Primary Caregivers Of Young Children Research Articles

Prevalence of food insecurity among caregivers of young children during the COVID-19 pandemic in Ireland.

Our objectives were to explore the prevalence of food insecurity in primary caregivers of young children in Ireland and to compare two tools for measuring food insecurity during the COVID-19 crisis. A cross-sectional online survey was conducted among caregivers of children aged <2 years in Ireland in May/June 2020. Relevant survey questions were closed-ended using two established tools for measuring food poverty/insecurity; the Irish Food Poverty Indicator and the Food Insecurity Experience Scale, developed by the Food and Agriculture Organization. Descriptive statistics were used to calculate the prevalence of food poverty/insecurity. To explore agreement in the classification of food insecurity by the Food Poverty Indicator and the Food Insecurity Experience Scale, Cohen's κ was used. Analyses are based on 716 participants; most had a 3rd-level education and were married or in a partnership. Per the food poverty index, Ireland's national measure of food poverty, 3.9% (n = 28) of our sample were experiencing food poverty. This rose to 10.5% (n = 75) experiencing food insecurity when using the Food Insecurity Experience Scale, which also measures worry/anxiety around access to food. There was low agreement between the tools, with 11.3% of the sample classified as food secure by one tool and food insecure by the other. Our current measure of food poverty in Ireland may not be sufficient to describe the food-access struggles or worry/anxiety about food access, experienced by the population, particularly during an emergency like COVID-19.

A structural equation modelling approach to understanding the determinants of childhood vaccination in Nigeria, Uganda and Guinea.

Vaccines have contributed to reductions in morbidity and mortality from preventable diseases globally, but low demand for vaccination threatens to reverse these gains. Explorations of the determinants of vaccination uptake may rely on proxy variables to describe complex phenomena and construct models without reference to underlying theories of vaccine demand. This study aimed to use the results of a formative qualitative study (described elsewhere) to construct and test a model to explain the determinants of vaccination uptake. Using the results of a survey among more than 3,000 primary caregivers of young children in Nigeria, Uganda and Guinea, factor analysis produced six explanatory factors. We then estimated the effects of each of these factors on uptake of immunization using a structural equation model. The results showed that the probability that a child is fully vaccinated increases if a caregiver has support from others to vaccinate them (B = 0.33, β = 0.21, p<0.001) and if caregivers had poor experiences with the healthcare system (B = 0.09, β = 0.09, p = 0.007). Conversely, the probability of full vaccination decreases if the caregiver's husband exerts control over her decision-making ability (B = -0.29, β = -0.20, p<0.001), or if the caregiver perceives vaccines to be of low importance (B = -0.37, β = -0.27, p<0.001). Belief in religious protection (B = -0.07, β = -0.05, p = 0.118) and a belief that vaccines are harmful (B = -0.12, β = -0.04, p = 0.320) did not have an observed effect on vaccination status. This research suggests that interventions may benefit from that including entire families and communities in their design.

Inventário de Sistemas e Estilos Parentais: Uma Medida para a Primeira Infância

Abstract The Component Model of Parenting (CMP), from an evolutionary perspective, proposes a phylogenetically evolved repertoire of six systems (body contact, body stimulation, face-to-face exchange, object stimulation, and primary care) and two parenting styles (distal and proximal) by combining some of these systems. We developed the Inventory of Parenting Systems and Styles (ISEP) and applied it to hospitals and schools to analyze its psychometric properties. The parenting measure analysis we propose evolved 70 primary caregivers of young children with a mean age of 22.44 months. ISEP consists of 26 daily situations and assesses the most common parenting practices caregivers adopted in each one of them. Besides, we created a Coding Guide to Parenting Practice. It enabled us to classify each response according to the CMP systems. We found a variance of 84.67% and 95.55% in codification agreement between expert judges and a significant intraclass correlation coefficient for all parenting systems, which discloses validity evidence on the response process of the inventory. Our analyses indicated the occurrence of all parental systems, with a prevalence of narrative envelope and body stimulation. Cluster analysis revealed two clusters, one formed by proximal style and another by distal style, in accordance with the interactions of the system, representing a validity of evidence based on the internal structure of the instrument. ISEP provides reasonable measures for research and professional practice in Psychology. Further research with more extensive and diverse samples is necessary to refine the instrument and, especially its guide.

