Date of Award

1-1-2011

Document Type

Campus Access Dissertation

Department

Health Promotion, Education and Behavior

First Advisor

Edward A Frongillo

Abstract

Mothers are typically the primary caregivers, and are responsible for realizing appropriate child feeding practices. Mixed methods were used to understand the effect of maternal demands (i.e., workload, poor health, perceptions, family decisions about child feeding, and poor resources) and capabilities (i.e., mothers' knowledge of child feeding, family support, and food availability) on maternal ability to feed children and children's food consumption. Using qualitative methods, we examined the effect of maternal demands and capabilities on maternal ability to feed children, and how program messages promoting child feeding practices affect maternal ability to feed children. Using a priori codes and allowing for emerging codes, themes were generated and compared across 62 interviews. Twelve group discussions were conducted with mothers to confirm results from individual interviews. Results suggest that demands and capabilities co-exist, and interplay among them influences maternal ability to feed children. Capabilities such as mothers' awareness of program messages and having family support to feed children positively affected maternal ability to feed children. Presence of a single demand such as limited resources in this context, however, sometimes negated these capabilities. Logistic regression was used to examine the association between mothers' food consumption, maternal demands and capabilities, and children's food

consumption of seven foods (egg, fish, legume, meat, dairy, cereal, and vegetables and fruits) in 6-12 and 12-24 month age groups. Some maternal demands (i.e., mothers' misperceptions, lack of time, lack of family support, and child refusal to eat), and capabilities (i.e., knowledge and family support) were significantly associated with children's food consumption for some foods. Mothers' consumption of five of seven foods was significantly associated with children's consumption in both age groups. Some demands and capabilities had direct and indirect effect on children's food consumption for some foods, and the indirect effect was partially mediated through maternal food consumption. Family support emerged to be an important capability. Programs should therefore target family members as well along with mothers to generate support for implementing recommended child feeding practices. Recognizing that programs have to work within the existing set of maternal demands and capabilities is important for designing effective programs.

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