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Open Access 01-12-2021 | Nutrition | Research article

Exploring differences in perceptions of child feeding practices between parents and health care professionals: a qualitative study

Authors: Athira Rohit, Renae Kirkham, Leisa McCarthy, Valentina Puruntatameri, Louise Maple-Brown, Julie Brimblecombe

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Evidence on child feeding practice is often based on the perspectives and experiences of parents and less that of health practitioners. In this study, we explored child feeding practice in Aboriginal communities in northern Australia from both the parents and health practitioners’ perspectives with the aim of informing nutrition improvement programs.

Methods

Qualitative research methods were employed. Using semi-structured interviews, parents (n = 30) of children aged 2–5 years, and 29 service providers who were involved in the delivery of child health and nutrition programs in the same communities, were asked about child feeding attitudes and practices. Responses were analyzed through inductive and deductive analysis, recognizing that worldviews influence child feeding practices.

Results

Sharing food was a central practice within families. Parents highly valued development of child independence in food behavior but were conflicted with the easy access to unhealthy food in their communities. This easy access to unhealthy food and inadequate food storage and kitchen facilities for some families were major challenges to achieving optimal diets for children identified by Aboriginal families and service providers. The responsive style of parenting described by parents was often misunderstood by service providers as sub-optimal parenting when viewed through a dominant western lens.

Conclusions

Approaches to support healthy feeding practices and optimal child nutrition require health-enabling food environments. Along with a community-based Aboriginal health workforce, it is paramount that the non-Aboriginal workforce be supported to be reflective of the impact of worldview on their practice, to ensure a culturally safe environment for families where parenting styles are understood and appropriately supported.

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Arabena K, Ritte R, Panozzo S, Leah J, Rowley K. First 1000 days Australia: an Aboriginal and Torres Strait islander led early life intervention. Aborig Isl Health Work. 2016;40(Jan/Dec):21–2.

Gevers DW, Kremers SP, de Vries NK, van Assema P. Clarifying concepts of food parenting practices. A Delphi study with an application to snacking behavior. Appetite. 2014;79:51–7. https://doi.org/10.1016/j.appet.2014.04.002.CrossRefPubMed

Baumrind D. Child care practices anteceding three patterns of preschool behavior. Genet Psychol Monogr. 1967;75(1):43–88.PubMed

Baumrind D. Effects of authoritative parental control on child behaviour. Child Dev. 1966;37(4):887. https://doi.org/10.2307/1126611.CrossRef

Maccoby E, Martin J. Socialization in the context of the family: Parentchild interaction. In: Mussen PHC L, editor. Handbook of child psychology: Socialization, personality, and social development. 4. New York: Wiley; 1983. p. 1–101.

Hughes SO, Power TG, Orlet Fisher J, Mueller S, Nicklas TA. Revisiting a neglected construct: parenting styles in a child-feeding context. Appetite. 2005;44(1):83–92. https://doi.org/10.1016/j.appet.2004.08.007.CrossRefPubMed

Shloim N, Edelson LR, Martin N, Hetherington MM. Parenting styles, feeding styles, feeding practices, and weight status in 4–12 year-old children: a systematic review of the literature. Front Psychol. 2015;6:1849.CrossRef

Johnson R, Welk G, Saint-Maurice PF, Ihmels M. Parenting styles and home obesogenic environments. Int J Environ Res Public Health. 2012;9(4):1411–26. https://doi.org/10.3390/ijerph9041411.CrossRefPubMedPubMedCentral

Tovar A, Hennessy E, Pirie A, Must A, Gute DM, Hyatt RR, et al. Feeding styles and child weight status among recent immigrant mother-child dyads. Int J Behav Nutr Phys Act. 2012;9(1):62. https://doi.org/10.1186/1479-5868-9-62.CrossRefPubMedPubMedCentral

10.

Olvera N, Power TG. Brief report: parenting styles and obesity in Mexican American children: a longitudinal study. J Pediatr Psychol. 2010;35(3):243–9. https://doi.org/10.1093/jpepsy/jsp071.CrossRefPubMed

11.

Scrimgeour M, Dunbar T. Cultural competence in Aboriginal education service delivery in Australia: Some lessons from the Aboriginal health service sector; 2009.

12.

Health AIo, Welfare. Aboriginal and Torres Strait islander health performance framework (HPF) report 2017. Canberra: AIHW; 2018.

13.

Commonwealth of Australia. Closing the Gap Prime Minister’s Report. In: Department of the Prime Minister and Cabinet, editor. 2020.

14.

Azzopardi PS, Sawyer SM, Carlin JB, Degenhardt L, Brown N, Brown AD, et al. Health and wellbeing of indigenous adolescents in Australia: a systematic synthesis of population data. Lancet. 2018;391(10122):766–82. https://doi.org/10.1016/S0140-6736(17)32141-4.CrossRefPubMed

15.

