Nursing student perspectives on improving mental health support services at university in Saudi Arabia - a qualitative study.

BACKGROUND: University students' needs for mental health (MH) services are an important aspect of academic success or failure. Nursing students enrolled at Saudi Arabian universities in need of MH care encounter obstacles in accessing this type of care. AIMS: The present work explores students' views and suggestions about the existing problems surrounding university students' MH and well-being support services. METHODS: Twenty students enrolled in a Master of Nursing program were recruited as research participants. Individual interviews of students' perceptions of the needs and availability of MH services during their studies provided inductive data. These data were analysed through a constructivist thematic method. FINDINGS: Three major themes and sub-themes regarding the issues and possibilities of MH services were distinguished from the research data, namely, social implications, access and opportunity, and ways to improve care. Participants emphasised a need for a university-wide approach to reforming MH services to provide students with the required support and alleviate service demand by qualified professionals. CONCLUSION: The present work underscores the need for provision of good quality MH care for university students and health promotion which strives to reduce stigma related to MH care.

Saudi Arabian Nurses' Motivations and Barriers to Employment in Inpatient Mental Health Facilities: A Qualitative Investigation.

BACKGROUND: The shortage of inpatient psychiatric mental health care nurses in Saudi Arabia represents an important health care challenge. AIM: The aim of this study was to illuminate perspectives of psychiatric mental health nurses employed in psychiatric inpatient settings about their employment experiences. METHOD: This study adopted an exploratory qualitative approach using thematic content analysis. Ten professional nurses with psychiatric inpatient caring experience participated in two focus groups composed of Master of Nursing students. RESULTS: Four main themes emerged: inadequate professional skills and knowledge for psychiatric mental health care practice, negative public attitudes toward psychiatric/mental health nurses, concerns for personal safety, and alternatives and advantages. The findings of this study suggest that nurses' lack of interest in working in psychiatric units is not merely personal but also social and organizational. CONCLUSIONS: The study findings may encourage managers and authorities to develop measures to attract more mental health nurses to work in psychiatric units. Such strategies may include modification of nurses' skills, training, and professional knowledge, collegial supervision, mentoring, and working conditions and environment.

Psychiatric Mental Health Nurses' Perceptions and Experiences of Inpatient Mental Health Care Safety Culture in Saudi Arabia.

BACKGROUND: Although patient safety culture is gaining attention globally, more studies are needed to investigate its relevance to the nursing care of mental health (MH) patients. AIMS: This study aimed to illustrate the perceptions and experiences of nurses who work in inpatient mental health care (IMHC) concerning the patient safety practices that are employed to avert safety hazards encountered during the provision of care in IMHC settings. METHODS: Eighteen postgraduate students working as MH nurses in nonprofit hospitals comprised the study sample. The participants had a minimum of 2 years' nursing experience in IMHC settings. Each participant was interviewed individually using a guided interview technique. The inductive data underwent thematic analysis. RESULTS: Patient protection and a safety perspective were the overarching themes that emerged from the data. Three principal themes and 9 subthemes were illuminated: (a) patient care safety knowledge and background, (b) improving MH care, and (c) development of MH nursing care. CONCLUSIONS: The findings of this investigation may assist in providing guidance for the further research into and development of a patient safety culture appropriate for IMHC nursing practice, including increased structured educational experiences, judicious risk assessment, assignment of staff to include a mixture of skills and experience levels during assignments, use of standardized handoff procedures, engagement with multidisciplinary care providers, blame-free reflective information sharing and mentoring, and attention to the built environment with consideration of patient and staff safety needs.

Predictors of Leadership Competencies Among Nurse Executives in the Kingdom of Saudi Arabia.

