A Qualitative Study Exploring Healthy Eating and Physical Activity in Families with Young Children
DOI:
https://doi.org/10.18192/riss-ijhs.v9i1.2289Abstract
Overweight and obesity in childhood affects health long-term. Parent attitudes and behaviours play major roles in their child’s weight despite no consensus on appropriate and effective family-focused interventions to successfully tackle childhood obesity. This research aims to explore caregiver perceptions, attitudes, and behaviours around children’s diet, exercise, and weight in East Sussex. In-depth qualitative interviews with mothers, fathers, and grandparents of children aged 2-11 years were conducted. Caregivers wanted to influence their children’s diet and exercise habits but were unable due to perceived and actual barriers. Barriers included cost, time, and a lack of control over food choices as children aged. Moreover, caregivers admitted to providing unhealthy sweets and snacks to please their children. While caregivers openly discussed their own weight concerns, they were less likely to discuss concerns about their children’s or grandchildren’s weight. When asked about the ideal amount of exercise, caregivers found it easy to describe a regime for adults but did not know the ideal amount of exercise for children. Many caregivers found it difficult to quantify exercise when it came to their children because children naturally played in ways that could be considered exercise. Family-based interventions should begin in early childhood and promote walking and dog-walking as forms of exercise, parental education on childhood exercise guidelines, and preparing and eating healthy home-cooked meals in the home.
References
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Dietz, W. H. (1998). Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics, 101(3 Pt 2), 518–525. http://doi.org/10.1007/s12098-011-0489-7
Douglas, F., Clark, J., Craig, L., Campbell, J., & McNeill, G. (2014). “It’s a balance of just getting things right”: mothers’ views about pre-school childhood obesity and obesity prevention in Scotland. BMC Public Health, 14(1), 1009. http://doi.org/10.1186/1471-2458-14-1009
Dreibelbis, R., Winch, P. J., Leontsini, E., Hulland, K. R. S., Ram, P. K., Unicomb, L., & Luby, S. P. (2013). The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings. BMC Public Health, 13(1), 1015. http://doi.org/10.1186/1471-2458-13-1015
Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (2002). Childhood obesity: public-health crisis, common sense cure. Lancet, 360(9331), 473–82. http://doi.org/10.1016/S0140-6736(02)09678-2
Etelson, D., Brand, D. a, Patrick, P. a, & Shirali, A. (2003). Childhood obesity: do parents recognize this health risk? Obesity Research, 11(11), 1362–1368. http://doi.org/10.1038/oby.2003.184
French, J., Blair-Stevens, C., McVey, D., & Merritt, R. (2010). Social Marketing and Public Health: Theory and Practice. New York, NY: Oxford University Press Inc.
Gardner, D. S. L., Hosking, J., Metcalf, B. S., Jeffery, A. N., Voss, L. D., & Wilkin, T. J. (2009). Contribution of early weight gain to childhood overweight and metabolic health: a longitudinal study (EarlyBird 36). Pediatrics, 123(1), e67–e73. http://doi.org/10.1542/peds.2008-1292
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory. International Journal of Qualitative Methods, 5, 1–10. http://doi.org/10.2307/588533
Golan, M. (2006). Parents as agents of change in childhood obesity--from research to practice. International Journal of Pediatric Obesity : IJPO : An Official Journal of the International Association for the Study of Obesity, 1(December 2005), 66–76. http://doi.org/10.1080/17477160600644272
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He, M., & Evans, A. (2007). Are parents aware that their children are overweight or obese? Do they care? Canadian Family Physician, 53(9), 1493–1499. http://doi.org/53/9/1493 [pii]
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Breslow, A. (2007). Parental ability to discriminate the weight status of children: results of a survey. Pediatrics, 120(1), e112–9. http://doi.org/10.1542/peds.2006-2143
Klesges, R. C., Stein, R. J., Eck, L. H., Isbell, T. R., & Klesges, L. M. (1991). Parental influence on food selection in young children and its relationships to childhood obesity. The American Journal of Clinical Nutrition, 53(4), 859–864.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalist inquiry. Beverly Hills, CA: Sage.
