Qualitative Evaluation of Drivers of Eating Decisions among SNAP Participants in Mississippi.

OBJECTIVE: To explore food-related decision patterns among Supplemental Nutrition Assistance Program (SNAP) recipients in Mississippi. DESIGN: A qualitative design was used to conduct focus groups (n = 18) based on the Health Belief Model with low-income female caregivers of children aged under 13 years. SETTING: Mississippi. PARTICIPANTS: Cluster sampling was used to recruit participants (n = 126) from the 4 regional divisions of Mississippi State University Extension. PHENOMENON OF INTEREST: Drivers of eating decisions among SNAP participants. ANALYSIS: Focus groups were recorded, transcribed, and coded by 2 independent coders using thematic analysis. RESULTS: Drivers of food selection often overlapped with barriers to healthy eating. Participants used many strategies to manage costs and viewed healthy foods as out of reach and quick to perish. Cost, taste preferences, habits, and family factors were primary drivers of food selection and preparation; each of these presented barriers to healthier eating. Health was most often shared as a driver of food selection once disease was established. Participants reported a variety of strategies used in striving for healthier eating. CONCLUSIONS AND IMPLICATIONS: Focusing on ways to manage the costs of healthy foods, honor taste preferences, and work within habits/families may enhance efforts to support healthy eating among SNAP participants.

Childhood nutrition in the Mississippi Delta: challenges and opportunities.

Childhood obesity in the USA has more than tripled in the last three decades, and the prevalence is higher in the Mississippi Delta. Insight into the social, cultural and environmental factors that influence inequity can inform efforts to mediate health disparities. Focus groups (n = 12) among parents/guardians of elementary school children (n = 44) and teachers (n = 59) in the Mississippi Delta were used to investigate barriers and facilitators of healthy eating. Transcriptions were analyzed for themes. A strong preference for junk food among children and the pervasiveness of junk foods in schools and communities were cited as barriers to healthy eating. Potential facilitators of healthy eating included desire to avoid chronic disease, effort to limit junk food consumption and school support. Despite support for efforts to improve nutrition in the Delta, participants voiced a sense of inevitability related to children's consumption of unhealthy foods. This study suggests that parents and teachers express concern related to eating habits of children, yet they experience barriers to healthy eating which contribute to a sense of disempowerment. Improving health in the Mississippi Delta requires comprehensive strategies that offer its citizens a sense of agency.

We Never See Children in Parks: A Qualitative Examination of the Role of Safety Concerns on Physical Activity Among Children.

BACKGROUND: Previous literature indicates physical activity and obesity are interrelated problems, especially among children in disorganized environments. METHODS: Qualitative focus groups were conducted with parents of elementary school children located within the Mississippi Delta to answer one overarching research question: "What influence do safety concerns have on physical activity for children in the Mississippi Delta?" RESULTS: There were 2 large themes; first was that recreational areas were criminal and the second was that safety concerns were a barrier to physical activity. Safety concerns as a barrier to physical activity rendered 3 sub-themes, including 1) Parental fear of crime inhibited the use of public recreational spaces, 2) Parental perceptions of police as ineffective and untrustworthy reduced the use of public spaces where children might play, and 3) Parents often expressed safety-induced intense supervision requirements that limited the physical activity of their children. CONCLUSIONS: Our study provides valuable insights into the mechanisms by which safety concerns limit physical activity of children in the Mississippi Delta.

Race and gender disparities in nutrient intake are not related to metabolic syndrome in 20- to 59-year-old US adults.