Titmuss A, Davis EA, Brown A, Maple-Brown LJ. Emerging diabetes and metabolic conditions among Aboriginal and Torres Strait Islander young people. Med J Aust. 2019;210(3):111–3.e1.

16.

Smith K, Fatima Y, Knight S. Are primary healthcare services culturally appropriate for Aboriginal people? Findings from a remote community. Aust J Prim Health. 2017;23(3):236–42. https://doi.org/10.1071/PY16110.CrossRefPubMed

17.

Harfield SG, Davy C, McArthur A, Munn Z, Brown A, Brown N. Characteristics of Indigenous primary health care service delivery models: a systematic scoping review. Global Health. 2018;14(1):12.CrossRef

18.

Lea T. The work of forgetting: germs, aborigines and postcolonial expertise in the Northern Territory of Australia. Soc Sci Med. 2005;61(6):1310–9.CrossRef

19.

Durey A, Thompson SC. Reducing the health disparities of Indigenous Australians: time to change focus. BMC Health Serv Res. 2012;12:151.CrossRef

20.

Wilson AM, Magarey AM, Jones M, O'Donnell K, Kelly J. Attitudes and characteristics of health professionals working in Aboriginal health. Rural Remote Health. 2015;15(1):2739.PubMed

21.

Si D, Bailie RS, Togni SJ, DˈAbbs PHN, Robinson GW. Aboriginal health workers and diabetes care in remote community health centres: a mixed method analysis. Med J Aust. 2006;185(1):40–5. https://doi.org/10.5694/j.1326-5377.2006.tb00451.x.CrossRefPubMed

22.

Clifford A, McCalman J, Bainbridge R, Tsey K. Interventions to improve cultural competency in health care for indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review. Int J Qual Health Care. 2015;27(2):89–98. https://doi.org/10.1093/intqhc/mzv010.CrossRefPubMed

23.

Mooney N, Bauman A, Westwood B, Kelaher B, Tibben B, Jalaludin B. A quantitative evaluation of Aboriginal cultural awareness training in an urban health service. Aborig Isl Health Work J. 2005;29:23–30.

24.

Dunbar T, Bourke L, Murakami-Gold L. More than just numbers! Perceptions of remote area nurse staffing in Northern Territory government health clinics. Aust J Rural Health. 2019;27(3):245–50. https://doi.org/10.1111/ajr.12513.CrossRefPubMed

25.

Fleming T, Creedy DK, West R. Evaluating awareness of cultural safety in the Australian midwifery workforce: a snapshot. Women Birth. 2019;32(6):549–57. https://doi.org/10.1016/j.wombi.2018.11.001.CrossRefPubMed

26.

Kruske S, Belton S, Wardaguga M, Narjic C. Growing up our way: the first year of life in remote Aboriginal Australia. Qual Health Res. 2012;22(6):777–87. https://doi.org/10.1177/1049732311432717.CrossRefPubMed

27.

Little K, Sanson A, Zubrick SR. Do individual differences in temperament matter for indigenous children?: The structure and function of temperament in footprints in time. Fam Matters. 2012;91:92–105.

28.

Byers L, Kulitja S, Lowell A, Kruske S. ‘Hear our stories’: child-rearing practices of a remote Australian Aboriginal community. Aust J Rural Health. 2012;20(6):293–7. https://doi.org/10.1111/j.1440-1584.2012.01317.x.CrossRefPubMed

29.

Rohit A, Tonkin E, Maple-Brown L, Golley R, McCarthy L, Brimblecombe J. Parent feeding practices in the Australian indigenous population within the context of non-indigenous Australians and indigenous populations in other high income countries – a scoping review. Adv Nutr. 2019;10(1):89–103. https://doi.org/10.1093/advances/nmy050.CrossRefPubMedPubMedCentral

30.

Moustakas C. Phenomenological research methods. SAGE publications; 1994. https://doi.org/10.4135/9781412995658.

31.

Patton MQ. Qualitative evaluation and research methods. SAGE publications; 1990.

32.

Bynum WEI, Artino ARJ, Uijtdehaage S, Webb AMB, Varpio L. Sentinel emotional events: the nature, triggers, and effects of shame experiences in medical residents. Acad Med. 2019;94(1):85–93. https://doi.org/10.1097/ACM.0000000000002479.CrossRefPubMed

33.

Australian Bureau of Statistics. The Australian Statistical Geography Standard (ASGS) remoteness structure. Available from: https://www.abs.gov.au/websitedbs/d3310114.nsf/home/remoteness+structure. Accessed 17 May 2021.

34.

ABS. 2016 Census QuickStats Northern Territory (STE), Indigenous Profile 2016.

35.