Background: Awareness and development of nurse executives' leadership competencies has been considered a key strategy for the success of healthcare organizations. However, only a few studies about nurse executives' leadership competencies are available in the literature, and no study has been conducted about the topic within Saudi Arabian context. The aim of this study was to assess the leadership competencies of nurse executives and the predictors of these competencies. Methods: This quantitative study used a descriptive, cross-sectional, and correlational design. The study recruited a total convenience sample of 136 nurse executives who voluntarily consented to participate. The respondents self-rated the online survey, "Leadership Competency Assessment Tool: Self-Assessment." Data collection was conducted between September 2022 and November 2022. Test of correlation and multiple regression analyses were conducted. Results: The overall mean score of nurse executives' leadership competencies was 3.38 out of 5.0, which was below the level of having excellent leadership competencies. Four dimensions had mean scores below the level of having excellent leadership competencies, namely, communication and relationship building (3.48), knowledge of the healthcare environment (3.29), leadership (3.45), and business skills (3.15), while nurse executives had excellent leadership competencies only in the professionalism dimension (3.51). Age (p=0.04), highest educational attainment (p=0.01), current role (p<0.01) and length of experience (p=0.02) as nurse executive, monthly salary (p=0.03), nationality (p=0.04), and having seminars/trainings in leadership and management (p=0.01) were considered predictors of the leadership competencies of nurse executives. Conclusion: Nurse executives reported a low level of leadership competencies, thus implying necessary actions for improvement. There were personal factors that influenced the level of nurse executives' leadership competencies. To achieve quality outcomes and maintain a high level of nursing care in hospital organizations, these findings must be considered in planning strategies related to the improvement of the leadership competencies of nurse executives.

Exploring Nurse perceptions of structural empowerment in midwifery practice in Saudi Arabia: A qualitative study.

Perceptions and experiences of midwives regarding structural empowerment during practice in Saudi Arabia were explored using a qualitative, constructive, descriptive design. Data was gathered using individual semi-structured interviews with ten midwives employed in delivery rooms, and prenatal and postnatal units of governmental hospitals in Saudi Arabia's eastern province. Data was analyzed with assistance of NVivo software, Version 12. Five themes emerged from our study: the meaning of structural empowerment, ambiguous hospital policies, the insufficient numbers of midwives, midwife-physician dynamics, and continuing education and training. Structural empowerment of midwives in maternity units may be useful in improving midwifery services in Saudi Arabia and worldwide.

What is the further research?Further studies on this topic should expand the current study's sample and include participants from more regions of Saudi Arabia. In addition, research on the psychological empowerment of midwives is needed.What is known on the subject?Midwives are educated to care for women during pregnancy, birth, and postnatal, and midwives must be empowered to fulfill this professional role. The evidence showed the importance of structural empowerment for midwives to perform their professional function and provide quality care for women during pregnancy, birth, and postnatal.What does this paper add to existing knowledge?In Saudi Arabia, there is little research evidence on how to explore the perceptions and experiences of structural empowerment among midwives. Our study provided valuable recommendations for identifying environmental practices, positive workplace characteristics, and promoting higher-quality midwifery in the workplace.What are the implications for practice?Midwife workplace empowerment is correlated with the quality of care, job satisfaction, staff effectiveness, and the positivity of the work environment. The results of this study suggest that every healthcare organization must work to bring about structural empowerment for midwives to facilitate successful practice.

Exploring the Healthcare Services' Contribution to Reducing Postpartum Depression.

Introduction: The postpartum period is accompanied by health risks that impact many women. Postpartum depression (PPD) is a mental health problem that has been neglected in maternal healthcare services. Objective: The purpose of this study was to explore nurses' perceptions towards health services' contribution to lowering the incidence of PPD. Methods: An interpretive phenomenological approach was adopted in a tertiary hospital in Saudi Arabia. A convenience sample of 10 postpartum nurses was interviewed face-to-face. The analysis followed Colaizzi's data analysis method. Results: Seven main themes emerged on how to improve maternal health services to contribute to reducing the incidence of PPD among women: (1) maternal mental health, (2) follow-up of mental health status, (3) screening mental health status, (4) enhancing health education, (5) reducing stigma toward mental health, (6) updating resources, and (7) empowering nurses. Conclusion: The integration of mental health services into maternal services that are provided to women needs to be considered in the context of Saudi Arabia. This integration will result in high-quality holistic maternal care.

Nurse views of obstacles encountered by nurses in Saudi Arabia during the provision of psychiatric care.

