Challenges and Facilitators to Promoting a Healthy Food Environment
and Communicating Effectively with Parents to Improve Food
Behaviors of School Children
Hiershenee B. Luesse1 · Rachel Paul2 · Heewon L. Gray3 · Pamela Koch2 · Isobel Contento2 · Victoria Marsick4
Published online: 14 February 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Background Childhood obesity is a major public health concern and families play an important role. Improving strategies
to reach parents and directing tailored nutrition education to them is needed. Purpose To investigate the challenges and
facilitators to promoting a healthy environment at home and to identify communication preferences to inform intervention
strategies for effectively reaching low-income urban minority families. Procedure Semi-structured focus group interviews
were conducted with four groups involving 16 low-income urban parents (94% female; 88% Hispanic/Latino, 12% African
American) of elementary school children. Interviews were transcribed and analyzed applying Social Cognitive Theory and
using in-vivo coding. Main Findings The most common barriers to parents providing healthy foods to their children were
accommodating child preferences and familial opposition. Parents showed intentionality to engage in healthy behaviors,
and often shared procedural knowledge for reaching health goals. The analyses of desired communication channels yielded
major preferences: tailored information, information provided through multiple mediums, appropriate duration/frequency
of messages, and presented from a voice of authority. Conclusion and Implication While parents expressed desires to be
healthy, the home food environment presented substantial challenges. Multi-media supports such as workshops, flyers, and
text messaging may be useful to facilitate the sharing of information to minimize the tensions between intentionality and
reaching desired goals to be healthy. Some parents thought that information received through text messaging could be easily
shared and would act as a voice of authority to support child behavior change.
Keywords Home environment · Childhood obesity · Social cognitive theory · Qualitative study
Childhood obesity is a major public health issue with high
prevalence in African American and Hispanic subgroups.
School-based programs have been targeted as effective
venues to reach children. However, for elementary
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