Depression, anxiety, and psychological distress among caregivers of young children in rural Lesotho: Associations with food insecurity, household death and parenting stress

Good mental health is a critical resource for mothers and caregivers of young children, given the central role of mental health in enabling responsive caregiving. However, fulfilling caregiving responsibilities under challenging circumstances such as extreme poverty, food insecurity, and gender inequality intensifies vulnerability to poor mental health. Previous research focuses on mental health of mothers, while in many LMICs children are cared for by other caregivers, such as grandparents. We examined the prevalence of mental health problems among primary caregivers of young children in rural Lesotho, and investigated factors associated with these mental health problems.We analysed baseline data from a cluster randomised controlled trial, where all caregivers with children between 1 and 5 years old across 34 villages were invited to participate. The analysis included mental health data from 781 caregivers of 998 children. We assessed caregiver mental health using three self-report screening instruments. Univariate and multivariate regression modelling tested associations between caregiver, child and household variables and (1) depression symptoms (PHQ-9), (2) anxiety symptoms (GAD-7), (3) psychological distress (SRQ-20), (4) suicidal ideation and (5) help-seeking for mental health.This study reported a high prevalence of symptoms of psychological distress (46.2%), depression (25.7%), anxiety (17.1%) and suicidal ideation (27.5%) among caregivers. Greater prevalence was associated with food insecurity, parenting stress or recent death in the family/household. Older caregivers reported higher rates of psychological distress and depression, while younger caregivers reported higher rates of anxiety. Suicidal ideation was associated with greater food insecurity and parenting stress, and lower caregiver education.Our findings support the need to address intersecting public health issues to improve conditions for caregivers in these settings. Targeting modifiable risk factors such as food insecurity among individuals within a society who carry disproportionate burdens of caregiving should be prioritised, especially in contexts of scarcity, where mental health is not prioritised.

It’s Just the Fact It’s Against Us: The Role of Social Determinants of Health in Young Children’s Caregivers’ Preventive Health Behaviors

Persistent racial-, ethnic-, and income-related disparities in health outcomes for children suggest that there is still much to do to develop interventions that are responsive to communities’ needs. Cultural health capital, the health-related attitudes, beliefs, and behaviors needed to engage in a healthy lifestyle, is acquired throughout childhood and informs adult preventive health behaviors (PHBs). However, primary caregivers’ social determinants of health (SDH) dictate the opportunities they have for building children’s cultural health capital. Given that targeted, responsive interventions and policies to promote PHB in young children are needed, the purpose of this study was to explore how caregivers with varying SDH define preventive health and what affects their engagement in PHBs for themselves and their children. Six focus groups with primary caregivers of young children ( N = 37, 89% female, mean age = ∼37.9 years old, ∼36% White) were conducted at community organizations. Data were analyzed using a deductive approach, and emergent themes were categorized by types of SDH (downstream, upstream, or both) within each focus group. Focus groups were categorized into three clusters based on participants’ SDH and access to resources: high-resource, low-income/moderate-resource, and low-income/low-resource. Caregivers’ definitions of preventive health were rooted in upstream and downstream determinants and differed by cluster. All clusters identified money and access to resources as barriers to engaging in PHBs and acknowledged that structural inequity impacted access to resources. Policies, programs, and structural change to address systemic barriers and mistrust in systems are vital to reduce disparities in health outcomes for children.

School-based management of type 1 diabetes in the Republic of Ireland: a cross-sectional mixed-methods analysis.

Qualitative research regarding the experience of diabetes self-care management in schools is underrepresented in published literature. In addition, there are methodologic limitations in some of the existing studies. To investigate experiences of school-based diabetes self-care management in children and adolescents with type 1 diabetes. Cross-sectional mixed-methods questionnaire survey. Sentiment analysis was undertaken of free-text responses by primary caregivers of young children and adolescents or adolescents themselves in relation to experiences regarding school-based support for self-care. Statements were rated on a 5-point Likert scale from strongly negative (1) to strongly positive (5). Responses were also grouped using thematic analysis. A quantitative analysis of the similarities and differences in responses between primary and secondary school students was undertaken. Text responses for analysis were present in 273 (65%) primary and 226 (56%) secondary school questionnaires. Sentiment analysis yielded mean scores of 3.5 and 2.8 for primary and secondary students, respectively. Three major themes were identified in the statements, namely attitude, education/knowledge, and resources. Scores within each theme were significantly higher for primary compared to secondary students. Attitude scored highest and education/knowledge scored lowest in both groups. Comments in relation to resources were significantly more frequent in primary school questionnaires, and comments regarding education and knowledge were more commonplace in secondary school responses. Our findings suggest that experiences regarding self-care management of type 1 diabetes are generally more positive among primary school students. Education and knowledge of school staff should be a particular area of focus in both cohorts.