BACKGROUND: Nursing staff within the mental health sector are major actors in delivering healthcare. They face considerable obstacles that may hinder the provision of high-quality care to patients with mental health challenges. AIM: The current study offers a description of mental health nurses' viewpoints, insights into obstacles encountered during their experiences, and recommendations for enhancing psychiatric inpatient nursing care and achieving progress toward the goals set out by Saudi Vision 2030. METHODS: The study employed a phenomenological qualitative design. Semistructured interviews were conducted with 10 currently practicing mental health nurses during two focus group sessions. The inductive data produced underwent member and peer checking. Emergent themes and subthemes were extracted. RESULTS: Two main themes and related subthemes were identified. The first theme-obstacles faced by mental health nurses-was composed of the following subthemes: policy at institutions; clear job roles; low professional self-confidence and inadequate support; stressed, insecure, and unsafe; and stigmatization. The second theme-recommendations to improve the quality of mental health nursing-was composed of two subthemes: to enhance mental health awareness and improve professional skills and education. CONCLUSION: The data suggest that maintaining high-quality nursing standards within an inpatient psychiatric facility requires a consistent and accountable organizational structure, which can lead to fostering the development and improvement of relevant nursing skills through continuing education, improved awareness of mental health disorders and care within the community, and initiatives to combat the stigma of mental disorders among patients, families, and communities.

Saudi Arabian Primigravid Women's Experiences of Mindfulness to Reduce Childbirth Stress: A Qualitative Study.

Introduction: Pregnancy is a significant transitional life experience. It can also be one of the most stressful experiences in life and some women go on to develop postpartum depression. Adopting mindfulness techniques during childbirth may allow women to experience less labor pain and require fewer medical interventions, which improve the mother's health. Objective: To investigate the effectiveness of mindfulness in reducing childbirth stress in primigravid women in Saudi Arabia. Methods: The researcher recruited primigravid women from an antenatal clinic in a government hospital in the Eastern Province of Saudi Arabia. The study adopted a qualitative interpretive descriptive design, using individual interviews to collect the data before conducting thematic content analysis using NVivo 10.1 software. Results: Five key themes emerged from the data: (a) stress reduction, (b) recognition of thoughts and feelings, (c) life satisfaction, (d) insufficient knowledge leads to challenges, and (e) empowerment of a spiritual aspect. Conclusions: Mindfulness is an effective technique that supports a mother's physical and psychological well-being.

Undergraduate Nursing Student Mental Health Clinical Experiences in Saudi Arabia: Findings From a Qualitative Study.

BACKGROUND: Clinical experience is an important way of resolving preregistration challenges. Negative feelings toward pursuing a career in mental health nursing may be modified by well-structured practicums. AIMS: To explore nursing student perspectives of clinical practicums in mental health in Saudi Arabia for the purpose of enhancement of nurse education in mental health care. METHODS: This qualitative study used thematic analysis from semistructured focus group interviews of 20 female undergraduate nursing students. Inductive outcomes and emergent conceptual data were reviewed by investigators, doctoral prepared faculty peers, and members of the sample. NVivo 10.1 software was used to suggest conceptual groupings into themes based on inductive codes. RESULTS: The core theme-enhancement of mental health care skills-comprised four emerging subthemes, including the application of theory for clinical improvement, positive feelings, and motivation toward removal of discrimination and stigmatization, experience with apprehension, anxiety, fear, and stress, and therapeutic communication skills. DISCUSSION: Clinical placement in mental health-related practice may assist undergraduate nursing students in addressing anxiety and stress related to contacting patients, confronting stigmatizing and negative emotions, applying theoretical knowledge to clinical practice, having therapeutic communication skills, and enhancing overall professional experiences of nursing students. It is hoped that undergraduate clinical mental health placement will contribute valuable skills and viewpoints to nursing students who aim to enter professional practice in all areas and especially mental health.

Using mobile health applications to enhance physical activity in Saudi Arabia: a cross-sectional study on users' perceptions.

BACKGROUND: This research aims to assess the users' perceptions of usability and quality of mobile health applications used for promoting physical activity in Saudi Arabia. METHODS: This was a quantitative cross-sectional study. A survey was developed based on the Technology Acceptance Model (TAM) and the Mobile Application Rating Scale (MARS) and distributed among the Saudi population through social media to assess the users' perceptions of using mobile applications to enhance physical activity. The survey questionnaire consisted of 27 questions in six sections, including demographics (nine items), perceived usefulness (three items), perceived ease of use (three items), attitudes (three items), user experience (six items) and subjective quality (three items). All the participants were in Saudi Arabia and >15 y of age. RESULTS: A total of 195 m-Health users participated in the survey. Of the total participants, 25.1% were overweight and 21.0% were obese. The workout frequency of most users was rarely (32.3%) and three to four times a week (29.2%). In addition, 55.9% of the users agreed that the application they use served all fitness levels and >80% either agreed or strongly agreed that it was easy for them to learn how to use the application. More than 70% of users agreed or strongly agreed that the application enhanced their knowledge of workouts and physical activity and >90% would recommend the application to others. There were no differences identified between the male and female participants and younger (<40 y) and older (>40 y) participants with respect to perceived usefulness and ease of use, attitudes, experiences and subjective quality. However, significant differences were observed between participants <40 y and >40 y of age in terms of perceived ease of use of mHealth applications. CONCLUSION: mHealth users across Saudi Arabia believe that the mHealth applications have good usability and quality factors. As a result, they can motivate people and help them achieve their goals in relation to physical activities.

