Experiences and Situations of Shame among Food-insecure Adolescents in South Carolina and Oregon.

Shame experienced with food insecurity and participating in food assistance may affect adolescents. We investigated adolescents' experiences of shame related to food insecurity and situations for these experiences in an ethnically diverse sample of 40 adolescents aged 9-15 years from South Carolina and Oregon. In-depth interviews were recorded, transcribed, coded, and analyzed. Participants described feelings of sadness, anger, and internalized shame with food insecurity. Salient situations were participating in food assistance, seeking food assistance from others or community services, and social encounters at school among peers. Adolescents felt shame knowing that peers were aware of their food insecurity and about them participating in food assistance through school.

Disrupted Relationships, Chaos, and Altered Family Meals in Food-Insecure Households: Experiences of Caregivers and Children.

BACKGROUND: Regular family meals foster healthy physical and social development of children but often occur less frequently in households experiencing food insecurity. How food insecurity influences the quality of these interactions is not understood well. OBJECTIVE: To better understand family meal experiences of caregivers and children living in food-insecure households. DESIGN: A qualitative method with cross-sectional sample was used, collecting data using semistructured interview guides. PARTICIPANTS: Twenty ethnically diverse caregiver-child (aged 9 to 15 years) dyads in South Carolina were interviewed. STATISTICAL ANALYSIS: Data were analyzed using grounded theory in Nvivo 10. RESULTS: Food-insecure households described family meals that varied in frequency, location, and quality of foods served, especially during times of food shortages. Interpersonal relationships drove the quality of mealtime interactions for these households. Household chaos not only influenced the frequency and location of meals, but also strained mealtime interactions in households with poor interpersonal relationships. In these homes, household chaos included conflicts with work and afterschool schedules, food shortages, coping with poverty and food insecurity (eg, working extra hours or seeking food assistance), and children visiting multiple homes, particularly when food was limited. All households experienced chaos, but strong interpersonal relationships were described as the primary reason for enjoyable mealtime experiences with few disruptions. CONCLUSIONS: Exploring family meal experiences of children in food-insecure households highlights the importance of interpersonal relationships and regular, positive mealtime interactions that may strengthen emotional connections in families to improve child health outcomes.

Sensitizing Future Health Professionals to Determinants of Childhood Obesity.

Long-term solutions to the childhood obesity epidemic will require concerted interdisciplinary efforts that are sensitive to both individual and social determinants of health. The Junior Doctors of Health© (JDOH) program involves interprofessional education (IPE) with university students from health science fields (e.g., medicine, pharmacy, social work, public health) who deliver an interactive program in teams to at-risk school-aged youth. The purpose of this study was to assess the impact of participation in the JDOH IPE program on university students' beliefs about childhood obesity. Fifty-three of the 71 health sciences students enrolled in the JDOH IPE program between 2011 and 2013 participated in this study. Pre- and post-surveys assessed students' beliefs about the importance, causes of, and responsibility for reducing childhood obesity with both closed- and open-ended questions. In 2013, quantitative data were analyzed using Wilcoxon matched-pairs signed-rank tests and qualitative data were analyzed through open coding to identify emergent themes. Results indicate that after participation in the JDOH IPE program, students' identification of social and environmental causes of childhood obesity increased significantly. Further, students' ranking of the importance of obesity was initially higher than those of different issues typically portrayed as social or environmental (e.g., youth violence) but it was similarly ranked after participation in JDOH. This suggests a greater sensitivity to social and environmental challenges faced by youth. Findings suggest that IPE experiences that bring clinical and community-oriented health professions together to engage with disadvantaged youth foster sensitivity to the complexities of childhood obesity in low-income settings.