Food Insecurity and Changes in Diet Quality and Body Mass Index z-Scores Among Elementary School Students.

Background: Previous research has identified food insecurity as a risk factor for obesity but those studies employed cross-sectional designs and were largely focused on adults and young children. In addition, there is a paucity of studies examining the association between food insecurity and changes in children's overall diet quality. This study aimed to assess whether food insecurity is associated with subsequent changes in diet quality and BMI z-scores over 2 years among 7- to 12-year-old children. Methods: We used 2011-2019 secondary data (n = 404) from three randomized controlled trials in Minnesota. Food insecurity was identified using the U.S. Household Food Security Survey Module at baseline (Time 0). Diet quality was determined using the Healthy Eating Index (HEI)-2015 from 24-hour recalls, and BMI z-scores were calculated using measured height and weight. These two outcomes were measured at Time 0, Time 1 (10-12 months from Time 0), and Time 2 (15-24 months from Time 0). Results: Compared with children from food-secure households, those from food-insecure households experienced a 0.13 greater increase in BMI z-scores from Time 0 to Time 2 [95% confidence interval (CI): 0.04 to 0.21] and a 4.5 point increase in HEI-2015 from Time 0 to Time 1 (95% CI: 0.99 to 8.01). Conclusion: Household food insecurity may widen weight disparities among elementary school-aged children. Further studies are needed to identify the role of diet quality in weight changes among children with food insecurity. Clinical Trial Registration Number: NCT01538615, NCT02029976, NCT02973815.

Differences in mobile food market customer outcomes between 2019 and 2021.

OBJECTIVES: To evaluate the outcomes of increasing mobile market service from mostly biweekly in 2019 to weekly in 2021. DESIGN: Repeated, cross-sectional customer intercept surveys. SAMPLE: Mobile market customers in Summers 2019 (N = 302) and 2021 (N = 72). INTERVENTION: Mobile food markets bring affordable, high-quality foods to communities that lack such access. MEASURES/ANALYSIS: Outcomes included food security, fruit/vegetable intake, and food-related characteristics and behaviors. General linear and logistic regression models were used to assess associations between outcomes and survey year and length of mobile market shopping. Models were adjusted for economic assistance use, race, and ethnicity. RESULTS: No outcomes were significantly different between 2019 (with mostly biweekly service) and 2021 (with weekly service). Length of mobile market shopping (e.g., >2 years, 1-2 years, etc.) was positively associated with affordable, quality food access (ß = 0.20, SE = 0.10, p = .03) and fruit/vegetable intake (ß = 0.28, SE = 0.08, p < .001) as well as lower odds of food insecurity in the last 12 months (aOR = 0.79, 95% CI = 0.64, 0.99). CONCLUSIONS: Despite COVID-19 interrupting scheduled market service, the length of time that a survey respondent identified as a full-service mobile market customer was associated with higher food access and fruit/vegetable intake and reduced food insecurity odds. These findings suggest promise and encourage further evaluation.

Food Insecurity and Parent Feeding Practices in Urban and Rural Children Ages 7-12 years.

Objective: To examine associations between food insecurity and parent feeding practices for children ages 7-12 years; to determine differences between cohorts in urban and rural communities. Design: Secondary analysis using baseline data from 2 randomized controlled trials: HOME Plus (urban) and NU-HOME (rural). Participants: Convenience sample of 264 parent-child dyads. Children were 51.5% female, 9.28 ± 1.45 years. Variables Measured: Dependent variables included the Child Feeding Questionnaire (CFQ) restrictive feeding subscale, parent modeling of fruits and vegetables score, and family meal frequency (FMF) at breakfast and the evening meal. Food insecurity was the primary independent variable. Analysis: Multivariable linear or Poisson regression for each outcome. Results: Food insecurity was associated with a 26% lower weekly rate of FMF at breakfast (95% CI 6%-42%; p=0.02). In stratified analysis, this association was only in the rural NU-HOME study (44% lower weekly rate; 95% CI 19%-63%; p=0.003). Food insecurity was not associated with CFQ restrictive score, parent modeling score, or FMF at the evening meal. Conclusions and Implications: Food insecurity was associated with less frequent family breakfast, but not with other parent feeding practices. Future studies could investigate supportive mechanisms for positive feeding practices in households experiencing food insecurity.

Parent Weight, Diet, Active Living, and Food-Related Outcomes of the Family-Focused:NU-HOME Randomized Controlled Trial: NU-HOME Randomized Controlled Trial.