Recruiting and retaining parents in behavioral intervention trials: Strategies to consider

ObjectiveRecruitment and retention are paramount to the success of randomized controlled trials (RCTs); however, strategies and challenges to optimize recruitment and retention are often omitted from outcomes papers. The current manuscript presents strategies used to recruit and retain over 97% parents of young children newly diagnosed with type 1 diabetes for over 15-months post-randomization enrolled in First STEPS, a behavioral, two-site RCT. MethodParticipants included 157 primary caregivers of young children newly diagnosed with type 1 diabetes. Recruitment and retention strategies are described and include collaboration with medical teams, careful selection and training of study staff, inclusion of a behavioral run-in prior to randomization, financial incentives, creation of a study identity using retention items, obtainment of feedback from community stakeholders, and minimization of participant burden. ResultsUse of recruitment and retention strategies resulted in enrollment of 58% of eligible and reached families, with retention of the enrolled sample above 97% for over 15 months. Participants reported high acceptability of and satisfaction with specific recruitment and retention strategies. ConclusionsThe strategies used to recruit and retain caregivers of young children newly diagnosed with a chronic illness were feasible to implement within multidisciplinary diabetes clinics and may apply to other pediatric populations. Future research may benefit from a focus on strategies to engage more diverse samples.Trial Registration: ClinicalTrials.gov identifier: NCT02527525

Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis.

Parents are the primary caregivers of young children. Responsive parent-child relationships and parental support for learning during the earliest years of life are crucial for promoting early child development (ECD). We conducted a global systematic review and meta-analysis to evaluate the effectiveness of parenting interventions on ECD and parenting outcomes. We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Global Health Library for peer-reviewed, published articles from database inception until November 15, 2020. We included randomized controlled trials (RCTs) of parenting interventions delivered during the first 3 years of life that evaluated at least 1 ECD outcome. At least 2 reviewers independently screened, extracted data, and assessed study quality from eligible studies. ECD outcomes included cognitive, language, motor, and socioemotional development, behavior problems, and attachment. Parenting outcomes included parenting knowledge, parenting practices, parent-child interactions, and parental depressive symptoms. We calculated intervention effect sizes as the standardized mean difference (SMD) and estimated pooled effect sizes for each outcome separately using robust variance estimation meta-analytic approaches. We used random-effects meta-regression models to assess potential effect modification by country-income level, child age, intervention content, duration, delivery, setting, and study quality. This review was registered with PROSPERO (CRD42018092458 and CRD42018092461). Of the 11,920 articles identified, we included 111 articles representing 102 unique RCTs. Pooled effect sizes indicated positive benefits of parenting interventions on child cognitive development (SMD = 0.32, 95% CI [confidence interval]: 0.23, 0.40, P < 0.001), language development (SMD = 0.28, 95% CI: 0.18 to 0.37, P < 0.001), motor development (SMD = 0.24, 95% CI: 0.15 to 0.32, P < 0.001), socioemotional development (SMD = 0.19, 95% CI: 0.10 to 0.28, P < 0.001), and attachment (SMD = 0.29, 95% CI: 0.18 to 0.40, P < 0.001) and reductions in behavior problems (SMD = -0.13, 95% CI: -0.18 to -0.08, P < 0.001). Positive benefits were also found on parenting knowledge (SMD = 0.56, 95% CI: 0.33 to 0.79, P < 0.001), parenting practices (SMD = 0.33, 95% CI: 0.22 to 0.44, P < 0.001), and parent-child interactions (SMD = 0.39, 95% CI: 0.24 to 0.53, P < 0.001). However, there was no significant reduction in parental depressive symptoms (SMD = -0.07, 95% CI: -0.16 to 0.02, P = 0.08). Subgroup analyses revealed significantly greater effects on child cognitive, language, and motor development, and parenting practices in low- and middle-income countries compared to high-income countries; and significantly greater effects on child cognitive development, parenting knowledge, parenting practices, and parent-child interactions for programs that focused on responsive caregiving compared to those that did not. On the other hand, there was no clear evidence of effect modification by child age, intervention duration, delivery, setting, or study risk of bias. Study limitations include considerable unexplained heterogeneity, inadequate reporting of intervention content and implementation, and varying quality of evidence in terms of the conduct of trials and robustness of outcome measures used across studies. Parenting interventions for children during the first 3 years of life are effective for improving ECD outcomes and enhancing parenting outcomes across low-, middle-, and high-income countries. Increasing implementation of effective and high-quality parenting interventions is needed globally and at scale in order to support parents and enable young children to achieve their full developmental potential.

