A qualitative study of the role of food in family relationships: An insight into the families of Brazilian obese adolescents using photo elicitation

Cultural Sets Shape Adult Conceptualizations and Relationships to Nature

The variability of nature and the nature construct have complicated interpretations of empirical evidence from nature-based health studies. The challenge of defining nature exposure for purposes of methodological standardization may encompass constructs beyond vegetated landcover. This study offers a new construct for defining 'nature exposure' that considers cultural sets and nature familiarity. Focus group discussions across the United States (N = 126) explored the concept of what constitutes the relationship to nature. The participant diversity included regions, cultural demographics, cumulative nature experience, and everyday nature exposure. Mixed methods of semi-structured discussion and a photo exercise that prompted nature connectedness allowed for data triangulation and the detection of contradictions between approaches. Individuals conceptualized nature in ways reflecting highly personal and differentiated experiences, which defied consensus toward a single nature construct. The group scoring of photo imagery showed consistent high and low levels of nature connectedness with respect to wildness and outdoor urban venues, respectively, but diverged in the assessment of nature within the built environment. Everyday nature exposure significantly differentiated how groups conceptualized and related to nature imagery. This result may indicate an unmet biophilic need among groups with low backgrounds of nature exposure. The contrasts between the discussion content and the observed reactions to nature imagery showed the value of using mixed methods in qualitative research.

The Role of Food in the Family Relationships of Adolescents With Anorexia Nervosa and Bulimia in Northeastern Brazil: A Qualitative Study Using Photo Elicitation

Family components can play roles both as protective factors and maintenance mechanisms of eating disorders. We aimed to investigate the role of food in the family relationships of adolescents with anorexia nervosa and bulimia in northeastern Brazil. Using photo elicitation, a visual narrative method that gives insight into the participants' perspective through photograph, we conducted semi-structured interviews with 26 people: four teenage girls with anorexia, four with bulimia, eight mothers, four fathers, five grandmothers, and one sister. Data were analyzed using the principles of Interpretative Phenomenological Analysis, which highlighted the following themes: control of the parent-adolescent relationship through food; food as a mean of experiencing parental presence-absence; food as the focus of conflict in the nuclear family, and food as a source of three-generational conflict. Food seemed to be a means for teens and parents to express physical suffering and psychological violence. Moreover, mourning appeared to influence the girls' relationships with food. Conflict in these families is not focused solely on food, but extends to other subjects, and teenagers' emotional reactivity concerning their relationship with their parents and food during family mealtimes varied. These features reinforced the cultural aspect and influences of eating experiences among adolescent girls with eating disorders. Remarkable disparities exist in the generations' views on what rules and rituals these adolescents must follow at meals. These disparities can obfuscate generational boundaries in these families. Our data reinforce the need to focus on the adolescent's autonomy in the family setting and on family identity as related to food among three generations. These findings necessitate a reorganization of boundaries between these generations.

A specific method for qualitative medical research: the IPSE (Inductive Process to analyze the Structure of lived Experience) approach

BACKGROUND

This paper reports the construction and use of a specific method for qualitative medical research: The Inductive Process to Analyze the Structure of lived Experience (IPSE), an inductive and phenomenological approach designed to gain the closest access possible to the patients' experience and to produce concrete recommendations for improving care. This paper describes this innovative method.

METHODS

IPSE has five steps: 1) set up a research group, 2) ensure the originality of the research, 3) organize recruitment and sampling intended to optimize exemplarity, 4) collect data that enable entry into the subjects' experience, and 5) analyze the data. This final stage is composed of one individual descriptive phase, followed by two group phases: i) structure the experience, and ii) translate the findings into concrete proposals that make a difference in care.

RESULTS

This innovative method has provided original findings that have opened up new avenues of research and have important practical implications, including (1) the development of patient-reported outcomes, (2) clinical recommendations concerning assessment and treatment, (3) innovative ways to improve communication between patients and doctors, and (4) new insights for medical pedagogy.

CONCLUSIONS

IPSE is a qualitative method specifically developed for clinical medical research to reach concrete proposals, easily combined with quantitative research within a mixed-method study design and then directly integrated within evidence-based medicine.