BACKGROUND: Little is known about parent outcomes of rural, family-focused childhood obesity prevention trials. OBJECTIVE: Our aim was to evaluate parent outcomes of the rural, family-focused NU-HOME (New Ulm at HOME [Healthy Offerings via the Mealtime Environment]) randomized controlled trial designed to prevent obesity in children aged 7 through 10 years. DESIGN: Families were randomized to the intervention or wait-list control group after baseline data collection. Staff measured parent height, weight, and percent body fat. Surveys measured parent cognitive and behavioral outcomes (eg, portion-size confidence, dietary intake, total and moderate-to-vigorous physical activity, and screen time). Post-intervention data were collected 8 to 10 months after baseline. PARTICIPANTS/SETTING: The randomized controlled trial took place in rural, south central Minnesota, and enrolled parent and child dyads (N = 114; 2017-2018); 98 parents provided data at post intervention (2018-2019) and comprise the analytic sample. Parent inclusion criteria were being the primary meal preparer, living with the child most of the time, and being willing to attend intervention sessions. Exclusion criteria were planning to move or having a medical condition that would contraindicate participation. INTERVENTION: The theory-guided intervention (7 sessions and 4 goal-setting calls) focused on family eating and active living behaviors. MAIN OUTCOME MEASURES: Height, weight, and percent body fat were measured and the survey assessed diet, active living, and food-related outcomes. STATISTICAL ANALYSES PERFORMED: Multiple linear regression models tested change in parent outcomes from baseline to post intervention by treatment group adjusted for demographic characteristics and baseline values. RESULTS: In the intervention group vs control group, parent total weekly hours of physical activity was 1.73 hours higher (95% CI 0.11 to 3.35 hours) and portion-size confidence was 1.49 points higher (95% CI 0.78 to 2.19). No other statistically significant changes were observed by treatment group. CONCLUSIONS: Findings indicate that parent cognitive and behavioral outcomes are amenable to change in family-focused childhood obesity prevention programs. Parent increases in portion-size confidence and total physical activity hours may support long-term parent health and provide positive context for child health.

Are patterns of family evening meal practices associated with child and parent diet quality and weight-related outcomes?

Family meal practices such as family member presence, fast food consumption and media usage have been associated with health outcomes. However, little is known about combinations of family meal practices and their effects on diet and health. This secondary data analysis aimed to identify patterns of family evening meal practices and examine their associations with family characteristics (e.g., demographics and chaos) and child and parent diet quality and weight-related outcomes. We used baseline data from a community-based randomized controlled trial with 7- to 10-year-old children and their parents in rural Minnesota (n = 114). Parent-reported structural (e.g. media usage) and interpersonal (e.g. mealtime routines) aspects of family evening meal practices were included in latent profile analyses to identify patterns. Diet quality was assessed by child Healthy Eating Index-2015 and parent fruit and vegetable intake. Weight-related outcomes were determined using measured body mass index (z-scores) and percent body fat. A 3-class model was the model of best-fit. The Unplanned Infrequent Family Evening Meals with Mixed Healthfulness class (C1) featured the least frequent family evening meals and the lowest scores for mealtime routines and planning skills. The Family Evening Meals with Fast Food class (C2) characterized having family evening meals four times a week, but fast food was often served. The Planful, Healthful and Frequent Family Evening Meals class (C3) reported the highest meal routine and planning scores as well as frequent family evening meals. Parents in C3 had higher consumption of fruits and vegetables and children in C3 had lower percent body fat, compared to those in other classes. Distinctly different patterns of family evening meal practices suggest a need for considering heterogeneity of family evening meal practices in developing tailored family-meal interventions.

Family Characteristics Associated with Preparing and Eating More Family Evening Meals at Home.