Supporting Early Communication Skills of Children with Developmental Disorders in South Africa: Caregiver and Clinician Perspectives about Mobile Health Applications.

Using a mobile health application (i.e. app) to empower primary caregivers of young children with developmental disorders in low- and middle-income countries is opening up new avenues for early childhood intervention. Thirteen caregivers and ten speech-language pathologists participated in three focus groups to explore their perspectives about the potential benefits and suitability of a mobile health app as part of intervention, its features, the likelihood of using and recommending it, as well as potential pitfalls to be avoided. Both participant groups were generally positive, although there was little overlap between their responses. Caregivers generally focused on increased knowledge and skills (of all family members), as well as on empowerment and reduced costs. Speech-language pathologists on the other hand focused on how current service delivery would be enriched by increasing the dosage of therapy and enhancing parental cooperation. They also expected that the reach of service delivery would be expanded as more children and caregivers could potentially benefit. Although technology (i.e. mobile apps) could open up new possibilities for service delivery in this population, the perspectives of all stakeholder groups should be considered to ensure successful adoption of such technologies.

The effect of mHealth and conventional awareness campaigns on caregivers’ developmental literacy

ABSTRACT Children in impoverished settings face a multitude of risk factors that may impact early childhood development (ECD). Poor ECD can lead to negative outcomes and the continuation of the intergenerational cycle of poverty. Early stimulation from caregivers can counter the effects of risk factors. Increased developmental literacy supports positive parenting, thus improving ECD outcomes. This study aimed to determine if mHealth and conventional awareness campaigns have an effect on caregivers’ developmental literacy. Caregivers were recruited from a primary healthcare facility in a low-resource setting. Participants were randomly divided into three groups; two intervention groups (mHealth and conventional awareness campaigns) and a control group. Caregivers’ developmental literacy was assessed prior to their exposure to awareness campaigns. Participants were reassessed after three months, during which the intervention groups received the same information, through different mediums. The results showed that neither of the awareness campaigns was more effective (p=.359); as the intervention groups’ results were similar to those of the control group. There was, however, a significant improvement (p=.000) from pre-test to post-test, across the entire sample. The improvements may be due to pre-test face-to-face (FTF) interviews between healthcare professionals and caregivers. FTF interviews may be effective in fostering developmental literacy in primary caregivers of young children in low socio-economic populations.

Maternal nutrition counselling is associated with reduced stunting prevalence and improved feeding practices in early childhood: a post-program comparison study

BackgroundDespite progress, suboptimal feeding practices and undernutrition particularly in the form of stunting still remains a major issue among children aged less than 5 years in Bangladesh. Since mothers are the primary caregivers of young children, maternal nutrition counselling can be effective in improving knowledge and practices on child feeding. The Building Resources Across Communities (BRAC) initiated a nutrition counselling intervention using its essential health care (EHC) skeleton in 114 sub-districts of Bangladesh in 2012. This study assessed the role of this intervention on the prevalence of stunting and feeding practices among children aged less than 5 years.MethodsThe data was collected as part of a nationwide cross-sectional survey, which followed a two-stage cluster random sampling procedure and was conducted between October 2015 and January 2016. The present study analyzed the information of 3009 mother-children dyads from two selected survey areas: i) areas where the EHC package was delivered (comparison; n = 1452), ii) areas with EHC plus nutrition counselling package (intervention; n = 1557) was delivered. The Chi-square test was done to compare the child feeding practices and stunting prevalence between intervention and comparison. The degree of strength of the association of stunting and the intervention was estimated using a mixed-effect logistic regression model.ResultsThe study revealed that the prevalence of stunting was significantly lower in areas where the intervention was delivered compared to the comparison areas (29% vs. 37%, P < 0.001). Furthermore, after adjusting for administrative zone, household wealth quintile, child’s age, gender, maternal age, education, occupation, cluster disparity, and variation between study groups, it was seen that the risk of stunting was 25% lower in the intervention areas compared to the comparison areas (aOR: 0.75, 95% CI: 0.60–0.94; P = 0.012). Optimal child feeding practices were also more common among mothers from intervention areas than those of the comparison areas (exclusive breastfeeding: 72.7 vs. 59.4%, P = 0.008; feeding 4+ food groups: 42.9 vs. 34.1%, P < 0.001; having minimum acceptable diet: 31.2 vs. 25.3%, P = 0.017; feeding multiple micro-nutrient powder: 16.2 vs. 7.4%, P < 0.001).ConclusionsThe study highlighted that nutrition counselling of mothers may be effective in reducing childhood stunting with concomitant improvement in optimal feeding practices in children under 5 years of age. The frontline community health workers can be trained to counsel mothers on optimal child feeding practices and this could help reduce the prevalence of stunting.

