Abstract
Purpose
This qualitative study aimed to understand parental perception of (1) sugar-sweetened beverages (SSB) and implications of SSB on health; (2) their role in shaping their children’s consumption of SSB; (3) the influences on SSB consumption of their children; and (4) potential government policies targeted at controlling SSB consumption.
Methods
English-speaking parents of pre-schoolers aged 2–6 years were recruited. Semi-structured interviews based on the knowledge, attitude, practice framework were conducted, and transcripts were subjected to thematic analysis based on inductive approaches. Recruitment continued until data saturation was reached.
Results
Twenty parents participated in the study and themes addressing the objectives identified. (1) There were misconceptions regarding the healthfulness of certain non-packaged SSB such as traditional remedies and juices. Some were unaware about the association between SSB and dental caries. (2) The need to reduce and restrict sugar consumption for overall and oral health reasons was well-recognised, but the extent of control varied. (3) Multiple stakeholders including pre-schools, grandparents and domestic helpers were involved in shaping children’s diet. Children’s sugar intake was also influenced by environmental factors, such as the ubiquitously available SSB, targeted marketing and high cost of healthy alternatives. (4) Participants were less accepting towards SSB taxation than the ban of SSB sales.
Conclusion
Despite the awareness of the types of SSBs and the general/oral health implications of sugar consumption, misconceptions exist. Although most parents possessed the knowledge and attitude, this did not translate into the practice of reducing sugar consumption in their children. There was no SSB reduction policy that had overwhelming acceptability.
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References
Andreyeva T, Chaloupka FJ, Brownell KD. Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue. Prev Med. 2011;52(6):413–6. https://doi.org/10.1016/j.ypmed.2011.03.013.
Bélanger-Gravel A, Desroches S, Janezic I, Paquette M-C, De Wals P. Pattern and correlates of public support for public health interventions to reduce the consumption of sugar-sweetened beverages. Public Health Nutr. 2019;22(17):3270–80.
Colchero MA, Popkin BM, Rivera JA, Ng SW. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ. 2016;352: h6704. https://doi.org/10.1136/bmj.h6704.
Eliason J, Acciai F, DeWeese RS, Vega-López S, Ohri-Vachaspati P. Children’s consumption patterns and their parent’s perception of a healthy diet. Nutrients. 2020;12(8):2322.
Evans EW, Hayes C, Palmer CA, Bermudez OI, Cohen SA, Must A. Dietary intake and severe early childhood caries in low-income, young children. J Acad Nutr Diet. 2013;113(8):1057–61. https://doi.org/10.1016/j.jand.2013.03.014.
Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2006;5(1):80–92.
Goh LL, Tan TWW, Wu HF, Tan JJ, Wong TH, Lim LHC, Lee EF, Chua YLF, P JCE, Wong S, Phay JYA, Ramli HY, Li NA, Tan XW, Choo CEY, KH. Public housing in Singapore: social wellbeing of HDB communities. In: Sample Household Survey 2013. Housing & Development Board Singapore. 2013. https://www20.hdb.gov.sg/fi10/fi10296p.nsf/PressReleases/7F139C04DF52A35648257DBA001F7471Accessed 1 June 2021.
Health Promotion Board. National nutrition survey 2018 shows gradual improvements in Singaporeans’ dietary habits. In: Newsroom. Health promotion board Singapore. 2018. https://www.hpb.gov.sg/article/national-nutrition-survey- 2018-shows-gradual-improvements-in-singaporeans-dietary-habits. https://www.hpb.gov.sg/article/national-nutrition-survey-2018-shows-gradual-improvements-in-singaporeans-dietary-habitsAccessed 1 June 2021.
Liu Y, Wang Z, Zhang J. Dietary Chinese herbs: chemistry, pharmacology and clinical evidence. Vienna: Springer Vienna; 2015. p. 681–91.
Meyer BD, Lee JY. The confluence of sugar, dental caries, and health policy. J Dent Res. 2015;94(10):1338–40. https://doi.org/10.1177/0022034515598958.
Muleme J, Kankya C, Ssempebwa JC, Mazeri S, Muwonge A. A framework for integrating qualitative and quantitative data in knowledge, attitude, and practice studies: a case study of Pesticide Usage in eastern Uganda. Front Public Health. 2017;5:318.
Muth ND, Dietz WH, Magge SN, Johnson RK. Public policies to reduce sugary drink consumption in children and adolescents. Pediatrics. 2019;143(4).
OECD. Rapid improvement followed by strong performance. Singapore: OECD Publishing; 2011. p. 159–76.
Oliver TR. The politics of public health policy. Annu Rev Public Health. 2006;27:195–233.
Rampersaud GC, Kim H, Gao Z, House LA. Knowledge, perceptions, and behaviors of adults concerning nonalcoholic beverages suggest some lack of comprehension related to sugars. Nutr Res. 2014;34(2):134–42. https://doi.org/10.1016/j.nutres.2013.11.004.
Rav-Marathe K, Wan T, Marathe S. A systematic review of Kap-O framework for diabetes education and research. Med Res Arch. 2016;4(1).
Robinson S, Marriott L, Poole J, Crozier S, Borland S, Lawrence W, et al. Dietary patterns in infancy: the importance of maternal and family influences on feeding practice. Br J Nutr. 2007;98(5):1029–37. https://doi.org/10.1017/S0007114507750936.
Rojas C, Wang E. Do taxes for soda and sugary drinks work? Scanner data evidence from Berkeley and Washington State. Econ Inquiry. 2021;59(1):95–118.
Sheiham A, James WP. Diet and dental caries: the pivotal role of free sugars reemphasized. J Dent Res. 2015;94(10):1341–7. https://doi.org/10.1177/0022034515590377.
Tan BQM, Hee JM, Yow KS, Sim X, Asano M, Chong MF. Feeding-related knowledge, attitudes, and practices among grandparents in Singapore. Nutrients. 2019;11(7):1696. https://doi.org/10.3390/nu11071696.
Tang Q, Lin Q, Yang Q, Sun M, Liu H, Yang L. Knowledge, attitude, and practice of adolescent parents on free sugar and influencing factors about recognition. Int J Environ Res Public Health. 2020;17(11):4003. https://doi.org/10.3390/ijerph17114003.
Acknowledgements
This study was supported by the National University of Singapore, Faculty of Dentistry Post-graduate Grant.
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This study was supported by the National University of Singapore, Faculty of Dentistry Post-graduate Grant.
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JC is considered the first author and SH the senior author. SH, KSC and CH conceived the idea; JC participated in data collection; JC and MLW conducted the data analysis; JC, XG and SH led the interpretation and writing; MLW, KSC and CH revised the manuscript for important intellectual content.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted from the Ethics committee, National University Institutional Review Board (NUS-IRB Reference Number: S-18-220E).
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Chan, J.X.Y., Wong, M.L., Gao, X. et al. Parental perspectives towards sugar-sweetened beverages and polices: a qualitative study. Eur Arch Paediatr Dent 22, 1033–1040 (2021). https://doi.org/10.1007/s40368-021-00648-9
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DOI: https://doi.org/10.1007/s40368-021-00648-9