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

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.

A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children’s nutrition

“…Nine studies were identified reporting user-testing by parents of digital health tools targeting improvements in children's nutrition. Five evaluated apps [18,[40][41][42][43], three evaluated websites [19,39,44] and one evaluated both an app and website [45] (Table 2; Additional file 3). Studies were conducted in the USA [41][42][43][44], Australia [18,19,45], Canada [40] and Switzerland [39].…”

“…Five evaluated apps [18,[40][41][42][43], three evaluated websites [19,39,44] and one evaluated both an app and website [45] (Table 2; Additional file 3). Studies were conducted in the USA [41][42][43][44], Australia [18,19,45], Canada [40] and Switzerland [39]. Evaluations of preferences for content, features, technology, delivery mode, useability and barriers were conducted using focus groups [39][40][41][42]44] and questionnaires [18,19,39,41,43,45].…”

“…Studies were conducted in the USA [41][42][43][44], Australia [18,19,45], Canada [40] and Switzerland [39]. Evaluations of preferences for content, features, technology, delivery mode, useability and barriers were conducted using focus groups [39][40][41][42]44] and questionnaires [18,19,39,41,43,45]. Given the small number of included studies and overall consistent findings across apps and websites, reporting of findings have been combined.…”

“…appropriate recipes) [39-41, 44, 45]. Parents disliked general or vague information, wanted to be able to access content that was tailored or personalised [40,44], and desired practical information that supported behaviour change, for instance by addressing barriers [39,40]. Three studies noted that parents wanted trustworthy, evidence-based information that was sourced from, or endorsed by, Universities or Government organisations [41,44,45].…”

“…Parents disliked general or vague information, wanted to be able to access content that was tailored or personalised [40,44], and desired practical information that supported behaviour change, for instance by addressing barriers [39,40]. Three studies noted that parents wanted trustworthy, evidence-based information that was sourced from, or endorsed by, Universities or Government organisations [41,44,45]. Two studies also identified that parents wanted positive content, and that they disliked content and terminology focused solely on obesity and weight management, which elicited negative reactions such as fear, guilt or shame [40,45].…”