Time use patterns among U.S. disengaged youth

In 2018, 4.6 million youth in the U.S. were neither working nor enrolled in school, a rate of 11.7 percent. These individuals are often referred to as disengaged. Youth disengagement has profound negative consequences for substance use, mental health, and later life earnings. Little is known about how disengaged youth occupy their time or how activity patterns might vary among disengaged youth. This study used 2010–2016 data from the American Time Use Survey (ATUS) to examine patterns of daily life for 1,129 disengaged youth ages 16–24. Hierarchical Cluster Analysis identified five subgroups. These were youth who focused on social activities, youth who appeared to be the primary caregivers of young children, youth engaged in religious pursuits, volunteering-focused youth, and youth who spent extensive time on court-related tasks and travel. Males, younger individuals, the unmarried, and those with fewer children were more likely to be focused on social activities than their counterparts. Females, Whites, older respondents, and those with children were more likely to be caregivers. Black youth and those from higher-income families were more likely to report religious activities.

P61 EFNEP Families Adopting Healthy Choices in Tulare County of California

Objective To implement/evaluate a USDA funded Expanded Food & Nutrition Education Program (EFNEP) among low-income families. Use of Theory or Research Existing research indicates behavioral and economic benefits of nutrition education programs with limited resources population who are likely to have poor eating habits, inactive lifestyle, and higher risk for multiple chronic diseases. Target Audience Primary caregivers of young children across schools/community settings in Tulare County, California. Program Description During FY2017-18, trained bilingual nutrition educator implemented the nine-week EFNEP program using series-based adult curriculum-Eating Smart Being Active. Each class was held once a week for 60-90 minutes in duration. Evaluation Methods Participants completed About Me demographics questionnaire, Food Tracker dietary recall, and a pre-post Food & Physical Activity Questionnaire (FPAQ). Descriptive and Pre-Post analyses were completed using WebNEERS reporting tool. Results Of the total 239 program families reached, 159 participants who attended all the lessons graduated from EFNEP. Majority of the participants were Hispanic. Differences in change from pre-to-post indicated improvements in all the program areas. Of the 159 graduates, 80% of participants showed improvement in one or more food resource management practices, 94% showed improvements in one or more diet quality/ nutrition practices, 85% showed improvements in one or more food safety practices, and 55.06% indicated a positive change in physical activity behaviors. Additionally, results indicated $57.30 in average cost savings. Conclusions EFNEP program reached low-income families in Tulare county of California. Findings advance the field of nutrition education and behavior with implications for programming, policy, and practice. Nutrition education matters and EFNEP is helping save dollars. Continuing to fund EFNEP is a good investment and public policy. Making informed food decisions can help families improve nutrition and food resource management behaviors essential to maximizing use of limited resources, supporting a healthy diet, and improving food security. Funding Expanded Food and Nutrition Education Program.

Depressive Symptoms and Care Demands Among Primary Caregivers of Young Children with Evidence of Congenital Zika Virus Infection in Brazil.