NT Market Basket Survey 2019. Northern Territory Government. 2020. Available from: NT Market Basket Survey 2019 - Datasets - NTG Open Data Portal. Accessed 17 May 2021.

36.

Colles S, Maypilama E, Brimblecombe J. Food, food choice and nutrition promotion in a remote Australian Aboriginal community. Aust J Prim Health. 2014;20(4):365–72. https://doi.org/10.1071/PY14033.CrossRefPubMed

37.

McCarthy L, Chang AB, Brimblecombe J. Food security experiences of Aboriginal and Torres Strait islander families with young children in an urban setting: influencing factors and coping strategies. Int J Environ Res Public Health. 2018;15(12):2649. https://doi.org/10.3390/ijerph15122649.CrossRefPubMedCentral

38.

Maple-Brown LJ, Brown A, Lee IL, Connors C, Oats J, McIntyre HD, et al. Pregnancy and neonatal diabetes outcomes in remote Australia (PANDORA) study. BMC Pregnancy Childbirth. 2013;13(1):221. https://doi.org/10.1186/1471-2393-13-221.CrossRefPubMedPubMedCentral

39.

Jansen E, Mallan KM, Nicholson JM, Daniels LA. The feeding practices and structure questionnaire: construction and initial validation in a sample of Australian first-time mothers and their 2-year olds. Int J Behav Nutr Phys Act. 2014;11(1):72. https://doi.org/10.1186/1479-5868-11-72.CrossRefPubMedPubMedCentral

40.

NHMRC. Road map 3: a strategic framework for improving Aboriginal and Torres Strait islander health through research. Canberra: National Health and Medical Research Council; 2018.

41.

Smith LT. Decolonizing methodologies: research and indigenous peoples: zed books; 2012.

42.

Rohit A, Brimblecombe J, O'Dea K, Tonkin E, Maypilama L, Maple-Brown L. Development of a short-item diet quality questionnaire for indigenous mothers and their young children: the Menzies remote short-item dietary assessment tool. Aust J Rural Health. 2018;26(3):220–4. https://doi.org/10.1111/ajr.12412.CrossRefPubMed

43.

Tonkin E, Kennedy D, Golley R, Byrne R, Rohit A, Kearns T, et al. The Relative Validity of the Menzies Remote Short-Item Dietary Assessment Tool (MRSDAT) in Aboriginal Australian Children Aged 6−36 Months. Nutrients. 2018;10(5):590.

44.

Creswell JW. Standards of validation and evaluation. Qualitative inquiry and research design: choosing among five approaches. 3rd. Thousand Oaks: SAGE Publications; 2013. p. 243–68.

45.

Vallance RJ. A Cultural Bridge. Annual Meeting of the Australian Association for Research in Education; December 2–6; Fremantle, Australia; 2001.

46.

Hofstede G. The cultural relativity of organizational practices and theories. J Int Bus Stud. 1983;14(2):75–89. https://doi.org/10.1057/palgrave.jibs.8490867.CrossRef

47.

Hamilton A. Nature and nurture : Aboriginal child-rearing in north-central Arnhem Land. Australian Institute of Aboriginal S. Canberra: Australian Institute of Aboriginal Studies; 1981.

48.

Harrison L. Diet and nutrition in a Tiwi community. A study of factors affecting the health status of under threes at Milikapiti, North Australia: PhD Thesis, Australian National University; 1986.

49.

Priest K, King S, Nangala I, Brown WN, Nangala M. Warrki Jarrinjaku ‘working together everyone and listening’: growing together as leaders for Aboriginal children in remote Central Australia. Eur Early Child Educ Res J. 2008;16(1):117–30. https://doi.org/10.1080/13502930801897186.CrossRef

50.

Kearins J. Child-rearing practices in Australia : variation with life-style. Perth: Education Dept. of Western Australia; 1984.

51.

Smith D, Mununggurr L, Bamundurruwuy D, Edmond K. How children grow: indigenous and health professional perceptions. Darwin: Cooperative Research Centre for Aboriginal and Tropical Health; 2003.

52.

Harbron J, Booley S, Najaar B, Day C. Responsive feeding: establishing healthy eating behaviour early on in life. South Afr J Clin Nutr. 2013;26:S141–9.CrossRef

53.

Australian Institute of Family Studies. Strengths of Australian Aboriginal cultural practices in family life and child rearing. Child Family Community Australia. 2014; Paper No 25.

54.

Brimblecombe J, Maypilama E, Colles S, Scarlett M, Dhurrkay JG, Ritchie J, et al. Factors influencing food choice in an Australian Aboriginal community. Qual Health Res. 2014;24(3):387–400. https://doi.org/10.1177/1049732314521901.CrossRefPubMed

55.

Elliott C, Brierley M. Healthy choice?: exploring how children evaluate the healthfulness of packaged foods. Can J Public Health. 2012;103(6):e453–8. https://doi.org/10.1007/BF03405637.CrossRefPubMedPubMedCentral

56.

