Exploring the Role of Grandparents in the Feeding of Grandchildren Aged 1-5 Years

Multigenerational inequalities of opportunity in health outcomes

This paper studies multigenerational health transmission mechanisms in Australian panel data. Using inequality-of-opportunity (IOP) models, we demonstrate that grandparental socioeconomic status (SES) is an important determinant of personal health, even after controlling for health and SES at the parental level. Our findings hold over a range of health/biomarkers of individuals' physical and mental well-being and appear to be especially sensitive to educational outcomes on the father's side. Since ingrained socioeconomic (dis)advantages that persist over multiple generations may be indicative of social class, our results suggest that subtle attitudinal and behavioural characteristics associated with this variable may be a key factor driving health disparities.

The Influence of Grandparents on Children's Dietary Health: A Narrative Review

PURPOSE OF REVIEW

To examine and synthesise recent evidence on the role of grandparents in shaping children's dietary health.

RECENT FINDINGS

The influence of grandparents on children's dietary health was evident across studies. Grandparents frequently provide their grandchildren with meals and snacks, and engage in many of the same feeding practices used by parents. Although grandparents report providing their grandchildren with healthy foods, the provision of treat foods high in sugar or fat was a common finding. This provision led to family conflict, with the indulgent behaviours of grandparents seen by parents as a barrier to healthy eating. Grandparents are exerting significant influence on child dietary health. Efforts are needed to ensure these care providers are considered key stakeholders in the promotion of healthy eating and are targeted in policies and programs addressing children's diets. Research that determines how to best support grandparents to foster healthy behaviours in children is critical.

Effectiveness of the positive discipline program applied to parents of preschool children: A randomized-controlled trial

BACKGROUND

Although the Positive Discipline Program is used extensively internationally, there are very few evidence-based studies on it. This study aims to examine the experimental results of the Positive Discipline Program.

METHOD

This randomized-controlled study had the following types of groups: intervention, active control, and non-contact control. The study sample consisted of 72 parents with children aged between 3 and 6 years. The intervention group participated in an eight-session online Positive Discipline Program, the active control group participated in an eight-session online free interaction program, and the non-contact control group received no intervention.

RESULTS

Parents in the intervention group demonstrated an increase in cooperation with their children after the training and during the follow-up period. In the intervention group, parents' oppressive and authoritarian attitudes decreased after the training and during the follow-up period; spouses' democratic attitudes increased after the training and their overprotective attitudes decreased in the follow-up period. Parent-child communication and unhindered listening increased in the intervention and active control groups. The problem-solving skills of the intervention group increased after the training and during the follow-up period, and sensitivity increased in the follow-up period.

CONCLUSION

As one of the few experimental studies implementing the Positive Discipline Program, this study revealed the strengths of the program as well as culture-specific aspects that need to be improved. Further, this program was effective in improving parents' relationships with their children, attitudes, and problem-solving skills, and it provided evidence for the program's positive contributions to raising a child.

IMPLICATIONS FOR PRACTICE

The Positive Discipline Program can guide parents in solving the developmental and school-related problems of preschool children as well as school and adolescence children.

Child food portion sizes in the home environment: how do parents decide?

The consumption of larger portion sizes (PS) of food has been implicated in the increased prevalence of childhood obesity. The home is usually the first place children learn about food, however, little is known about how parents determine child PS in the home environment. This narrative review aimed to explore parental beliefs, decisions, strategies and barriers to the provision of appropriate food PS for children in the home environment. Results indicate that parental decisions on child food PS are based on the amounts they serve themselves, personal intuition and knowledge of child appetite. Owing to the habitual nature of food provision, parental decisions on child PS may be taken without conscious thought and/or could be part of a complex decision-making process influenced by several interlinked factors, including parental childhood mealtime experiences, other family members and child weight status. Strategies to determine child-appropriate PS include modelling the desired PS behaviour, use of unit-based food packaging and PS estimation aids, and providing the child with a degree of autonomy to rely on their own appetite cues. A lack of knowledge/awareness of PS guidance is a key barrier identified by parents to the provision of age-appropriate PS, warranting the inclusion of salient child-appropriate PS guidance within national dietary recommendations. Further home-based interventions to improve the provision of appropriate child PS are required, leveraged on parental strategies already in use, as outlined in this review.

Exploring Mothers' Perspectives About Why Grandparents in Appalachia Give Their Grandchildren Cariogenic Foods and Beverages: A Qualitative Study

BACKGROUND

Dental caries is the most common chronic childhood disease. Past studies revealed that grandparents provide their grandchildren with cariogenic foods and beverages (eg, those with free sugars and/or modified starches). Qualitative research can help identify what drives this phenomenon.

OBJECTIVE

Our aim was to examine mothers' explanations for why grandparents in north central and central Appalachia give their grandchildren cariogenic foods and beverages.

DESIGN

A qualitative study on children's oral health in Pennsylvania and West Virginia from 2018 through 2020 was performed. In-person, semi-structured interviews were conducted. Qualitative data from interviews were recorded, transcribed, and then coded using NVivo. Data analysis for this study was performed using thematic analysis with iterative theme development.

