Parental information, motivation, and behavioral skills correlate with child sweetened beverage consumption.

OBJECTIVE: To evaluate fit of the Information-Motivation-Behavioral Skills (IMB) model applied to sweetened beverage (SB) consumption in children. DESIGN: Cross-sectional. Parents completed a home beverage inventory and IMB survey regarding SB consumption. SETTING: Health fairs, Special Supplemental Nutrition Program for Women, Infants, and Children clinics. PARTICIPANTS: Convenience sample of 198 parents of low socioeconomic status. MAIN OUTCOME MEASURES: Independent variables included scores from 3 indices calculated from the IMB survey, information, motivation, and behavioral skills. The dependent variable was average child daily caloric consumption from SB consumption calculated from the home beverage inventory. ANALYSIS: Structural equation modeling. RESULTS: Parental information had direct and indirect negative relationships with SB consumption. Parental motivation was only indirectly associated with SB consumption mediated through behavioral skills. Parental behavioral skills had a negative correlation with SB consumption. CONCLUSIONS AND IMPLICATIONS: In applying the IMB model to SB consumption, the authors found preliminary support for relationships between parental information, motivation, behavioral skills, and child SB consumption. Application of this model shows promise in identifying the complex interactions between factors influencing consumption behaviors. As nutrition educators frequently desire to alter behaviors, use of the IMB model may help with both targeting and assessment efforts.

Parental perceptions of overweight during early childhood.

Prior to developing an overweight prevention program, researchers examined perceptions of overweight during early childhood among minority, low-socioeconomic status (SES) parents of preschoolers living in Hartford, Connecticut (USA). Content analysis of 10 focus groups (average size = 7) and 18 follow-up interviews revealed parents have a distorted, detached view of clinically defined overweight preschoolers, and they do not include weight in their definition of health. The result is a disconnect in communicating with health care providers regarding overweight during early childhood. Findings suggest that overweight intervention programs will be more effective by focusing on the main concern of parents, which is good health rather than weight. By developing new approaches to communicating the diagnosis and implications of overweight during early childhood, health providers are more likely to be able to work collaboratively with parents to prevent and treat overweight during early childhood.

Differing perspectives of inner-city parents and pediatric clinicians impact management of iron-deficiency anemia.

OBJECTIVE: To ascertain the beliefs and experiences of inner-city pediatric clinicians and parents regarding anemia in young children. DESIGN: Focus groups and in-depth interviews. SETTING: Pediatric clinics and community agencies in Hartford, Connecticut. PARTICIPANTS: Convenience sample of 41 pediatric clinicians (93% white, 73% female) and 85 parents (100% minority, 88% female, 47% < 12 years education). PHENOMENON OF INTEREST: Identification, understanding, and management of anemia. ANALYSIS: Researcher pairs coded complete transcriptions. Recurrent themes were identified, which were then contrasted and compared between clinicians and parents. RESULTS: Both clinicians and parents were familiar with, but frustrated by the persistence of anemia. They noted time constraints and poor communication during office visits as contributing to the problem. Parents felt alarmed upon initial diagnosis; linked anemia with heredity, food patterns, and activity; reported culturally linked management strategies; but were uncertain of the seriousness. Health clinicians saw physiological processes as outside the parents' understanding and emphasized prevention through feeding recommendations. CONCLUSIONS AND IMPLICATIONS: In order to address childhood anemia effectively, differing socio-cultural perspectives of clinicians and parents need to be incorporated into a unified health care plan. Nutritionists are well suited to collaborate on the health care team to effectively address this issue.

Managing anemia in low-income toddlers: barriers, challenges and context in primary care.

Iron-deficiency remains a concern among low-income toddlers in the U.S. This formative study describes how primary care providers serving high-risk 1- to 3-year-old children in an urban ambulatory care setting approach anemia. Data collection included a retrospective review of randomly selected medical records (n=264) and semi-structured interviews with clinicians (n=41). Thirty-eight percent of the children presented with anemia (Hgb < 11.0 g/dl) at least once between 12 and 36 months of age. Just under half of these children were treated for anemia. Follow-up laboratories for iron-treated children were completed within 35 days in 16% of cases (median: 3 months). Interviews identified four key themes (iron-deficiency, communication, poverty, system) running through the two major categories of prevention and treatment. Treatment cut-points were variable. While providers felt clinically comfortable with anemia, they felt burdened and challenged by follow-up. Communication and system barriers weighed most heavily on perceived treatment outcomes.