Moore, L. C., Harris, C. V., & Bradlyn, A. S. (2012). Exploring the relationship between parental concern and the management of childhood obesity. Maternal and Child Health Journal, 16(4), 902–908. http://doi.org/10.1007/s10995-011-0813-x
Moss, B., & Yeaton, W. (2014). Early Childhood Healthy and Obese Weight Status: Potentially Protective Benefits of Breastfeeding and Delaying Solid Foods. Maternal and Child Health Journal, 18(5), 1224–1232. http://doi.org/10.1007/s10995-013-1357-z
National Obesity Observatory. (2011). A simple guide to classifying body mass index in children. Retrieved from http://www.noo.org.uk/uploads/doc/vid_11601_A_simple_guide_to_classifying_BMI_in_children.pdf
National Social Marketing Centre. (2012). Save the crabs - then eat ’em.
Pan, L., Blanck, H. M., Sherry, B., Dalenius, K., & Grummer-Strawn, L. M. (2015). Trends in the Prevalence of Extreme Obesity Among US Preschool-Aged Children Living in Low-Income Families, 1998-2010. JAMA, 308(24), 2563–2565. http://doi.org/10.1001/jama.2012.108099
Patton, M. Q. (2002). Qualitative research and evaluation methods. Qualitative Inquiry (Vol. 3rd). http://doi.org/10.2307/330063
Pocock, M., Trivedi, D., Wills, W., Bunn, F., & Magnusson, J. (2010). Parental perceptions regarding healthy behaviours for preventing overweight and obesity in young children: A systematic review of qualitative studies. Obesity Reviews, 11(5), 338–353. http://doi.org/10.1111/j.1467-789X.2009.00648.x
Pratt, C. A., Stevens, J., & Daniels, S. (2008). Childhood obesity prevention and treatment: recommendations for future research. American Journal of Preventive Medicine, 35(3), 249–52. http://doi.org/10.1016/j.amepre.2008.05.025
Reilly, J. J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. International Journal of Obesity (2005), 35(7), 891–898. http://doi.org/10.1038/ijo.2010.222
Sallis, J. F., Prochaska, J. J., & Taylor, W. C. (2000). A review of correlates of physical activity of children and adolescents. Medicine and Science in Sports and Exercise, 32(5), 963–975. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-0034056937&partnerID=tZOtx3y1
Stamatakis, E., Zaninotto, P., Falaschetti, E., Mindell, J., & Head, J. (2010). Time trends in childhood and adolescent obesity in England from 1995 to 2007 and projections of prevalence to 2015. Journal of Epidemiology and Community Health, 64, 167–174. http://doi.org/10.1136/jech.2009.098723
Toftemo, I., Glavin, K., & Lagerløv, P. (2013). Parents’ views and experiences when their preschool child is identified as overweight: A qualitative study in primary care. Family Practice, 30(6), 719–723. http://doi.org/10.1093/fampra/cmt056
Ventura, A. K., & Birch, L. L. (2008). Does parenting affect children’s eating and weight status? The International Journal of Behavioral Nutrition and Physical Activity, 5(1), 15. http://doi.org/10.1186/1479-5868-5-15
Wiecha, J. L., Sobol, A. M., Peterson, K. E., & Gortmaker, S. L. (2001). Household television access: Associations with screen time, reading, and homework among youth. Ambulatory Pediatrics, 1(5), 244–251. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-0035468113&partnerID=tZOtx3y1
World Health Organization (WHO). (2015). Factsheet: Obesity and overweight. Retrieved December 2, 2015, from http://www.who.int/mediacentre/factsheets/fs311/en/
Zehle, K., Wen, L. M., Orr, N., & Rissel, C. (2007). “It’s not an issue at the moment”: a qualitative study of mothers about childhood obesity. MCN. The American Journal of Maternal Child Nursing, 32(1), 36–41. http://doi.org/10.1097/00005721-200701000-00008
Zoumas-Morse, C., Rock, C. L., Sobo, E. J., & Neuhouser, M. L. (2001). Children’s patterns of macronutrient intake and associations with restaurant and home eating. Journal of the American Dietetic Association, 101(8), 923–925. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-0035430976&partnerID=tZOtx3y1