BACKGROUND: The goal of this study was to examine the relationship between macronutrient and micronutrient intake and metabolic syndrome within race and gender cohorts of young US adults. METHODS: The 2007-2010 National Health and Nutrition Examination Survey (NHANES) data for adults (n=2440) aged 20-59 were analyzed. Two 24-hr dietary recalls were used to measure intake of total calories, macronutrients, and 20 vitamins and minerals. Metabolic syndrome and its components were defined by the National Heart, Lung and Blood Institute criteria. Differences in statistical tests were noted when significant at P<0.05. RESULTS: Prevalence of metabolic syndrome among 20- to 59-year-old adults was 30.4% [95% confidence interval 27.6-33.2]. Among cohorts, metabolic syndrome was highest in black women and white men, and lowest in black men and white women. Regression analysis indicated that no macronutrients were associated with greater risk of metabolic syndrome. For relative macronutrient intake, men with metabolic syndrome consumed more polyunsaturated fats, whereas women with metabolic syndrome consumed more total, saturated and monounsaturated fats and less fiber and starch than women without metabolic syndrome. Among races, white men and women consumed greater absolute quantities of all macronutrients except carbohydrates and sugar. Micronutrient intake was greatest for white men and women; women without metabolic syndrome had greater micronutrient adequacy than women with metabolic syndrome. CONCLUSION: Nutrient intake varied between race/gender cohorts; however, there were few clinically significant differences in nutrient intake between those with and without metabolic syndrome. Diet may be marginally related to diagnosis of metabolic syndrome.

Family characteristics have limited ability to predict weight status of young children.

The ability of (a) family characteristics (marital status, income, race, and education), (b) parental control over child's food intake, and (c) parental belief in causes of overweight to predict weight status of children was assessed. Parents/caretakers of elementary school-aged children were surveyed to determine attitudes related to childhood nutrition and overweight. Anthropometric measurements were obtained from children to determine weight status (n=169 matched surveys and measurements). chi(2) tests and nested logistic regression models were used to determine relationships between children's weight status and family characteristics, parental control, and parental belief in the primary cause of overweight. Low household income was an important predictor of overweight; marital status and race added no further explanatory power to the model. Parental control was not a significant predictor of overweight. Parental belief in the primary cause of overweight in children (diet vs physical activity) was significantly related to children's weight; however, it was not significant after controlling for income. Low household income relates strongly to increased childhood weight status; therefore, school and government policies should promote an environment that supports affordable, safe, and feasible opportunities for healthful nutrition and physical activity, particularly for low-income audiences.

Dietary acculturation of Hispanic immigrants in Mississippi.

OBJECTIVE: Assisting Hispanic immigrants in making culturally acceptable food choices may affect their health for generations. As a relatively new enclave of Hispanics, Scott County, Mississippi, was chosen to study dietary acculturation and health concerns of immigrants. MATERIAL AND METHODS: The research method consisted of interviews with community representatives (N=11), a focus group (N=6), and interviews with Hispanic immigrants (N=18). RESULTS: Community representatives mentioned availability influenced immigrants' food choices and suggested promoting cultural awareness and offering nutrition classes on local ingredients. Food cost, health concepts, food selection, and eating habits of children were salient themes from the focus group and interviews with Hispanics. Hispanic participants mentioned long work hours affect food selection and that U.S. produce lacks freshness and flavor. CONCLUSIONS: Results indicate that an intervention must be formulated that preserves healthful dietary practices and minimizes the negative health aspects of acculturation to the "American diet"

Dietary acculturation of Hispanic immigrants in Mississippi

OBJETIVO: Ayudar a inmigrantes hispanos en la elección de una dieta culturalmente aceptable puede incidir sobre su salud por generaciones. Para estudiar la relación entre aculturación alimentaria y salud en los inmigrantes, se escogió Scott County, Mississippi, un enclave relativamente nuevo de inmigrantes hispanos en Estados Unidos de América (EUA). MATERIAL Y MÉTODOS: El método de investigación consistió en entrevistas con representantes de la comunidad (N=11), un grupo focal (N=6) e inmigrantes hispanos (N=18). RESULTADOS: Representantes de la comunidad mencionaron que lo que influye en la elección de sus alimentos es la disponibilidad de éstos; asimismo sugirieron la organización de actividades para conocer diferentes culturas, al igual que clases de nutrición para aprender cómo utilizar ingredientes locales. Cinco fueron los temas más relevantes que se identificaron durante las entrevistas con los inmigrantes y el grupo focal: el precio de la comida, ideas sobre la salud, factores que influyen en la selección de la comida y la nutrición de los niños inmigrantes. Los participantes hispanos mencionaron que las jornadas de trabajo tan largas afectan la selección de la comida y que los productos del campo en EUA no son frescos ni tienen sabor. CONCLUSIONES: Los resultados indican que hace falta una intervención que ayude a preservar prácticas alimentarias saludables y que minimice los aspectos negativos de la aculturación por la dieta predominante en EUA.