (2010). Kharbanda et al. respond. American Journal of Public Health, 100(6), 970–970.  https://doi.org/10.2105/AJPH.2009.189639.CrossRefPubMedCentralGoogle Scholar
  21. Kiernan, M., Moore, S. D., Schoffman, D. E., Lee, K., King, A. C., Taylor, C. B., Kiernan, N. E., Perri, M. G. (2012). Social support for healthy behaviors: scale psychometrics and prediction of weight loss among women in a behavioral program. Obesity, 20(4), 756–764.CrossRefPubMedGoogle Scholar
  22. Kim, Y. (2009). Minority parental involvement and school barriers: Moving the focus away from deficiencies of parents. Educational Research Review, 4(2), 80–102.CrossRefGoogle Scholar
  23. Krueger, R. A., & Casey, M. A. (2009). Focus groups: A practical guide for applied research. Thousand Oaks: Sage Publications.Google Scholar
  24. Kumanyika, S. K. (2008). Environmental influences on childhood obesity: Ethnic and cultural influences in context. Physiology & Behavior, 94(1), 61–70.CrossRefGoogle Scholar
  25. Lindsay, A. C., Sussner, K. M., Kim, J., & Gortmaker, S. L. (2006). The role of parents in preventing childhood obesity. The Future of Children, 16(1), 169–186.CrossRefPubMedGoogle Scholar
  26. Liontos, L. B. (1991). Involving at-risk families in their children’s education. ERIC Digest Series Number EA 58.Google Scholar
  27. Mascola, A. J., Bryson, S. W., & Agras, W. S. (2010). Picky eating during childhood: A longitudinal study to age 11 years. Eating Behaviors, 11(4), 253–257.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Mazur, R. E., Marquis, G. S., & Jensen, H. H. (2003). Diet and food insufficiency among Hispanic youths: acculturation and socioeconomic factors in the third National Health and Nutrition Examination Survey. The American Journal of Clinical Nutrition, 78(6), 1120–1127.CrossRefPubMedGoogle Scholar
  29. McAlister, A. L., Perry, C. L., & Parcel, G. S. (2008). How individuals, environments, and health behaviors interact. Health Behavior, 169.Google Scholar
  30. Neumark-Sztainer, D., Wall, M., Perry, C., & Story, M. (2003). Correlates of fruit and vegetable intake among adolescents: Findings from Project EAT. Preventive Medicine, 37(3), 198–208.CrossRefPubMedGoogle Scholar
  31. 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
  32. Patrick, K., Raab, F., Adams, M., Dillon, L., Zabinski, M., Rock, C., Norman, G. (2009). A text message-based intervention for weight loss: Randomized controlled trial. Journal of Medical Internet Research, 11(1), e1.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Pérez-Escamilla, R. (2009). Dietary quality among latinos: Is acculturation making us sick? Journal of the American Dietetic Association, 109(6), 988–991.  https://doi.org/10.1016/j.jada.2009.03.014.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Phillips, A. L., Kumar, D., Patel, S., & Arya, M. (2014). Using text messages to improve patient–doctor communication among racial and ethnic minority adults: An innovative solution to increase influenza vaccinations. Preventive Medicine, 69, 117–119.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Rasmussen, M., Krølner, R., Klepp, K.-I., Lytle, L., Brug, J., Bere, E., & Due, P. (2006). Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: Quantitative studies. International Journal of Behavioral Nutrition and Physical Activity, 3(1), 22.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Reynolds, K. D., Yaroch, A. L., Franklin, F. A., & Maloy, J. (2002). Testing mediating variables in a school-based nutrition intervention program. Health Psychology, 21(1), 51.CrossRefPubMedGoogle Scholar
  37. Ritchie, J., & Spencer, L. (2002). Qualitative data analysis for applied policy research. The Qua,itative Researcher’s Companion. 573(2002), 305–329.Google Scholar
  38. Robinson-O’Brien, R., Neumark-Sztainer, D., Hannan, P. J., Burgess-Champoux, T., & Haines, J. (2009). Fruits and vegetables at home: Child and parent perceptions. Journal of Nutrition Education and Behavior, 41(5), 360–364.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Ryan, G. W., & Bernard, H. R. (2003). Techniques to identify themes. Field Methods, 15(1), 85–109.CrossRefGoogle Scholar
  40. Sharifi, M., Dryden, E. M., Horan, C. M., Price, S., Marshall, R., Hacker, K., Finkelstein, J. A., Taveras, E. M. (2013). Leveraging text messaging and mobile technology to support pediatric obesity-related behavior change: A qualitative study using parent focus groups and interviews. Journal of Medical Internet Research, 15(12), e272.  https://doi.org/10.2196/jmir.2780.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Sherry, B., McDivitt, J., Birch, L. L., Cook, F. H., Sanders, S., Prish, J. L., Francis, L.A., Scanlon, K. S. (2004). Attitudes, practices, and concerns about child feeding and child weight status among socioeconomically diverse white, Hispanic, and African-American mothers. Journal of the American Dietetic Association, 104(2), 215–221.  https://doi.org/10.1016/j.jada.2003.11.012.CrossRefPubMedGoogle Scholar
  42. Slusser, W., Prelip, M., Kinsler, J., Erausquin, J. T., Thai, C., & Neumann, C. (2011). Challenges to parent nutrition education: a qualitative study of parents of urban children attending low-income schools. Public Health Nutrition, 14(10), 1833–1841.CrossRefPubMedGoogle Scholar
  43. Sohn, S., & Wang, X. C. (2006). Immigrant parents’ involvement in American schools: Perspectives from Korean mothers. Early Childhood Education Journal, 34(2), 125–132.CrossRefGoogle Scholar
  44. Thompson, V. J., Baranowski, T., Cullen, K. W., Rittenberry, L., Baranowski, J., Taylor, W. C., & Nicklas, T. (2003). Influences on diet and physical activity among middle-class African American 8-to 10-year-old girls at risk of becoming obese. Journal of Nutrition Education and Behavior, 35(3), 115–123.CrossRefPubMedGoogle Scholar
  45. Vaughn, S., Schumm, J. S., & Sinagub, J. M. (1996). Focus group interviews in education and psychology. Thousand Oaks: Sage.CrossRefGoogle Scholar
  46. Webb, T., Joseph, J., Yardley, L., & Michie, S. (2010). Using the internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. Journal of Medical Internet Research, 12(1), e4.CrossRefPubMedPubMedCentralGoogle Scholar
  47. Wu, Y., Lau, B. D., Bleich, S., Cheskin, L., Boult, C., Segal, J. B., & Wang, Y. (2013). Future research needs for childhood obesity prevention programs. Rockville: Agency for Healthcare Research and Quality.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Research, Evaluation, Strategy Consulting8RES, LLCNew YorkUSA
  2. 2.Department of Heath & BehaviorTeachers College, Columbia UniversityNew YorkUSA
  3. 3.Department of Community and Family Health, College of Public HealthUniversity of South FloridaTampaUSA
  4. 4.Department of Art and HumanitiesTeachers College Columbia UniversityNew YorkUSA

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