The role of food in family relationships amongst adolescents with bulimia nervosa: A qualitative study using photo-elicitation

Bulimia nervosa (BN) is a serious psychiatric disorder, with potentially dangerous complications. Family relationships play an important role in the way the condition develops or is perpetuated. The present study aims to better grasp the role of food in family interactions amongst teenagers with BN. Eleven interviews were carried out with five teenagers with BN aged from 16 to 18 and their parents, using photo-elicitation to carry out the qualitative investigation. A photograph of the table after a family meal, produced by the subject, was used as the basis for discussion. Interpretative Phenomenological Analysis was used to process the data. Our results were organised along two axes. The first describes the relationship between parent and child (the sharing of disarray about food between parent and child, food and the issue of children becoming autonomous from parents, food as a catalyser of conflict amongst other stressors). The second showcases relationships in the family as a group (the dining table as a likeness of family functioning, food at a crossroads between sharing and solitude). Our study showed that the dynamics in these families present differences from those of teenagers with anorexia nervosa, which must be taken into account. It confirmed the necessity of a systemic approach in addition to individual therapy (centred on the managing of emotions), and the benefits of creating occasions of family interaction which do not involve food to re-establish communication in the family relationships (including those with siblings).

Sowing social inclusion for marginalised residents of a social housing development through a community garden

ISSUE ADDRESSED

In addition to food, physical activity, mental health and environmental benefits, community gardens (CGs) provide opportunities for social inclusion and increased social capital. These are particularly important to the socially isolated residents of social housing developments (SHDs). This scoping study explored the feasibility of a CG program for tenants of SHD in inner eastern Melbourne by assessing their interest in, and requirements for, inclusively designed CGs.

METHODS

In this phenomenological enquiry, focus group discussions, supported by photo-elicitation, were employed. Three focus groups (N = 19) were conducted with self-selected participants who consented to participate. Two focus groups were conducted with English-speaking tenants while a third focus group was conducted with Mandarin-speaking tenants.

RESULTS

There was a demand for CGs by the English-speaking participants driven by desire for networking, social connectedness and inclusion; for improved access to fresh produce, connection with nature, physical activity and mental well-being. Participants expressed interest in a garden located near their SHD with supportive physical and social environments including disability access, plot autonomy, fencing, socio-cultural events, training programs and management opportunities. However, the Mandarin-speaking tenants maintained that age, language difficulty and neighbourhood insecurity posed significant barriers to their participation.

CONCLUSION

Guided by the Ottawa Charter for Health Promotion, social inclusion and community development theories, the study recommends that to establish socially inclusive CGs, a dynamic relationship of the design principles of a CG and the socio-ecological determinants of health should be established to address any barriers and successfully facilitate engagement. In addition, CG programs need to be guided by community development principles. Future research could employ community-based participatory research models in the implementation and evaluation of a CG program for socially isolated population groups.

[The relational issues surrounding food in obese teenagers and their family]

Several qualitative studies have been carried out into the relational issues in families where a teenager is suffering from obesity. Power struggles, issues related to love, relational distance and family organisation must be taken into account in the care of these teenagers. Work on the intrafamily relational aspects can help to improve the effectiveness of standard treatments.

Social media platforms as a photo-elicitation tool in research on alcohol intoxication and gender

Aim:

This methodological article aims to describe the use of comparative social media platforms within a photo-elicitation (PE) activity as part of a multi-method interview-based study on the gendered meanings of alcohol intoxication among young adults (aged 18–25 years, n = 200).

Method:

Early interviews revealed social media as a particularly engaging topic for participants, and discussions of social media exposed relevant issues that often were not discussed in other sections of the interview guide. By embedding photos of young people drinking within three social media platforms with photo-sharing capabilities – Instagram, SnapChat and Facebook – we elicited narrative data revealing important aspects of the meanings of intoxication and providing information on how participants manage and judge drinking behaviours shared through online social networking systems (SNS).

Conclusions:

Given that social media use and photo-sharing are so common, familiar, and endemic among young people, to ignore this feature of contemporary social interaction would have limited our exploration of meanings of intoxication. We suggest that embedding existing methods, such as photo-elicitation, into social media contexts that are salient for youth may be a valuable strategy for providing a more comprehensive approach for investigating contemporary social issues.