Australian Food and Grocery Council. Responsible CHILDREN'S marketing INITIATIVE. 2018.

57.

Gwynn J, Sim K, Searle T, Senior A, Lee A, Brimblecombe J. Effect of nutrition interventions on diet-related and health outcomes of Aboriginal and Torres Strait islander Australians: a systematic review. BMJ Open. 2019;9(4):e025291. https://doi.org/10.1136/bmjopen-2018-025291.CrossRefPubMedPubMedCentral

58.

Brimblecombe J, McMahon E, Ferguson M, De Silva K, Peeters A, Miles E, et al. Effect of restricted retail merchandising of discretionary food and beverages on population diet: a pragmatic randomised controlled trial. Lancet Planet Health. 2020;4(10):e463–e73. https://doi.org/10.1016/S2542-5196(20)30202-3.CrossRefPubMed

59.

Brimblecombe J, Ferguson M, Chatfield MD, Liberato SC, Gunther A, Ball K, et al. Effect of a price discount and consumer education strategy on food and beverage purchases in remote indigenous Australia: a stepped-wedge randomised controlled trial. Lancet Public Health. 2017;2(2):e82–95. https://doi.org/10.1016/S2468-2667(16)30043-3.CrossRefPubMed

60.

Green L, Kreuter M. Health program planning: an educational and ecological approach: McGraw-hill education; 2005.

61.

Brimblecombe J, Bailie R, van den Boogaard C, Wood B, Liberato SC, Ferguson M, et al. Feasibility of a novel participatory multi-sector continuous improvement approach to enhance food security in remote indigenous Australian communities. SSM Population Health. 2017;3:566–76. https://doi.org/10.1016/j.ssmph.2017.06.002.CrossRefPubMed

62.

Shaw G. An Ethnographic Exploration of the Development in Child Rearing Style among the Ngaanyatjarra People from the Pre-Contact Era to the Present: Masters Thesis, University of New South Wales; 2002.

63.

Kildea S, Tracy S, Sherwood J, Magick-Dennis F, Barclay L. Improving maternity services for indigenous women in Australia: moving from policy to practice. Med J Aust. 2016;205(8):374–9. https://doi.org/10.5694/mja16.00854.CrossRefPubMed

64.

Dunbar T. Aboriginal People's experiences of health and family Services in the Northern Territory. Int J Crit Indigenous Stud. 2011;4(2):2–16. https://doi.org/10.5204/ijcis.v4i2.60.CrossRef

65.

Reibel T, Walker R. Antenatal services for Aboriginal women: the relevance of cultural competence. Qual Prim Care. 2010;18(1):65–74.PubMed

66.

Bourke S, Wright A, Guthrie J, Russell L, Dunbar T, Lovett R. Evidence review of indigenous culture for health and wellbeing. Int J Health Wellness Soc. 2018;8(4):11–27. https://doi.org/10.18848/2156-8960/CGP/v08i04/11-27.CrossRef

67.

Lowitja Institute. Cultural competence of mainstream health services and systems roundtable. Melbourne: The Lowitja Institute; 2014.

68.

Came H, Griffith D. Tackling racism as a “wicked” public health problem: enabling allies in anti-racism praxis. Soc Sci Med. 2018;199:181–8. https://doi.org/10.1016/j.socscimed.2017.03.028.CrossRefPubMed

69.

McGuire-Adams T. Settler allies are made, not self-proclaimed: unsettling conversations for non-indigenous researchers and educators involved in indigenous health. Health Educ J. 2021:001789692110092. Settler allies are made, not self-proclaimed: Unsettling conversations for non-Indigenous researchers and educators involved in Indigenous health - Tricia McGuire-Adams, 2021 (sagepub.com).

70.

Jongen C, McCalman J, Bainbridge R. Health workforce cultural competency interventions: a systematic scoping review. BMC Health Serv Res. 2018;18(1):232. https://doi.org/10.1186/s12913-018-3001-5.CrossRefPubMedPubMedCentral

71.

Gwynne K, Lincoln M. Developing the rural health workforce to improve Australian Aboriginal and Torres Strait islander health outcomes: a systematic review. Aust Health Rev. 2017;41(2):234–8. https://doi.org/10.1071/AH15241.CrossRefPubMed

Title: Exploring differences in perceptions of child feeding practices between parents and health care professionals: a qualitative study
Authors: Athira Rohit
Renae Kirkham
Leisa McCarthy
Valentina Puruntatameri
Louise Maple-Brown
Julie Brimblecombe
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Nutrition
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11493-2

2024 ASCO Annual Meeting

Springer Medicine

Exploring differences in perceptions of child feeding practices between parents and health care professionals: a qualitative study

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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