Abstract
In the United States (US), racial/ethnic minority children, low-income children, and children of immigrant families are at increased risk of childhood obesity. Mounting evidence documents that sleep duration and sleep quality are important modifiable factors associated with increased risk of obesity among preschool-aged children. The number of Brazilian immigrants in the US is increasing, yet no existing research, to our knowledge, has examined factors affecting sleep and bedtime routines of children of Brazilian immigrant families. Therefore, the purpose of this qualitative study was to explore Brazilian immigrant mothers’ beliefs, attitudes, and practices related to sleep and bedtime routines among preschool-aged children. Seven focus group discussions (FGDs) were conducted with 37 Brazilian immigrant mothers of preschool-age children living in the US. The audio-recordings of the FGDs were transcribed verbatim in Portuguese without identifiers and analyzed using thematic analyses. Mothers also completed a brief questionnaire assessing socio-demographic and acculturation. Analyses revealed that most mothers were aware of the importance of sleep and sleep duration for their children’s healthy growth and development. Mothers also spoke of children needing consistent bedtime routines. Nevertheless, many mothers reported inconsistent and suboptimal bedtime routines (e.g., lack of predictable and orderly bedtime activities such as bath, reading, etc. and use of electronics in bed). These suboptimal routines appeared to be influenced by day-to-day social contextual and environmental factors that are part of Brazilian immigrant families’ lives such as parents’ work schedule, living with extended family, living in multi-family housing, neighborhood noise, etc. Analyses identified several modifiable parenting practices related to young children’s sleep and bedtime routines (e.g., irregular bedtime, late bedtime, inconsistent bedtime routines, use of electronics in bed, etc.) that can be addressed in parenting- and family-based obesity prevention interventions. Interventions should consider the social context of the home/family (e.g., parents’ work schedules) and the environment (e.g., multi-family housing; neighborhood noise, etc.) faced by Brazilian immigrant families when developing health promotion messages and parenting interventions tailored to this ethnic group.
Highlights
In the United States (US), racial/ethnic minority children, low-income children, and children of immigrant families are at greater risk of childhood obesity than white, middle- and high-income children [1,2,3,4]
This qualitative study was conducted in two cities in MA, US, Somerville and Everett, and is part of a larger ongoing mixed-methods research with Brazilian families living in the Greater Boston area that is exploring parenting styles and parenting practices related to the risk of childhood obesity [50,51]
Most mothers reported late bedtimes and inconsistent and suboptimal bedtime routines that appeared to be influenced by day-to-day social contextual and environmental factors that are part of Brazilian immigrant families participating in the current study
Summary
In the United States (US), racial/ethnic minority children, low-income children, and children of immigrant families are at greater risk of childhood obesity than white, middle- and high-income children [1,2,3,4]. Mounting evidence suggests that sleep duration and sleep quality are important modifiable factors associated with increased risk of obesity among preschool-aged children (2–5 years old) [8,9,10,11]. Several health organizations including the Health and Medicine Division (HMD) of the National Academies and the American Academy of Pediatrics (AAP) have made recommendations for sleep duration (children 1 to 2 years and 3 to 5 years of age should sleep 11 to 14 h, or 10 to 13 h per 24 h (including naps) on a regular basis, respectively) and sleep hygiene (i.e., consistent bedtimes, wake times, and bedtime routines) to prevent and control obesity in early childhood [19,20]
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