Evidence suggests that caring for a child with special health care needs can affect many domains of family life, including caregiver mental health. However, few studies have examined these outcomes among families impacted by the Zika virus (ZIKV). This study examines depressive symptom severity and care demands among primary caregivers of children, aged 15 to 26 months, with evidence of congenital Zika virus infection (ZVI). A sample of primary caregivers of children with evidence of congenital ZVI in northeastern Brazil (n = 150) reported on depressive symptoms, care demands, and their children's development. Children were categorized into groups according to their developmental delay status. Bivariate analyses were run to test for differences between groups. A path analysis model was used to examine the indirect effects of developmental delay on depressive symptoms through economic challenges and time spent providing health care at home and whether these associations varied by child care support. Compared to primary caregivers of children without developmental delay, primary caregivers of children with developmental delay had higher depression scores (p = 0.002), reported more economic (p < 0.001) and child care (p < 0.001) challenges, and spent more time providing health care at home (p < 0.001). Among primary caregivers who did not have child care support, developmental delay had a significant indirect effect on depressive symptoms through economic challenges but not through time spent providing health care at home. For families impacted by the ZIKV outbreak in Brazil, economic and child care challenges may be associated with primary caregiver mental health.

Fatigue and physical activity: Potential modifiable contributors to parenting sense of competence.

Parenting sense of competence, as measured by the Parenting Sense of Competence Scale (PSCS), is defined as one's levels of satisfaction and self-efficacy experienced in the parenting role. Previous studies have identified significant associations among PSCS scores and a host of parenting characteristics predictive of child outcomes. Existing approaches to improving parenting sense of competence focus on developing parenting knowledge and skills; however, other modifiable contributing factors to parenting sense of competence may exist. We examined associations among fatigue, physical activity, and parenting sense of competence in a community sample of female primary caregivers of young children (N=137) recruited from a university-based pediatric primary care clinic. Participants completed measures of child disruptive behavior disorders, parent fatigue, and parent physical activity level. Parenting sense of competence was measured with the 16-item PSCS. Participants' mean age was 32 years (SD=8 years), and most were non-Hispanic (87%) and White (70%). Multiple linear regression analyses revealed significant independent associations of fatigue (β=-0.19, p=.02) and physical activity level (β=0.20 and β=0.25, p<.05) with parenting sense of competence, controlling for child disruptive behaviors, child age, and socioeconomic status. In this non-clinical sample of mothers of young children, the significant relationships among fatigue, physical activity level, and parenting sense of competence could suggest potential targets for preventive intervention.

Sensory Processing and Maladaptive Behavior: Profiles Within the Down Syndrome Phenotype

Aim: Sensory processing impairments are well characterized in children with neurodevelopmental disorders, particularly autism, and have been associated with maladaptive behaviors. However, little is known regarding sensory processing difficulties within Down syndrome, or how these difficulties may influence maladaptive behavior. This study aims to characterize sensory processing difficulties within the Down syndrome phenotype and determine the influence of processing difficulties on maladaptive behavior. Methods: To explore this issue, we administered the Short Sensory Profile and the Developmental Behavior Checklist to parents or primary caregivers of young children with DS (N = 49; M nonverbal mental age (NVMA) = 30.92 months (SD = 12.30); M chronological age (CA) = 67.04 (SD = 25.13). Results: Results indicated that Low Energy/Weak, Under-responsive/Seeks Sensation, and Auditory Filtering were the areas of greatest sensory regulation difficulty, and that Self-Absorbed behavior and Disruptive/Antisocial behavior were elevated areas of maladaptive behavior. Multivariate regression analyses indicated that Under-responsive/Seeks Sensation was the only sensory regulation domain significantly associated with Self-Absorbed and Disruptive/Antisocial behavior. Conclusion: Findings indicate a consistent pattern of sensory processing impairments and associations with maladaptive behavior in children with DS. Implications for interventions are discussed.

Socioeconomic Position and Picky Eating Behavior Predict Disparate Weight Trajectories in Infancy.

Infant weight gain has long-term implications for the establishment of overall health. We examined whether socioeconomic position (SEP), the use of pressure as a feeding practice, and picky eating relate to changes infant in weight-for-length (WFL). A modified developmental design was used to examine whether current levels of child picky eating, parental use of pressure, and SEP were associated with changes in WFL during infancy. Health providers distributed survey packets during routine well-child visits made in the homes of families with young children in New Zealand (n = 193). Primary caregivers of young children provided their child's current level of picky eating, their use of pressure, and their SEP. They also reported their child's professionally-measured WFL from birth, 8, 15, and 21 months of age. A multi-level modeling analysis yielded an interaction between SEP and picky eating in predicting infant weight change over time. Children who had a low SEP and were not picky eaters were on the highest WFL trajectory and children who had a low SEP and were picky eaters were lowest on the WFL trajectory. A main effect revealed that higher levels of parental pressure predicted lower WFL in infants at each age, but did not interact with SEP or picky eating. Findings from this study indicate that the combination of eating behavior and SEP are associated with differential infant growth patterns. These results suggest that eating behavior and SEP should be included in the development of interventions designed to achieve healthy weight during childhood.