BACKGROUND: Research has demonstrated dietary quality benefits of family meals and meals prepared at home. Less is known about associations between the proportion of family evening meals made at home and key personal, behavioral, and environmental characteristics. Moreover, most studies often measure these data retrospectively. OBJECTIVE: The objective of this study is to describe the proportion of evening meals made at home measured in real time and to assess associations between personal, behavioral, and environmental characteristics that are associated with a higher proportion of evening meals prepared and consumed at home. DESIGN: This study is a cross-sectional secondary analysis of baseline data collected during 2017 and 2018 from the New Ulm at Home study, a randomized controlled trial conducted in rural Minnesota to evaluate the effectiveness of a childhood obesity prevention program for school-aged children. PARTICIPANTS/SETTING: The present study analyzes a subset of the New Ulm at Home trial data from families (N = 108) who completed at least four evening meal screeners collected in real time with ecological momentary assessment technology over a 2-week period. MAIN OUTCOME MEASURE: The main outcome measure was the proportion of family evening meals made at home, calculated using two cutpoints (≤50% of evening meals prepared at home vs >50%; ≤70% vs >70%). STATISTICAL ANALYSIS: Descriptive statistics were used to describe the proportion of evening meals prepared at home. Logistic regression analyses adjusted for parent education were used to assess associations between family characteristics and the two different proportions of meals made at home. RESULTS: Most family evening meals were prepared and eaten at home (62%). Logistic regression models indicated meal planning skills (odds ratio=1.19, 95% CI 1.01 to 1.39) and mealtime routines (odds ratio=1.20, 95% CI 1.03 to 1.40) were significantly associated with odds of preparing more than 50% of evening meals at home. Only meal planning skills (odds ratio=1.27, 95% CI 1.06 to 1.51) was significantly associated with odds of preparing more than 70% of evening meals at home. CONCLUSIONS: Study findings indicated mealtime routines and meal planning skills were associated with preparing more than 50% of evening meals at home, but only meal planning skills were associated with preparing more than 70% of evening meals at home, which may suggest the importance of adapting interventions for families. Future research should build on these findings in randomized controlled trials.

Food insecurity, food-related characteristics and behaviors, and fruit and vegetable intake in mobile market customers.

Mobile markets (MM) bring affordable, quality, healthy foods to high-need, low-food access communities. However, little is known about food insecurity of MM customers. This manuscript evaluates food insecurity prevalence in MM customers and assesses associations between food insecurity and MM use, food-related characteristics and behaviors, and fruit and vegetable (FV) intake. Customers (N = 302) completed cross-sectional surveys in summer 2019 that assessed: food security, food availability, cooking attitude, self-efficacy for healthy cooking, self-efficacy for cooking and eating FV, social connectedness, and FV intake. Descriptive and multivariate analyses were used to describe and assess associations with food insecurity and FV intake. Results show most MM customers were food insecure (85%). In logistic regression models adjusted for sociodemographic characteristics, long-term MM use (OR = 0.77, CI = 0.60-0.997), access to affordable, quality foods (OR = 0.81, CI = 0.71-0.93), and self-efficacy for both cooking healthy foods (OR = 0.88, CI = 0.80-0.97) and cooking and eating FV (OR = 0.90, CI = 0.82-0.98) were associated with lower odds of food insecurity; negative cooking attitudes (OR = 1.12, CI = 1.02-1.24) were associated with higher odds of food insecurity. Being food insecure (ß = -1.37, SE=0.43, p < 0.01) was associated with poorer FV intake; this association attenuated slightly (ß = -1.22, SE=0.43, p < 0.01) when length of MM use was added to the general linear model, which was also associated with higher fruit and vegetable intake (ß = 0.26, SE=0.10, p = 0.01). Results suggest the MM reaches customers experiencing high levels of food insecurity and long-term MM use is associated with lower food insecurity and higher FV intake. Relationships between food insecurity and several food characteristics/behaviors provide insight for potential targets for wrap-around interventions to address food insecurity among customers. Findings suggest longitudinal evaluation of the MM's impact on food security and other food-related characteristics/behaviors is warranted.

Risk for depression and suicidal ideation among food insecure US veterans: data from the National Health and Nutrition Examination Study.

BACKGROUND: Suicide and food insecurity (i.e., lack of access to food) are two major issues that affect US Veterans. PURPOSE: Using a US-based sample, we evaluated the association between food insecurity and suicidal ideation among Veterans. Because depression often precedes suicide, we also examined the association between food insecurity and depression. METHODS: Using data from 2630 Veterans who participated in the National Health and Nutrition Examination Survey 2007-2016, we conducted an adjusted linear regression model to evaluate the association between food insecurity (measured using 18-item Household Food Security Survey) and depression (measured using PHQ-9) and an adjusted binary logistic regression model to evaluate the association between food insecurity and suicidal ideation (measured using PHQ-9 Question 9). Models were adjusted for gender, age, income-to-poverty ratio, race/ethnicity, and education level. RESULTS: Of the sample, 11.5% were food insecure, depression scores averaged 2.86 (SD = 4.28), and 3.7% endorsed suicidal ideation. Veterans with marginal (ß = 0.68, 95%CI [0.09,1.28]), low (ß = 1.38, 95%CI [0.70,2.05]) or very low food security (ß = 3.08, 95%CI [2.34, 3.83]) had significantly increased depression scores compared to food secure Veterans. Veterans with low (OR = 2.15, 95%CI [1.08, 4.27]) or very low food security (OR = 3.84, 95%CI [2.05, 7.20]) had significantly increased odds for suicidal ideation compared to food secure Veterans. CONCLUSION: Food insecurity in Veterans is associated with increased depression symptoms and suicidal ideation. This association strengthens as food insecurity worsens. Veterans with food insecurity should be screened for depression and suicidal ideation. Simultaneously, depression treatment plans and suicide prevention programs should consider basic needs like food security.

