Vietnamese mother's conceptions of childhood overweight: findings from a qualitative study

Abstract

BackgroundChildhood overweight and obesity is a new and emerging problem in Vietnam. The so far observed prevalence increases have pointed to the need for public health intervention strategies with parents as crucial resources for change.ObjectiveThe aim of this study was to understand mothers’ conceptions of childhood overweight.DesignFour focus group discussions were conducted with a total of 33 mothers of preschool children, 4–6 years old, living in urban and rural districts of Hanoi, Vietnam. The discussions were audio taped and transcribed verbatim. The obtained data were analyzed using the principles of phenomenography.ResultsFour main categories with 13 subcategories emerged in the process of analysis. The first category, called ‘Concept of overweight’, contained mothers’ views on childhood overweight. A major concern was the negative aspects of overweight such as impaired social interaction and health problems. The second category, ‘Identification of overweight’, described the ways mothers use to recognize overweight in children: own experience, growth chart, and public or health care system's information. The third category, ‘Causes of overweight’, showed mothers’ understanding of factors possibly contributing to overweight development: unhealthy food and lifestyle, genetic susceptibility, parent's lack of knowledge, and limited time to take care of children as well as economic improvement. The fourth category, ‘Management of overweight’, described the ways mothers use to manage a child's weight problem: control of their food intake, increasing their physical activity, and encouraging their child self-control. However, they find such strategies difficult to implement and their intentions are sometimes challenged by the child's grandparents.ConclusionsThe study gives an understanding of the mothers’ conceptions of four important and practically useful aspects of overweight in children. The findings highlight the roles of media and the health care system in enhancing a social awareness of the problem and the need for prevention. Growth charts need to be used more regularly and consciously in child health care for early detection of children at risk and as a tool for information to parents. When designing intervention programs, the entire extended families, especially grandparents and their roles, need to be considered.

Perceptions of overweight by primary carers (mothers/grandmothers) of under five and elementary school-aged children in Bandung, Indonesia: a qualitative study

“…Most carers defined overweight subjectively from physical appearance. This finding is in keeping with studies from Germany, [ 30 ] the United Kingdom, [ 22 ] the United States, [ 23 , 31 ] and in Vietnam [ 32 ]. While some carers knew how to define overweight objectively, this knowledge is not very useful when they do not know their child’s current weight or height.…”

“…Some carers agreed with the ‘chubbier is healthier’ concept that is also found in other cultures. For example in Turkey (plump kids are healthy), [ 34 ] Vietnam (chubbiness is good), [ 32 ] the United States (“baby fat” is cute and healthy [ 31 ]; a bigger infant is a better infant [ 28 ]) and the United Kingdom (a big baby is a healthy baby) [ 35 ]. The concept of overweight symbolising family wellbeing is also found in China [ 36 ].…”

Early childhood factors associated with obesity at age 8 in Vietnamese children: The Young Lives Cohort Study

“…Other studies show high rates of mixed feeding [51] and bottle-feeding [52] in Vietnamespecially supplemental feeding with sweetened liquids and foods [53] that is associated with increased risk of child obesity [54]. Children of mothers with higher education may have greater risk of ow/ob because educated mothers may be working outside the home, curtailing the duration of breastfeeding, and leaving the child's caregiver with money to buy "treats" such as snacks or sugary drinks [55,56]. Furthermore, the common practice of giving children sweets as a reward leads children to associate sugary foods and beverages with positive emotions, and reduces preference for non-sugary options such as vegetables, unsweetened milk, and water [57][58][59].…”

“…In this study, we also found that children who drink powdered milk and milk products have higher odds of being ow/ob at age 8. In a recent qualitative study by Do et al, mothers acknowledged that one way to improve children's diets is to switch from milk with sugar to milk without sugar [55]. While milk and powdered milk have some nutritional benefits, the sugar and other additives may be a significant contributor to excess weight gain.…”

First line nurse managers’ experiences of opportunities and obstacles to support evidence‐based nursing

“…Focus group interviews are becoming more used for data collection in studies using phenomenography as method for data analysis (Arveklev, Berg, Wigert, Morrison-Helme, & Lepp, 2018;Loan Minh et al, 2016). The choice of using focus groups in this study was based on the apprehension that if a researcher asks about evidence-based nursing, the participant (as a FLNM) could experience this as a questioning of the FLNM's intention to work with that particular question.…”