Neighborhood and Parental Influences on Diet and Physical Activity Behaviors in Young Low-Income Pediatric Patients.

This study explores the relationship between neighborhood characteristics and caregiver preferences for establishing diet and physical activity behaviors among low-income African American and Hispanic young children (2-5 years). Primary caregivers of young children were recruited from 2 urban pediatric clinics to participate in focus groups (n = 33). Thematic analysis of transcripts identified 3 themes: neighborhood constraints on desired behaviors, caregivers' strategies in response to neighborhoods, and caregivers' sense of agency in the face of neighborhood constraints. This study elucidates the dynamic relationship between neighborhoods and caregiver preferences, their interrelated impacts on establishment of diet and physical activity behaviors among young children, and the important role of caregiver agency in establishing behaviors among young children. To effectively address obesity disparities among young children, primary care behavioral interventions must leverage and support such resilient caregiver responses to neighborhood constraints in order to optimally address racial/ethnic and socioeconomic disparities in obesity among young children.

Shaping our Kids’ Diets: Home and Neighborhood

ObjectiveFollowing the social‐ecological framework, we aimed to characterize barriers and facilitators that primary caregivers living in a food desert experience when providing foods for their children, and strategies to overcome those barriers.MethodsUsing a purposive sampling design, we identified 15 primary caregivers of young children (&lt; 10 years old) who live in Ward 7, a food desert in Washington DC. Semi‐structured, in‐depth interview guides were used to ask primary caregivers about a typical day, whether they agreed with the statement that they are feeding their children the foods that they would like to feed them, and what made it easier or harder for them to provide the foods they want to provide for the children. A participatory workshop with all respondents sought to identify common barriers and strategies to overcome those barriers. Interviews from all sessions were recorded, transcribed verbatim, and analyzed systematically following the social ecological framework (ATLAS.ti version 5).ResultsWe interviewed five mothers and ten grandparents. Common factors that acted as barriers or facilitators included health concerns of the primary caregiver that shape what was available at home to eat; monetary and time budgeting for food acquisition and preparation; child's food preferences and requests on foods; perceptions that kids waste foods if they are not fed what they desire; perception that kids’ appetite is not satisfied by what is offered at school or at home. The support of or conflict with family and friends can either mitigate or exacerbate challenges faced by kids’ preferences and health concerns. At the community level, respondents valued resources provided by organized groups (i.e. food giveaways, church lunches, dinners, and other programs offered by non‐governmental organizations). Results provide some evidence that the themes typically associated with a food desert emerged only among respondents who had access to a car (or to a friends’ or relative's car). For example, these respondents described how distance to supermarkets, external appearance of stores, and internal appearance of products, influenced place and frequency of shopping, and limited the types of foods they would have preferred to offer to their children. Among those who did not have good access to transportation, these themes did not emerge, and their barriers and facilitators related more to money and time budgeting, home and family conflicts, and availability of community resources. Participants expressed the desire to gain more knowledge about nutrition and diet, resources available in the community, and budgeting skills. A small group of respondents was interested in organizing to demand that the one supermarket in the neighborhood provided better food products.ConclusionBarriers and facilitators at the individual level are exacerbated or mitigated by family, social, and neighborhood characteristics. Our results suggest that perceived barriers and identified strategies were influenced by the respondents’ ability to compare and contrast their community environment to other neighborhoods.Support or Funding InformationHoney W. Nashman Center for Civic Engagement and Public Service

Primary caregivers of young children are unaware of food neophobia and food preference development.

Issues addressed: This research explored primary caregivers' awareness of food neophobia and how food preferences develop in young children aged between 1 and 2.5 years. Methods: This qualitative study used case study methodology and comprised interviews with 24 primary caregivers of young children aged between 1 and 2.5 years. Results and conclusions: Primary caregivers of young children are unaware of food neophobia and food preference development in young children. So what? Raising primary caregivers' awareness of food neophobia and how food preferences develop in young children may encourage caregivers to decrease their children's exposure to non-core foods.