Universal childhood obesity prevention in a rural community: Study design, methods and baseline participant characteristics of the NU-HOME randomized controlled trial.

Childhood obesity is a major health concern in the United States (US) and those living in rural communities are at higher risk than their urban counterparts. Few prevention trials have engaged whole families of school-age children in community settings, and none to date have promoted family meals, family activity and healthful home environments in rural settings through a rigorous, randomized controlled trial (RCT). The New Ulm at HOME (NU-HOME) study recruited 114 parent/child dyads in a two-arm (intervention versus wait-list control) RCT to test the efficacy of a family meals-focused program aimed to prevent excess weight gain among 7-10 year-old children in rural Minnesota. The NU-HOME program was adapted from a previously tested program for urban families through a unique community collaboration. The program included 7 monthly in-person sessions for all family members. Parents also participated in 4 motivational goal-setting phone calls. The primary outcome measures were age- and sex-adjusted child body mass index (BMI) z-score, percent body fat, and incidence of overweight and obesity post-intervention. Secondary outcomes included quality of food and beverage availability in the home; family meals and snacks; children's dietary intake quality (e.g., Healthy Eating Index (HEI)-2015, fruits and vegetables, sugar-sweetened beverages, snacks); and children's screen time and weekly minutes of moderate-to-vigorous physical activity, total physical activity, and sedentary behavior. The NU-HOME RCT was a collaborative effort of academic and health system researchers, interventionists and community leaders that aimed to prevent childhood obesity in rural communities through engagement of the whole family in an interactive intervention.

The East Side Table Make-at-Home Meal-Kit Program is feasible and acceptable: A pilot study.

Drawing from marketing literature, shopper solutions and food bundles (that group items to be used together) can promote purchase intention, efficacy, and related outcomes. Similarly, meal kits boxes (food bundles with step-by-step instructions to prepare home-cooked meals) have potential to be an accessible intervention to facilitate healthy, at-home food preparation and intake. This manuscript describes the feasibility, acceptability, and preliminary outcomes of a community-designed and -led program promoting healthy food skills, accessibility, and intake through meal kits. This pilot study was designed using community-based participatory research principles and 60 participants enrolled in the study. Participating families received a free meal kit weekly during the 10-week program. Meal-kit boxes also included language-appropriate recipe cards, step-by-step instructions, and supplemental educational material including links to videos with related food preparation tips and fact sheets about the meal. Data were collected at baseline, post-program, and follow-up (3 months post-program). Specifically, validated measures were used to assess food insecurity, food availability, cooking preparation techniques, self-efficacy, and fruit/vegetable intake. Process data were also collected. Descriptive statistics, paired t-tests, and Wilcoxon sign-ranked tests were used to describe data and evaluate outcomes. Content analysis was used to code open-ended survey responses into categories. Study findings indicated retention rates were high (≥90%); 83% made eight or more meal kits. At post-program, significant increases were observed in cooking/meal preparation self-efficacy, cooking techniques, and healthy food availability. At follow-up, only healthy food availability remained significantly higher. Findings suggest that meal-kit programs are feasible and acceptable, and there is a potential for these programs to influence factors important to increasing healthy home-cooked meals and dietary intake. Future research should use more rigorous designs and explore meal-kit dosage.

Service learning within community-engaged research: Facilitating nursing student learning outcomes.

The objective of this manuscript is to describe a method of integrating baccalaureate nursing student service-learning experiences within a randomized controlled trial conducted in a community setting to facilitate student learning and expose students to the nursing scientist role. Placing students in a research service-learning experience involved several steps beginning with finding a nursing program for potential collaboration where this service-learning opportunity would be a natural fit with course content and formalizing the collaboration between the two institutions. Upon receipt of research grant funding, researchers and course faculty worked to navigate logistics and place students within the service-learning experience. After research training, 35 students assisted with intervention delivery and completed course assignments to document their learning. The collaboration described between a community-engaged research team from a research-intensive university and course faculty from a distant institution could be replicated with all types of nursing research.