The opportunities and challenges of adopting ChatGPT in medical research.

Purpose: This study aims to investigate the opportunities and challenges of adopting ChatGPT in medical research. Methods: A qualitative approach with focus groups is adopted in this study. A total of 62 participants including academic researchers from different streams in medicine and eHealth, participated in this study. Results: A total of five themes with 16 sub-themes related to the opportunities; and a total of five themes with 12 sub-themes related to the challenges were identified. The major opportunities include improved data collection and analysis, improved communication and accessibility, and support for researchers in multiple streams of medical research. The major challenges identified were limitations of training data leading to bias, ethical issues, technical limitations, and limitations in data collection and analysis. Conclusion: Although ChatGPT can be used as a potential tool in medical research, there is a need for further evidence to generalize its impact on the different research activities.

Exploring Experiences of Workplace Violence and Attempts to Address Violence Among Mental Health Nurses in the Kingdom of Saudi Arabia.

Introduction: Workplace violence has emerged as a global phenomenon requiring immediate attention. The nursing profession is primarily affected, and the unique vulnerability of nurses to workplace violence is particularly evident in the field of mental health nursing. Aims: This study explores the experiences of mental health nurses with work-related violence and attempts to combat this violence in the context of inpatient mental health facilities in Saudi Arabia. Methods: This research comprises a qualitative exploratory study consisting of semistructured interviews with 16 participants using open-ended questions. The participants are psychiatric/mental health nurses with experience in the field, so this methodological approach facilitates a detailed investigation of their encounters with workplace violence. Results: This study reveals that nurses experience violence in accordance with two main themes and subthemes: experiences of workplace violence, the influence of violence on work settings, and efforts required to combat violence. Data show that these participants consider of prime importance access to training to increase safety through knowledge, improved communication, and protective skills, along with adequate staffing and a safe built environment. Conclusion: The research findings confirm the urgency of addressing the needs of mental health nurses in inpatient psychiatric hospitals. Policymakers in the healthcare field must be aware of the inpatient psychiatric care climate and the need for support from those who staff these areas of practice. Training in specialized knowledge and skills is required to ensure a safe work environment as well as appropriate staffing levels, and a safe built environment. These conditions may be required to recruit and retain mental health nurses capable of providing best-practice care.

Barriers to Implementing Evidence-Based Practice among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Study.

Several studies have been conducted to investigate the barriers to implementing evidence-based practice (EBP) worldwide. In Saudi Arabia, a few studies were conducted in hospital and mental health settings, and no study has explored the topic in primary healthcare settings. This study aimed to examine the barriers perceived by primary healthcare nurses in implementing EBP. This study employed a correlational and cross-sectional design. A total of 284 nurses were surveyed using the BARRIERS scale. Regression analysis was performed to identify the effects of predictor variables on the four subscales. The overall raw score on the BARRIERS scale was 86.21 (standard deviation = 16.15). The highest mean score was reported in the organizational subscale, followed by the innovation and communication subscales, whereas the lowest mean score was reported in the adopter subscale. The findings showed that the three top-ranked barriers were: (1) results of the studies are not generalizable to nurses' setting, (2) facilities are inadequate, and (3) physicians do not cooperate with the implementation. Findings showed that nurses encounter organizational-related barriers to a moderate extent and EBP implementation varies depending on gender, level of education, and job position. There is a need to create and implement educational interventions and programs to overcome the barriers to effective EBP implementation among primary healthcare nurses.

Perceptions of mental health nurses toward caring for suicidal hospital inpatients in Saudi Arabia.

