ABSTRACT
Background: Despite high rates of obesity and weight-related conditions observed in children with Down syndrome, little is known about how to prevent these conditions. Purpose: The purpose of this study was to identify parent-perceived facilitators and barriers to health for toddlers (12-36 months old) with Down syndrome. Materials and methods: We conducted in-depth, semi-structured interviews with the mothers of 25 toddlers with Down syndrome. All interviews were conducted using Zoom Video Technology, audio recorded and transcribed before being coded in NVivo software using a structured protocol. Thematic analysis was used to identify themes in perceived facilitators and barriers to health at the level of the child, family, and community. Data were triangulated using reflective journaling, video review of child meals, and member-checking techniques. Results: We identified unique themes for facilitators (on the move and sound sleep) and barriers (co-occurring conditions and eating behaviors) at the level of the child. At the level of the family and community, overarching themes that were viewed as either a facilitator or barrier, depending on the context, were identified (role models matter, time is critical, the importance of place, and social support). Conclusion: These themes can help clinicians and researchers tailor their health promotion interventions to meet the unique needs of children with Down syndrome by using strength-based approaches and providing families with the tools to overcome barriers.
ABSTRACT
Minority and low-income children are overrepresented among obese US children. Lack of basic nutrition knowledge among parents may contribute to this disparity. The purpose of this study is to measure nutrition knowledge of parents of Medicaid-insured obese children using a simple low-literacy tool. Parents, recruited from pediatric clinics, demonstrated their nutrition knowledge by placing food stickers into cells on a printed grid with food groups displayed in columns and three nutrition categories displayed in rows. In general, parents (n = 135; 74.8 % black; 79.2 % income of ≤$25,000/year) correctly identified food groups (median = 90.5 % correct). Nutritional categories were more commonly misidentified (median = 67 % correct), with parents mostly believing foods were healthier than they were. Multivariable linear regression revealed black race (p = 0.02), no college education (p = 0.02) and income of <$15,000 (p = 0.03) independently predicted misidentification of nutritional categories. Parents' understanding of food's nutritional value is variable. Black race, less education, and very low income are associated with poorer nutrition knowledge.