Full-Service Twin Cities Mobile Market Impact: Qualitative Findings From Focus Groups With Customers.

BACKGROUND: Creative solutions are required to mitigate poor food access and related health disparities in underserved, at-risk populations because healthy food access is an important social determinant of health. Mobile markets (ie, mobile grocery stores) present a potential solution to mitigate poor food access and related health disparities. However, no research has yet evaluated the impact of a full-service mobile market that sells healthy items from all food groups and pantry staples in underserved communities. OBJECTIVE: Therefore, the objective of this focus group research study was to inductively understand the impact of the full-service, Twin Cities Mobile Market, a mobile grocery store, that visits underserved, low-income communities. DESIGN: Qualitative focus group research. PARTICIPANTS/SETTING: Four moderated and audio-recorded, qualitative focus groups with customers (n = 29) were held in community rooms at mobile market stops. ANALYSIS: Focus group transcripts were analyzed using Krueger's systematic analysis process and content analysis to discover major categories and themes and subthemes within the categories. RESULTS: Findings indicate the full-service mobile market may facilitate purchase and eating of healthy foods through decreasing barriers and increasing access to quality, affordable healthy foods. Findings also indicate mobile market shopping may positively influence customer behaviors and health outcomes (eg, dietary intake and management of weight, diabetes, blood pressure, and mental health). CONCLUSIONS: Our results provide support for the potential impact of full-service mobile markets, encouraging continued mobile market service and future rigorous research on the effectiveness of the full-service mobile market model.

Appreciation of the Research-Practice Link: Authentic Learning Environments for Writing-Intensive Nursing Courses.

Undergraduate students often perceive a disconnect between research and nursing practice. To support student understanding of this relationship, an innovative, authentic learning environment was created in a writing-intensive, capstone-level nursing course. Authentic learning environments couple real-life situations/simulations with personal, experiential learner engagement. Students completed pre- and postsurveys assessing their beliefs about and confidence in using research to inform practice. Quantitative and open-ended qualitative responses were analyzed with inferential statistics and conventional content analysis techniques, respectively. Findings suggested the learning environment increased student confidence and facilitated connections between research and practice, supporting continued use and further evaluation of this approach.

Description of public health nursing nutrition assessment and interventions for home-visited women.

OBJECTIVE(S): The purpose of this manuscript was to describe: Public Health Nurse (PHN) home-visited, female client Nutrition Knowledge (K), Behavior (B), and Status (S); the number and types of nutrition interventions PHNs used with these clients; and the types of clients receiving nutrition interventions. DESIGN AND SAMPLE: This descriptive study used PHN-generated Omaha System, electronic health record data from January 2012 to July 2015. The analytic sample contains 558 women who received home visits in a rural Midwestern U.S. county that employed universal nutrition assessment for clients. MEASUREMENTS: Omaha System data included nutrition KBS scores (from 1 = low to 5 = high) and nutrition interventions delivered. Analyses included descriptive, bivariate, and multivariate analyses (means, frequencies, chi-squares, general linear models). RESULTS: PHNs assessed nutrition KBS scores for 84.1% of clients; average Nutrition Knowledge was 3.4 (SD = 0.7), Behavior 3.7 (SD = 0.8), and Status 4.3 (SD = 1.0). PHNs provided 0-36 nutrition interventions per client. Nutrition intervention patterns were detected by the type of visit clients received. CONCLUSIONS: Results suggest home-visited women have room to improve Nutrition KBS and PHNs utilize myriad nutrition interventions. Results also point to opportunities to improve home-visited client care by providing more nutrition interventions, especially to those not receiving interventions, and revising standard care plans to reflect important Case Management nutrition interventions.

Case study: Behavior changes in the family-focused obesity prevention HOME Plus program.