Boisvert, J. A., & Harrell, W. A. (2014). Dog walking: a leisurely solution to pediatric and adult obesity? World Leisure Journal, 56(2), 168–171. http://doi.org/10.1080/16078055.2014.903732
Carnell, S., Edwards, C., Croker, H., Boniface, D., & Wardle, J. (2005). Parental perceptions of overweight in 3-5 y olds. International Journal of Obesity, 29(4), 353–355. http://doi.org/10.1038/sj.ijo.0802889
Cole, T. J., Bellizzi, M. C., Flegal, K. M., & Dietz, W. H. (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ (Clinical Research Ed.), 320(7244), 1240–3. http://doi.org/10.1136/bmj.320.7244.1240
Deckelbaum, R. J., & Williams, C. L. (2001). Childhood obesity: the health issue. Obesity Research, 9(Suppl 4), 239S–243S. http://doi.org/10.1038/oby.2001.125
Department of Health. (2011). UK Physical Activity Guidelines. Retrieved from https://www.gov.uk/government/publications/uk-physical-activity-guidelines
Dietz, W. H. (1998). Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics, 101(3 Pt 2), 518–525. http://doi.org/10.1007/s12098-011-0489-7
Douglas, F., Clark, J., Craig, L., Campbell, J., & McNeill, G. (2014). “It’s a balance of just getting things right”: mothers’ views about pre-school childhood obesity and obesity prevention in Scotland. BMC Public Health, 14(1), 1009. http://doi.org/10.1186/1471-2458-14-1009
Dreibelbis, R., Winch, P. J., Leontsini, E., Hulland, K. R. S., Ram, P. K., Unicomb, L., & Luby, S. P. (2013). The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings. BMC Public Health, 13(1), 1015. http://doi.org/10.1186/1471-2458-13-1015
Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (2002). Childhood obesity: public-health crisis, common sense cure. Lancet, 360(9331), 473–82. http://doi.org/10.1016/S0140-6736(02)09678-2
Etelson, D., Brand, D. a, Patrick, P. a, & Shirali, A. (2003). Childhood obesity: do parents recognize this health risk? Obesity Research, 11(11), 1362–1368. http://doi.org/10.1038/oby.2003.184
French, J., Blair-Stevens, C., McVey, D., & Merritt, R. (2010). Social Marketing and Public Health: Theory and Practice. New York, NY: Oxford University Press Inc.
Gardner, D. S. L., Hosking, J., Metcalf, B. S., Jeffery, A. N., Voss, L. D., & Wilkin, T. J. (2009). Contribution of early weight gain to childhood overweight and metabolic health: a longitudinal study (EarlyBird 36). Pediatrics, 123(1), e67–e73. http://doi.org/10.1542/peds.2008-1292
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory. International Journal of Qualitative Methods, 5, 1–10. http://doi.org/10.2307/588533
Golan, M. (2006). Parents as agents of change in childhood obesity--from research to practice. International Journal of Pediatric Obesity : IJPO : An Official Journal of the International Association for the Study of Obesity, 1(December 2005), 66–76. http://doi.org/10.1080/17477160600644272
Gruber, K. J., & Haldeman, L. A. (2009). Using the family to combat childhood and adult obesity. Prev Chronic Dis, 6(3), A106. http://doi.org/A106 [pii]
He, M., & Evans, A. (2007). Are parents aware that their children are overweight or obese? Do they care? Canadian Family Physician, 53(9), 1493–1499. http://doi.org/53/9/1493 [pii]
Huang, J. S., Becerra, K., Oda, T., Walker, E., Xu, R., Donohue, M., …
Breslow, A. (2007). Parental ability to discriminate the weight status of children: results of a survey. Pediatrics, 120(1), e112–9. http://doi.org/10.1542/peds.2006-2143
Klesges, R. C., Stein, R. J., Eck, L. H., Isbell, T. R., & Klesges, L. M. (1991). Parental influence on food selection in young children and its relationships to childhood obesity. The American Journal of Clinical Nutrition, 53(4), 859–864.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalist inquiry. Beverly Hills, CA: Sage.