Maternal Food-Related Practices, Quality of Diet, and Well-Being: Profiles of Chilean Mother-Adolescent Dyads

OBJECTIVE

To identify mother-adolescent dyad profiles according to food-related parenting practices and to determine differences in diet quality, family meal frequency, life satisfaction, and sociodemographic characteristics.

DESIGN

Cross-sectional study.

SETTING

Mothers and children were surveyed in their homes or at schools in Temuco, Chile.

PARTICIPANTS

A total of 300 mothers (average age, 41.6 years) and their adolescent children (average age, 13.2 years; 48.7% female).

MAIN OUTCOME MEASURES

Maternal feeding practices using the abbreviated Family Food Behavior Survey (AFFBS), life satisfaction, food-related and family life satisfaction, diet quality, and eating habits.

ANALYSIS

Principal component factor analysis and confirmatory factor analysis were used to verify Family Food Behavior Survey components in mother and adolescent subsamples. Hierarchical cluster analysis was used to identify profiles.

RESULTS

Three AFFBS components were detected: maternal control of child snacking behavior, maternal presence during eating, and child involvement in food consumption. Cluster analysis identified 3 mother-adolescent dyad profiles with different food-related parenting practices (P ≤ .001), mother (P ≤ .05) and child (P ≤ .001) diet quality, frequency of shared family meals (P ≤ .001), and mother (P ≤ .001) and child (P ≤ .05) life satisfaction levels.

CONCLUSIONS AND IMPLICATIONS

Results indicated that maternal well-being increased with an increased frequency of shared mealtime. Significantly, in contrast to the findings of previous studies, greater control over child eating habits was shown to affect adolescent well-being positively. These findings, among others, may contribute to the development of strategies for improving diet quality, overall well-being, and well-being in the food and family domains for all family members.

A latent class analysis of family eating habits in families with adolescents

The objectives of the present study were to identify adolescent classes based on perceptions of their family's eating habits and to determine whether these classes differ in terms of family meal frequency and source, parents and adolescent diet quality, nutritional status, satisfaction with life, family life and food-related life. Questionnaires were administered to a sample of 300 two-parent families with one child between 10 and 17 years in Chile. Questionnaires included the Satisfaction with Life Scale (SWLS), the Satisfaction with Food-related Life scale (SWFoL), the Satisfaction with Family Life scale (SWFaL) and the Adapted Healthy Eating Index (AHEI). Adolescents also answered the Family Eating Habits Questionnaire (FEHQ). Latent class (LC) analysis was used to estimate the number of classes associated with the adolescent's perceptions about their family's eating habits, based on the three factors detected in the FEHQ. The LC analysis yielded three classes: "medium cohesion around family meals/healthy food-related parenting practices" (Class 1, 50.4%), "high cohesion around family meals/healthy food-related parenting practices" (Class 2, 25.9%) and "high cohesion around family meals/unhealthy food-related parenting practices" (Class 3, 23.7%). Classes also differed in the adolescents AHEI score, frequency and source of family meals; body mass index, SWLS and SWFaL scores in mothers, fathers and adolescents, adolescent sex and household financial situation. These findings suggest that frequent and cohesive family meals improve the well-being in both parents and adolescents, but are not enough to achieve healthier diets and weight statuses in adolescents.

Weight Fluctuation and Diet Concern Negatively Affect Food-Related Life Satisfaction in Chilean Male and Female Adolescents

Problematic eating behaviors and obesity are frequent problems encountered during adolescence that may potentially result in psychological, social and physical consequences that may interfere with adolescent development and well-being. The present study evaluates the relationship between satisfaction with food-related life and satisfaction with family life, and their relationship with life satisfaction in male and female adolescents. We explored the relationships between both subscales of the Revised Restraint Scale (RRS), Diet Concern (DC) and Weight Fluctuation (WF) and adolescent life satisfaction as well as satisfaction with food-related life and family life. We also explored the moderating role of socioeconomic status (SES). A questionnaire was applied to a non-probabilistic sample of 470 adolescents (mean age 13.2 years, 52.3% female) in Chile, including the RRS, Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWL-Food) scale and Satisfaction with Family Life (SWL-Family) scale. Using structural equation modeling, we found that adolescent life satisfaction was related to satisfaction with family life and food-related life in both genders. In male adolescents, a negative relationship was identified between WF and food-related life satisfaction. In contrast, a negative relationship was identified in female adolescents between DC and food-related life satisfaction. DC and WF were not directly related to life satisfaction or to satisfaction with family life in either gender. SES was found to moderate the relationship between food-related life satisfaction and life satisfaction and the relationship between WF and food-related life satisfaction in female adolescents. These findings suggest that reducing DC in female adolescents and reducing WF in male adolescents and female adolescents from higher SES may improve their food-related life satisfaction.

