Date of Award

Spring 2020

Document Type

Open Access Dissertation

Department

Health Promotion, Education and Behavior

First Advisor

Edward A. Frongillo

Abstract

Background: The diets of children in the United States typically do not meet dietary guidelines. Energy-dense nutrient-poor (EDNP) foods dominate children’s diets, contributing excessive energy, sugar, sodium, and fat intake. Home is the major source of children’s energy intake. Parents oversee household food purchases including foods for children.

Objectives: This research aimed to 1) identify parents’ food and beverage purchases for their household and for 6-11-year old children; 2) understand how parents made food purchase decisions by adjudicating among different values; 3) understand children’s food choice construction, strategies to influence parents for desired items, and extent of children’s influence.

Methods: Semi-structured qualitative interviews were conducted with 40 parents and their 6-11 years old children from South Carolina. Food shopping receipts for one week were collected. The interviews were audio-recorded, transcribed verbatim, and open-coded. Coding matrices compared decision-making processes by race/ethnicity, household food security, and child age; and parent-child perspectives on children’s strategies to influence parents’ food purchases.

Results: Satisfying children's desire was the driving value in parents’ food purchasing decisions. Parents purchased desired breakfast items, snacks, fruits, fast food, and drinks specifically for children. Parents experienced conflicts among children’s desire, food acceptance, emotions, health needs, food’s healthfulness, convenience, and cost. Value conflicts were exacerbated by stress. Parents wanted to purchase healthy foods if children desired. Children weighed three values, on average, to make food choices. Children in our sample reported 157 strategies that they used to influence parents’ food purchases including repeated polite requests, reasoned requests, and referencing friends. Parents had concordance with 83 of those strategies; more concordance was observed between parents and sons than daughters. Eighty percent of the parents perceived children had more than 50% influence on food purchases. One-third of the children perceived that their parents bought their desired items a lot or often.

Conclusions: Children’s desire for, acceptance of, and emotions toward foods and drinks were important in parents’ decision making. Foods that parents purchased as per children’s requests were mostly EDNP except fruits. Interventions may help parents develop alternative strategies to make healthy items appealing to children instead of yielding to unhealthy food requests, and bridge the gap between their knowledge and purchases. Parents’ acknowledgement of children’s substantial influence on them suggests that children can serve as change agents for improving parents’ food purchases if children request healthy options.

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