Moore, L. C., Harris, C. V., & Bradlyn, A. S. (2012). Exploring the relationship between parental concern and the management of childhood obesity. Maternal and Child Health Journal, 16(4), 902–908. http://doi.org/10.1007/s10995-011-0813-x
Moss, B., & Yeaton, W. (2014). Early Childhood Healthy and Obese Weight Status: Potentially Protective Benefits of Breastfeeding and Delaying Solid Foods. Maternal and Child Health Journal, 18(5), 1224–1232. http://doi.org/10.1007/s10995-013-1357-z
National Obesity Observatory. (2011). A simple guide to classifying body mass index in children. Retrieved from http://www.noo.org.uk/uploads/doc/vid_11601_A_simple_guide_to_classifying_BMI_in_children.pdf
National Social Marketing Centre. (2012). Save the crabs - then eat ’em.
Pan, L., Blanck, H. M., Sherry, B., Dalenius, K., & Grummer-Strawn, L. M. (2015). Trends in the Prevalence of Extreme Obesity Among US Preschool-Aged Children Living in Low-Income Families, 1998-2010. JAMA, 308(24), 2563–2565. http://doi.org/10.1001/jama.2012.108099
Patton, M. Q. (2002). Qualitative research and evaluation methods. Qualitative Inquiry (Vol. 3rd). http://doi.org/10.2307/330063
Pocock, M., Trivedi, D., Wills, W., Bunn, F., & Magnusson, J. (2010). Parental perceptions regarding healthy behaviours for preventing overweight and obesity in young children: A systematic review of qualitative studies. Obesity Reviews, 11(5), 338–353. http://doi.org/10.1111/j.1467-789X.2009.00648.x
Pratt, C. A., Stevens, J., & Daniels, S. (2008). Childhood obesity prevention and treatment: recommendations for future research. American Journal of Preventive Medicine, 35(3), 249–52. http://doi.org/10.1016/j.amepre.2008.05.025
Reilly, J. J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. International Journal of Obesity (2005), 35(7), 891–898. http://doi.org/10.1038/ijo.2010.222
Sallis, J. F., Prochaska, J. J., & Taylor, W. C. (2000). A review of correlates of physical activity of children and adolescents. Medicine and Science in Sports and Exercise, 32(5), 963–975. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-0034056937&partnerID=tZOtx3y1
Stamatakis, E., Zaninotto, P., Falaschetti, E., Mindell, J., & Head, J. (2010). Time trends in childhood and adolescent obesity in England from 1995 to 2007 and projections of prevalence to 2015. Journal of Epidemiology and Community Health, 64, 167–174. http://doi.org/10.1136/jech.2009.098723
Toftemo, I., Glavin, K., & Lagerløv, P. (2013). Parents’ views and experiences when their preschool child is identified as overweight: A qualitative study in primary care. Family Practice, 30(6), 719–723. http://doi.org/10.1093/fampra/cmt056
Ventura, A. K., & Birch, L. L. (2008). Does parenting affect children’s eating and weight status? The International Journal of Behavioral Nutrition and Physical Activity, 5(1), 15. http://doi.org/10.1186/1479-5868-5-15
Wiecha, J. L., Sobol, A. M., Peterson, K. E., & Gortmaker, S. L. (2001). Household television access: Associations with screen time, reading, and homework among youth. Ambulatory Pediatrics, 1(5), 244–251. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-0035468113&partnerID=tZOtx3y1
World Health Organization (WHO). (2015). Factsheet: Obesity and overweight. Retrieved December 2, 2015, from http://www.who.int/mediacentre/factsheets/fs311/en/
Zehle, K., Wen, L. M., Orr, N., & Rissel, C. (2007). “It’s not an issue at the moment”: a qualitative study of mothers about childhood obesity. MCN. The American Journal of Maternal Child Nursing, 32(1), 36–41. http://doi.org/10.1097/00005721-200701000-00008
Zoumas-Morse, C., Rock, C. L., Sobo, E. J., & Neuhouser, M. L. (2001). Children’s patterns of macronutrient intake and associations with restaurant and home eating. Journal of the American Dietetic Association, 101(8), 923–925. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-0035430976&partnerID=tZOtx3y1
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