Focus Group Results to Inform

¶ … Focus Group Results to Inform Preschool Childhood Obesity Prevention Programming

This was a qualitative study conducted to ascertain maternal feeding practices and beliefs as to be used as background for development a child obesity prevention program for multi-ethnic parents in the U.S.A. The authors utilized Social Cognitive theory and Self-efficacy theory as the theoretical framework for their study. Social Cognitive theory states that personal attributes, social-environment factors and personal factors all can contribute to or impede individual health behavior change. Self-efficacy describes one's perceived ability to act to make changes (McGarvey et. al 2006). This study found that there is a need to provide interventions that increase parent self-efficacy and build on themes that are specific to ethnic groups so as to prevent childhood obesity. Furthermore, information needs to be provided in the client's own language that takes into account ethnic differences in beliefs and traditions.

Assessment Procedures

The study was conducted in Northern Virginia. Convenience sampling was utilized to enlist WIC clients or those who were eligible but had not yet completed all the forms required to begin WIC services. The process involved the distribution of verbal and written information to parents in the waiting room of the WIC clinic in target areas over several days. Ultimately a total of 24 current or former WIC clients and 1 Vietnamese mother who was not yet a WIC client were recruited to participate. The 23 female participants were joined by 1 Caucasian male. Low income African-American, Caucasian, Hispanic, and Vietnamese parents participated in focus groups designed to elicit cross-cultural perspectives on infant and child feeding practices, childhood weight issues, healthy dietary intake, physical activity and inactivity, and infant feeding information sources. Focus groups were composed of six participants in the African-American group, eight in the Caucasian group, six in the Hispanic group and five in the Vietnamese group. All of the Vietnamese participants and most of the Hispanic participants had been in the country for less than five years, while the Caucasian and African-American participants had all been born in the United States. The focus groups were all conducted in the native languages of the participants by two trained female facilitators, at least one of whom was from the same ethnic group (McGarvey et. al 2006).

A loosely structured topic guide was used to facilitate the collection of relevant information from participants. The topic guide contained a series of open ended questions that were developed with the assistance of researchers with expertise in obesity and nutrition as well as experience conducting focus groups with multi-ethnic, low-income individuals. Wording was purposely neutral to reduce possible biases in responses. The goal was to gather information on participants' perceptions, attitudes, knowledge, beliefs and barriers as they related to infant and child feeding practices, childhood obesity, healthy dietary intake, physical activity and inactivity, and preferred sources of health and feeding information. Question for each of the following topics were developed: (a) what infants and children up to age 3 should eat, (b) how parents decide what to feed their children, (c) knowing when a child has been sufficiently fed, (d) parental control over a child's eating behaviors, (e) concern about overweight in children, (f) using food to influence behavior, (g) parent involvement in physical activity with the child, and (h) preferred methods for learning about child health issues (McGarvey et. al 2006). Furthermore, participants were invited to share experiences related to feeding their child that was outside of these general categories.

An analysis of the data provided three main commonalities to all four groups. A lack of awareness of the relationship between increased physical activity and health, the effects of the use of food to influence behavior, concern over a loss of parental control over feeding when a child starts child care or school and finally, the data revealed perspectives specific to each group on age appropriate food and infant satiety.

Reliability and Validity

Data analysis involved the audio taping and transcription of each focus group, omitting the names of the participants. Printed transcriptions were then provided to two additional independent researchers for analysis. Categories of participant responses were organized and researchers discussed and resolved issues around the conceptual framework and the credibility of the categorized major themes. The process of review was repeated until a point of theoretical saturation was reached. A summary of the themes was then compiled for final review.