Saudi nurse perceptions of suicide and its effect on their professional and personal lives have not been sufficiently discussed. This study aims to explore related mental health nurse experiences. A phenomenological qualitative inquiry of 20 practicing mental health nurses in one focus group provided data which were subjected to member and peer checking and NVivo software to extract five themes: nurse experience of patient suicide, expressed feelings, psychological responses, the effect on practice, and support. This study illuminated aspects of emotional labor of nurses and perceptions of caring for suicidal patients in Saudi Arabia.

Exploring the value of mindfulness for Saudi Arabian women mental health nurses.

Background: . Nurses engaged in mental health-related practice experience stress and burnout. We assessed the role of the practice of mindfulness in coping with these aspects of providing care in mental health settings. Methods: . Mindfulness as a coping method was explored using qualitative methods to illuminate its impact on practice from the perspective of mental health nursing graduate students at the College of Nursing, King Saud University, Riyadh, Saudi Arabia. Data were obtained by semi-structured interviews in focus groups of these nurses. Results: . The themes that emerged were (i) positive techniques; (ii) recognized stress; (iii) managing stress; (iv) acceptance; (v) psychological reaction; and (vi) physical responses. Conclusions: . The themes that emerged in this study confirm the stresses faced by nurses practising in mental healthcare and suggest improved coping methods.

Investigating healthcare practitioners' attitudes towards the COVID-19 outbreak in Saudi Arabia: A general qualitative framework for managing the pandemic.

BACKGROUND: Some previous studies have investigated the attitudes of healthcare professionals towards certain aspects of the COVID-19 outbreak. In addition, some general frameworks have been proposed to manage the pandemic. OBJECTIVE: The purpose of this article was to analyze the attitudes of healthcare practitioners in Saudi Arabia towards the treatment of patients with COVID-19, work planning of practitioners, leadership approaches to manage the pandemic, sharing information strategies, medical errors, compliance with procedures, and challenges faced by the practitioners. Furthermore, another objective was to propose a general framework for managing the COVID-19 outbreak in Saudi Arabia. METHODS: To achieve these purposes, a survey was designed based on an online questionnaire that was initially sent via WhatsApp, Twitter, Facebook, and email to 336 healthcare practitioners working in 7 hospitals in Saudi Arabia. The response rate was 30.4%. RESULTS: The outcomes indicated that healthcare practitioners in Saudi Arabia had positive attitudes towards effective communication and interaction between health professionals and patients, leadership and maintenance of team coordination, work planning, communication and cooperation between team members, training and skills development of healthcare professionals, implementing strict procedures to avoid errors and control the spread of the COVID-19 pandemic, maintaining an adequate supply of medicines and medical equipment, and obtaining the support of the government, the community, and the people. CONCLUSION: Based on the findings, it was possible to suggest that the management of health care operations related to the COVID-19 outbreak in Saudi Arabia requires effective collaboration and information sharing among various stakeholders. In this sense, communication, effective leadership, coordination and work planning, adequate treatment for patients, strict compliance with hospital rules and procedures, preventive and regulatory measures, and training and support for health professionals, were parameters considered in the general qualitative framework suggested in this study for managing the COVID-19 pandemic in Saudi Arabia. The propositions presented in this study can help the Saudi Arabian government implement an effective plan to control the spread of the COVID-19 pandemic in this country.

A Comparative Study on the Strategies Adopted by the United Kingdom, India, China, Italy, and Saudi Arabia to Contain the Spread of the COVID-19 Pandemic.

PURPOSE: The objective of this study was to compare the strategies adopted by the United Kingdom, Italy, China, India, and Saudi Arabia to contain the spread of the COVID-19 pandemic. MATERIALS AND METHODS: A review of the literature was carried out to collect data on the strategies used by China, Italy, India, the United Kingdom, and Saudi Arabia to contain the spread of the COVID-19 virus. The global analysis of 65 published literature references allowed observing the effectiveness and efficiency of the strategies used by these countries to control the spread of the COVID-19 virus. RESULTS: Both mitigation and suppression strategies were adopted by the United Kingdom, India, Italy, China, and Saudi Arabia to control the spread of the COVID-19 pandemic. It was observed that China has achieved a greater success in flattening the curve compared to the other countries. In China, few new daily cases have occurred since March, and it has been the only country that has managed to keep the COVID-19 pandemic under control. On the other hand, reductions in the number of daily cases (since May 2020) were detected in the United Kingdom, Italy, and Saudi Arabia (since July 2020). Also, during the last 3 months (June, July and August) India has shown the highest growth in the total number of confirmed cases and in the number of new daily cases, compared to the mentioned countries. CONCLUSION: The review of the strategies adopted by China, India, the United Kingdom, Italy and Saudi Arabia to combat the COVID-19 pandemic can guide countries in the design and development of mitigation and suppression approaches to control the spread of the COVID-19 virus. Containment strategies such as lockdowns cannot continue in the long term. Therefore, countries must adopt mitigation and prevention strategies to protect people from infection and learn to live with the virus.