Diet Quality and Satisfaction with Life, Family Life, and Food-Related Life across Families: A Cross-Sectional Pilot Study with Mother-Father-Adolescent Triads

Family is a major determinant of children's and adolescents' eating behavior. The objectives of the present study were to assess diet quality, eating habits, satisfaction with life, family life, and food-related life in mother-father-adolescent triads, and to identify profiles of families according to family members' diet quality. Questionnaires were administered to a sample of 300 two-parent families with one child over the age of 10 in the city of Temuco (Chile), including the Adapted Healthy Eating Index (AHEI), Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWFoL) scale, Satisfaction with Family Life (SWFaL) scales, and questions relating to their eating habits. Positive relationships were found between the diet quality of the family members, particularly between mothers and adolescents. Three family profiles with different diet qualities were identified: "families with an unhealthy diet" (39.3%), "families in which mothers and adolescents have healthy diets, but the fathers' diets require changes" (14.3%), and "families that require changes in their diet" (46.4%). These findings stress the key role of mothers in determining family diet quality and suggest a positive relationship between diet quality and satisfaction with life.

Photo-elicitation with adolescents in qualitative research: an example of its use in exploring family interactions in adolescent psychiatry

BACKGROUND

Photo-elicitation is a method used increasingly often in qualitative health research, and its positive effect on the research process is well established today. Photo-elicitation appears to facilitate verbalization and insight and to improve relationships between the researcher and participants, thereby enriching the quality of the data collected. Nonetheless, it is barely used at all in the field of adolescent psychiatry. With the aim of exploring the potential of these methods for research with adolescents receiving psychiatric care, we conducted a qualitative photo-elicitation data collection study with this population, asking them about family interactions around food.

METHODS

The data were collected from 15 adolescents and 17 parents during semi-structured interviews in which a photo taken by the adolescent served as the focus of discussion. Data were explored through inductive thematic analysis.

RESULTS

Photo-elicitation played a threefold role in this study: (1) it induced the teens' interest, thought, and pleasure, (2) it played a mediating function during the interviews, and (3) it enabled family interactions to be viewed from the adolescent's perspective. Three themes concerning family interactions were found: (1) parent-child relationship patterns, (2) the functioning of the family group, and (3) the adolescent's individual relation with food, that is, the issue of the adolescent's autonomy.

CONCLUSIONS

Photo-elicitation proved to be an innovative technique in qualitative research in the area of adolescent psychiatry, one that enriched the data and enabled the emergence of new themes in this field, related in particular to the process by which adolescents develop autonomy.

Life Satisfaction of University Students in Relation to Family and Food in a Developing Country

Life satisfaction and satisfaction with food-related life (SWFoL) are associated with healthy eating habits, family interaction around eating and family support. The present study evaluates the relationship between SWFoL and satisfaction with family life (SWFaL), and their relationship with life satisfaction in university students. We identify the relationship of two different types of family support and student SWFaL and explore a moderator effect of gender. A questionnaire was applied to a non-probabilistic sample of 370 students of both genders (mean age 21 years) in Chile, including Satisfaction with Life Scale, SWFoL scale, SWFaL scale, and the Family Resources Scale. Using structural equation modeling, we found that students' life satisfaction was related to SWFaL and food-related life. A high positive relationship was identified between intangible family support and students' SWFaL, which would have a mediating role between intangible support and life satisfaction. Using multi-group analysis, a moderator effect of gender was not found. These findings suggest that improving SWFoL, SWFaL and intangible family support is important for both female and male students.