OBJECTIVE: The purpose of this case study is to describe two successful HOME Plus participants and highlight how an intervention with individual and group components can help families make lifestyle changes that result in improvements in child weight status. DESIGN: One hundred and sixty families participated in the HOME Plus study, and were randomized to either a control or intervention group. SAMPLE: Two successful HOME Plus participants were chosen because of their healthful changes in weight status and behavior and high engagement in the program. MEASUREMENTS: Data were collected at baseline and postintervention, 1 year later. Data included height, weight, home food inventory, dietary recalls, and psychosocial surveys. INTERVENTION: Families in the intervention group participated in cooking and nutrition education sessions, goal-setting activities, and motivational interviewing telephone calls to promote behavioral goals associated with meal planning, family meal frequency, and healthfulness of meals and snacks. RESULTS: Analysis of the families' behaviors showed that Oliver (fictitious name) experienced changes in nutritional knowledge and cooking skill development while Sophia's (fictitious name) changes were associated with healthful food availability and increased family meal frequency. CONCLUSION: These cases show that offering a multicomponent, family-focused program allows participants to select behavior strategies to fit their unique family needs.

Relationships between public health nurse-delivered physical activity interventions and client physical activity behavior.

AIM: The purpose of this study was to identify physical activity interventions delivered by public health nurses (PHNs) and examine their association with physical activity behavior change among adult clients. BACKGROUND: Physical activity is a public health priority, yet little is known about nurse-delivered physical activity interventions in day-to-day practice or their outcomes. METHODS: This quantitative retrospective evaluation examined de-identified electronic-health-record data. Adult clients with at least two Omaha System Physical activity Knowledge, Behavior, and Status (KBS) ratings documented by PHNs between October 2010-June 2016 (N=419) were included. Omaha System baseline and follow-up Physical activity KBS ratings, interventions, and demographics were examined. RESULTS: Younger clients typically receiving maternal-child/family services were more likely to receive interventions than older clients (p<0.001). A total of 2869 Physical activity interventions were documented among 197 clients. Most were from categories of Teaching, Guidance, Counseling (n=1639) or Surveillance (n=1183). Few were Case Management (n=46). Hierarchical regression modeling explained 15.4% of the variance for change in Physical activity Behavior rating with significant influence from intervention dose (p=0.03) and change in Physical activity Knowledge (p<0.001). CONCLUSION: This study identified and described physical activity interventions delivered by PHNs. Implementation of department-wide policy requiring documentation of Physical activity assessment for all clients enabled the evaluation. A higher dose of physical activity interventions and increased Physical activity knowledge were associated with increased Physical activity Behavior. More research is needed to identify factors influencing who receives interventions and how interventions are selected.

Family dinner frequency interacts with dinnertime context in associations with child and parent BMI outcomes.

For youth and parents, frequent family meals have been consistently associated with positive dietary outcomes but less consistently associated with lower body mass index (BMI). Researchers have speculated dinnertime context (dinnertime routines, parent dinnertime media use) may interact with family meal frequency to impact associations with BMI. The present study evaluates the associations and interactions between dinnertime context measures and family dinner frequency with parent and child BMI. This cross-sectional study uses baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus randomized control trial that aimed to prevent childhood obesity. Participants (160 parent-child dyads) completed psychosocial surveys and were measured for height and weight. General linear models tested associations and interactions between dinnertime context measures and family dinner frequency with parent and child BMI, adjusted for race and economic assistance. Lower parent dinnertime media use and higher dinnertime routines were significantly associated with lower child BMI z scores but not parent BMI scores. Interaction-moderation findings suggest higher family dinner frequency amplifies the healthful impact of the dinnertime context on child BMI z scores. Additionally, findings emphasize that promoting frequent family meals along with consistent routines and reduction in parent dinnertime media use may be important for the prevention of childhood obesity. (PsycINFO Database Record

Reasons Parents Buy Prepackaged, Processed Meals: It Is More Complicated Than "I Don't Have Time".

OBJECTIVE: To investigate reasons why parents purchase prepackaged, processed meals and associations with parental cooking self-efficacy, meal-planning ability, and home food availability. METHODS: This secondary data analysis uses Healthy Home Offerings via the Mealtime Environment Plus study data from parents of children aged 8-12 years (n = 160). Associations between reasons why parents purchase prepackaged, processed meals and the outcomes were assessed with chi-square, Fisher exact, and t tests. RESULTS: The most frequently endorsed reasons for purchasing prepackaged, processed meals included lack of time (57%) and family preferences (49%). Five of 6 reasons were associated with lower parental cooking self-efficacy and meal-planning ability. Some reasons were associated with less-healthful home food environments; few reasons varied by socio-demographic characteristics. CONCLUSIONS AND IMPLICATIONS: Because lower cooking self-efficacy and meal-planning ability are associated with most reasons reported for purchasing prepackaged, processed meals, strategies to increase these attributes for parents of all backgrounds may reduce reliance on prepackaged processed meals for family mealtimes.