Date of Award


Document Type

Open Access Dissertation


Health Promotion, Education and Behavior


The Norman J. Arnold School of Public Health

First Advisor

Christine E. Blake


Family meals are important family activities that have many positive nutritional and emotional benefits for children. Positive family meal experiences may provide opportunities for children to strengthen emotional bonds, leading to a sense of security and, fostering improved children’s self-regulation of healthier food intake and emotional well-being. Unfortunately, children in food insecure households experience higher amounts of chaos, lower diet quality, and worry about having enough to eat compared to children in food-secure households, all of which may affect both family meal frequency and interpersonal quality. Yet, the relationships between food insecurity, household chaos, and family meal frequency and interpersonal quality are not well understood. Thus, there were two aims for this dissertation study. First, to better understand relationships between household chaos and the regularity and quality of mealtime interactions for food insecure households. Second, to examine the associations between household chaos, the family meal experience (construction, frequency, and mealtime interactions), and child diet quality and perceptions of food insecurity for children living in food insecure households. The first study aim was accomplished by conducting semi-structured interviews about daily activities and family meals with 20 ethnically diverse parent-child (9-15 y) dyads living in food-insecure households in South Carolina. Interviews were recorded and transcribed verbatim. Data were analyzed using a grounded theory approach involving the constant comparative method with Nvivo 10 qualitative data analysis software. The qualitative study results were used to refine the research questions and analysis for the second study aim. For the second aim, data from the Midlands Family Study and the Family Mealtime Study that contained surveys from 132 ethnically diverse caregiver-child (8-15 y) dyads living in food insecure households in South Carolina were used. The data also included a 24-hour recall from the children. Data were analyzed using a multiple mediator model, testing the family meal experience as mediators between household chaos and child outcomes, using STATA 13. Study one revealed that household chaos negatively impacts the construction and frequency of family meals, along with the mealtime interactions. Household chaos also indirectly impacted mealtime interactions through the strength of the interpersonal relationships. Families with poorer interpersonal relationships allowed chaos to negatively affect their mealtime interactions, whereas those with stronger interpersonal relationships sought meaningful interactions despite the chaos. In the second study, household chaos was significantly associated with child diet quality, even with the addition of the mediators. For child worry about food, the family meal experience did significantly mediate this relationship, with high quality mealtime interactions reducing child worry about food. However, television usage during meals was significantly associated with increased child worry about food. Understanding 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. The findings of this study also highlight the need for helping families reduce chaos for improved family functioning.