Implications of Public Understanding of COVID-19 in Saudi Arabia for Fostering Effective Communication Through Awareness Framework.

Background: Participation of the public is an important and most effective approach for controlling the spread of novel coronavirus. However, considering its novel nature, it is important to create awareness among the public to be able to take timely preventive measures. On the contrary, misinformation and myths from online communities result in severe damages in mitigation of this novel disease. Objective: Focusing on these aspects, this manuscript reviews public awareness about COVID-19, myths surrounding it, its symptoms, treatment, transmission, importance of information sources, types of information to be considered in awareness campaigns, promotional channels, and their implications in Saudi Arabia. Methods: An online questionnaire-based survey was used for collecting data related to five major aspects related to COVID-19 and awareness creation process. The survey was accessed by 1,881 people, out of whom 741 people participated in the survey. However, 150 dropouts left the survey in between, as a result of which a final sample of 591 was achieved, indicating the response rate of 39.3% and a completion rate of 79.76%. Results: Awareness levels of the participants related to COVID-19, its means of transmission, preventive measures, symptoms, and treatment were identified to be moderate to high (60-80%). However, reliance on a few myths and violation of certain preventive measures were identified with majority of the participants (more than 60%). The Ministry of Health was identified to be the most reliable source of information followed by family and friends. Moreover, 15 types of information were identified to be highly relevant and important, which need to be effectively disseminated among the public through effective communication channels. Conclusions: Lack of awareness can result in serious outcomes in relation to COVID-19. Effective awareness campaigns including relevant information from reliable sources can improve the knowledge of people, and they must be effective in developing positive attitudes among the public toward adopting preventive measures.

Perceptions of Media's Contribution Toward Stigmatization of Mental Health by Saudi Arabian Nurses.

BACKGROUND: Public often obtains mental health information from mass media and Saudi Arabia is characterized by high media penetration. Fictional and nonfictional media dramatize, trivialize, and misrepresent characteristics and needs of clients who need mental health care and may create and reinforce existing stigma. This pattern of stigma may adversely affect mental health care clients, practitioners, education, and programs. Portrayal of mental illness and opportunities for care in Saudi Arabia need development. OBJECTIVE: This study examined Saudi graduate nurses' perceptions of stigma created by mass media and influence on public perceptions of mental health issues and use of these views to formulate ways to effect changes in mental health care availability and delivery. METHOD: Participants included 18 graduate practicing female mental health nurses at King Saud University School of Nursing. Qualitative data were collected using individual interviews and analyzed using NVivo 10.1 software for thematic content analysis. RESULTS: The core theme that emerged was "stigma in media," which in turn had five subthemes: (a) media portrayal, (b) mass media, (c) social stigma, and (d) mental health care services. CONCLUSION: This inquiry may be helpful in enabling development of stigma-reduction programs by shedding light on the role of mass media in forming normative behavior and attitudes toward mental illness in Saudi culture.

Exploring the Contributory Factors Toward Childhood Obesity and Being Overweight in Saudi Arabia and the Gulf States.

Introduction: Saudi schoolchildren are 15.5% and 6% overweight and obese, respectively. Social dynamics contributing to being overweight or obese are not well explored. Purpose: Exploration of social interaction between parents, children, and society, which may influence feeding activities. Methodology: Grounded theory with embedded quantitative measures used a sample of 20 mothers of overweight or obese children in well-child clinics. Mothers discussed eating practices and completed an inventory providing food intake data, consumption patterns, and child height and weight. Results: Core category: against the tide. Main emerging categories: fun food, the way we do things, my voice, knowing how, emotional pegs, and family first. Quantitative data highlighted possible sources of excessive calories and consumption patterns. Discussion: Normative change, alteration of patterns of social interaction, and empowerment of the mother's role to promote prevention of child overweight and obesity may assist in addressing overweight and obesity among children in this group.