April 2014

A Qualitative Study of Family Healthy Lifestyle Behaviors of Mexican-American and Mexican Immigrant Fathers and Mothers

The obesity epidemic continues to be highly prevalent in society, not only among adults but among children. While obesity used to be limited to children ages 4 and above it has been increasing in those younger than 4. In fact, it has been reported that 25% of toddlers and pre-school aged children are obese or overweight. Research has aimed to determine the various factors that can contribute to obesity and has shown that over-consumption of calories, particularly from large amounts of calorically-dense beverages and high intakes of fat, and sedentary lifestyles play a major role in it.

While school-based interventions that include both a physical activity and nutrition education component have been shown to improve different aspects of overweight and obesity among children, there is little research that looks at family-based interventions. However, a recent study that investigated the effectiveness of an intervention developed by both researchers and family members that included both a physical activity and nutrition education component, and also addressed the unique barriers faced by the families, showed that they can improve BMI, physical activity level, and parents’ self-efficacy in regards to providing healthy meals. Some research has looked into the relationship between parents’ feeding strategies and overweight/obesity, but consistent findings are lacking in this area. Indeed, many of the studies have been done among the predominantly white, middle class female population, so findings are not generalizable across the board.

The purpose of this study was to investigate the relationship between parenting styles and children’s weight, particularly among Mexican-American/Mexican immigrant families. Two-parent families were recruited to participate in focus group meetings in which parents were asked questions to determine their parenting styles, as well as their diet and lifestyle habits at home. Questions that were asked included things like:
• What are the sorts of things that you and your family eat?
• What sorts of activities do you participate in?
• Who makes the decision about what is prepared and/or eaten and physical activities?
• Are you interested in changing anything about how you eat/the activities you participate in?
• Are there any specific challenges to eating a healthier diet/changing the activities you participate in?

Researchers used Maccoby and Martin’s four categories of parenting styles (authoritative, authoritarian, permissive, and neglectful) to determine parenting characteristics. They also used a variation on Prochaska’s Stages of Change model in which the five categories were combined into three (precontemplation, contemplation/preparation, and action/maintenance) to determine readiness for change.

The results showed that there were no neglectful parenting styles among parents in regards to either diet or physical activity. Most parents displayed a permissive parenting style when it came to diet, which was correlated with a higher risk of being overweight or obese. Parents generally reported that children were allowed to choose what they would eat, even if their choices were less healthy. Men also reported that their wives mostly planned and prepared meals. When it came to physical activity, women mostly displayed a permissive style while men mostly displayed an authoritative style. Parents generally reported that fathers were in charge of choosing and encouraging physical activities.

As for willingness to change, most parents were at the contemplation/preparation stage in regards to diet. Mothers were also mostly in the contemplation/preparation stage for physical activity but fathers were generally in the action/maintenance stage. Parents generally said that they wanted their children to eat healthy diets and be active. They acknowledged that as parents they serve as role models for a healthy diet and physical activity but that they usually did not meet this goal. Some parents reported barriers outside of their control, like unsafe neighborhoods. Other barriers included not knowing how or not having time to prepare healthier foods and higher costs of healthier foods.

This study had some definite limitations such as not having a control group to compare against and the fact that confirming findings is more appropriate for a quantitative study, not a qualitative one. This study also had a small sample size, which is not generalizable to the larger population. Further research should aim to address these limitations, particularly addressing parents’ reported barriers to diet and physical activity and their receptivity to dietary counseling and adherence to recommendations.

Original Research Article:
Turner, B.J., Navuluri, N., Winkler, P., Vale, S., & Finley, E. (2014). A qualitative study of family healthy lifestyle behaviors of Mexican-American and Mexican immigrant fathers and mothers. Journal of the Academy of Nutrition and Dietetics, 114, 562-569.

Supplementary Article:
Davison, K.K., Jurkowski, J.M., Li, K., Kranz, S., & Lawson, H.A. (2013). A childhood obesity intervention developed by families for families: Results from a pilot study. International Journal of Behavioral Nutrition and Physical Activity, 10(3), 2468-2480.