Understanding Attitudes and Practices of Low-Income Caregivers Toward Sugar-Sweetened Beverage Consumption in Preschool-Aged Children

Abstract

Sugar-sweetened beverage (SSB) consumption during early childhood has been linked to adverse health outcomes across the lifespan. Caregivers of young children are often unaware of the potential health harms of SSB and may lack knowledge, skills and environmental supports to limit SSB. The objectives of this study were to determine study caregivers’ attitudes and practices with regard to SSB and to identify themes that may inform future policies and interventions to limit these beverages. Guided by the Social Ecological Model (SEM), the research team interviewed low-income caregivers of children ages two to five at a health clinic in urban New York State. Interviews were recorded, transcribed, and coded for themes and further analyzed for determinants of behavior with regard to providing SSB. Five major themes emerged: Greater SSB knowledge led to healthier choices; confusion about the healthfulness of some SSB; SSB affordability, accessibility and cultural acceptability; children’s “pester power” to obtain SSBs; and, lack of SSB information from healthcare providers. Determinants such as perceived barriers to action, self-efficacy, cues to action, and perceived threat emerged from the themes. SSB are widely available, affordable and palatable. Healthcare providers seldom discuss children’s SSB intake specifically at well visits. SSB are frequently marketed and labeled as “healthy.” SSB are a significant source of empty calories and added sugars. Helping parents limit SSBs may reduce child overweight and obesity and minimize lifelong chronic disease risks. Heathcare providers, health campaigns and nutrition assistance programs may collaborate to help parents limit SSB intake in young children.