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Changing children's diets: developing methods and messages

Hart, K., Bishop, J., Truby, H.
Journal of human nutrition and dietetics 2003 v.16 no.5 pp. 365-366
attitudes and opinions, behavior change, child nutrition, childhood, childhood obesity, cohesion, education programs, exercise, focus groups, foods, gender, healthy diet, models, noninsulin-dependent diabetes mellitus, nutrition education, nutrition knowledge, parents, questionnaires, school children, socioeconomic status, stereotyped behavior, United Kingdom
With an increasing prevalence of childhood overweight and obesity within the UK (Chinn & Rona, 2001) and the emergence of type II diabetes as a childhood condition (Kaufman, 2002), primary school children represent an important target group for health promotion. However, the increasing social and financial freedom enjoyed by this population is unlikely to be matched by an increase in their food control, cognitive abilities or the perceived need required to facilitate healthy behaviours, especially food choice. Thus, indirect attempts at behavioural modification are needed, with parents indicated as potentially powerful education intermediaries. This presentation will summarize the key findings of a 3-year research project which aimed to investigate the current motivators and reinforcers for behaviour change within the families of primary school children in the UK. Three separate studies, utilizing both qualitative and quantitative methodologies, were undertaken with a total of 253 parents of primary school children, recruited from locations within the south east and the north west of the UK. Using focus groups and a questionnaire developed to assess the key constructs of the Theory of Planned Behaviour (Ajzen, 1988), the barriers and benefits perceived by parents to be associated with the provision of a healthy diet were identified and quantified. These results were used to inform the development of a parental education programme, which was subsequently pilot tested and evaluated in order to highlight the practical implications for intervention delivery within this population. Results indicated a general rejection by parents of traditional nutritional messages and sources in favour of a more concrete but flexible approach with a short-term health focus delivered by neutral agencies. Although healthy eating was viewed positively, parents tended to set themselves unrealistic targets and to have suboptimal nutritional knowledge and an inadequate awareness of their own influence as a model for their child's behaviour. Negative approaches to food control were frequently observed along with practical barriers to education uptake. Results would suggest that behavioural techniques should be promoted in preference to simple fact acquisition and novel, possibly ‘virtual’ approaches to parent–educator contact are worthy of further investigation. Differences in parental attitudes and behaviour were observed between families of different socio-economic status (SES). Parents also appeared to reinforce inappropriate gender stereotypes in relationship to food and exercise behaviour. Social support was shown to positively impact on parental intention to provide a healthy diet. Although tailored nutrition education programmes are required which promote behavioural techniques via SES sensitive approaches, this research has confirmed the overarching role of environmental support. By nurturing family and community cohesiveness, the potential for long-term behavioural change and health improvements in primary school-aged population may be realized.