PARTICIPANTS/SETTING

The participants were 126 mothers of children aged 3-5 years from West Virginia (n = 66) and Pittsburgh, PA (n = 60).

MAIN OUTCOME MEASURES

Mothers' perspectives about why grandparents give their grandchildren cariogenic foods and beverages were analyzed.

RESULTS

In the study sample, 85% of mothers (n = 107/126) named at least 1 of their children's grandparents as a member of their social network responsible for their children's oral health. From these interviews, 85% of mothers (n = 91/107) discussed that grandparents gave their grandchildren cariogenic foods and beverages. The mothers described the following 4 themes to explain why grandparents gave their grandchildren cariogenic foods and beverages: privilege of the grandparent role; responsibilities of the grandparent role; symbol of care and affection; and limited consideration or understanding of the detrimental impact.

CONCLUSIONS

Grandparents play a role in giving their grandchildren cariogenic foods and beverages, which could potentially contribute to childhood caries. Research is needed to develop effective social interventions to help some grandparents understand the implications of a cariogenic diet on their grandchildren's oral health and/or decrease their provision of cariogenic foods and beverages.

Examining School and Neighborhood Effects of Socioeconomic Status on Childhood Obesity in the U.S

Obesity amongst Kindergartners in Texas is above the national average, particularly among Hispanic students. Research on the impact of school and neighborhood-level SES on obesity in childhood using multilevel models is lacking. Survey data were collected from Hispanic caregivers of pre-kindergarten students in Fall 2019 (n = 237). Students were clustered in thirty-two neighborhoods and twelve schools. The dependent variable was the child’s body mass index z-score (BMIz). Covariates included the child’s sex, primary caregiver’s marital status, education level, relationship to the child, and family income. Level-two variables included neighborhood poverty and school SES. CTableross-classified multilevel linear regression models were conducted to examine the unique associations of neighborhood poverty and school SES with individual student BMIz, and how they interact. Twenty-four percent of students were classified as overweight, and five percent were classified as obese. The models resulted in a significant association between school SES and BMIz (B = −0.13; SE = 0.06; p < 0.05) and between neighborhood poverty and BMIz (B = −1.41; SE = 0.49; p < 0.01). Individual students’ BMIz decreased as school SES increased and decreased as neighborhood poverty increased. Neighborhood poverty and school SES appear to play a role in the development of obesity in childhood, although in differing directions.

The effects of received grandmothers' affection on adult grandchildren's health behaviors using affection exchange theory

BACKGROUND

Affection exchange theory (AET) explains the value of received affection for overall wellbeing in family relationships. However, this study extends prior work by investigating AET in grandmother-grandchild relationships and grandchildren's individual well-being. This study seeks to understand the relationships between adult grandchildren's received grandmother affection and health-related behaviors such as diet, exercise, substance abuse, and sleep.

METHODS

This cross-sectional study included 229 university student participants. Multiple regression analyses were performed to analyze received grandmother affection and grandchildren's health behaviors.

RESULTS

Using cross-sectional survey methods, it was found that grandchildren's reports of received memories and humor, and celebratory affection influenced grandchildren's dietary behaviors. Received love and esteem, memories and humor, and celebratory affection was also associated with grandchildren's exercise behaviors.

CONCLUSIONS

Grandchildren who receive grandmother affection may be likely to engage in the well-being process by engaging in health behaviors, while those who are not receiving affection might suffer the health consequences in adulthood. These findings support the assumption of affection exchange theory that received family affection, in this case, grandmother affection leads to positive health outcomes such as enhanced dietary and exercise behaviors among grandchildren.

Communication About Food and Nutrition in the Parent Child Dyad

PURPOSE

Developmentally appropriate messaging interventions may be an effective way to promote healthy behaviors in young children. However, there is a gap in the literature describing communication about food and nutrition within the parent-child dyad. Thus, we explored the content, frequency, context, and purpose of parental conversations about food and nutrition.

DESIGN

Using a semi-structured interview guide, 20 in-person interviews were conducted with parents of 3 to 9 year old children living in Washington and Oregon at the location of their choice.

METHODS

Qualitative data was analyzed using open coding and grounded theory.

RESULTS

Three categories described communication within the dyad: purpose, content, and the bidirectional interaction between the parent and the child. Purpose included three themes: consumption, variety, and balance. Content included three themes: food-related content, body-related content, and utilizing connections. Subthemes within food-related content included properties, production, and preparation. Body-related content subthemes were utilization of food in the body and interoceptive awareness. Parents highlighted connections between the food and body-related content. Lastly, parent-child conversations about food and nutrition were dynamic and bidirectional with parents adapting to child factors.

CONCLUSION

Our findings provide a description of parent communication about food and nutrition and suggest investigation of the purpose and content of communication and how parents tailor messages to their child.

Older Neighbors and The Neighborhood Context of Child Well-Being: Pathways to Enhancing Social Capital for Children

Drawing on Coleman's concept of social capital, researchers have investigated how the quality of neighborhood social networks influences child development and well-being. The role of non-kin older neighbors in advancing child well-being through the enhancement of social capital, however, has been under-studied. Our objective was to delineate specific pathways through which non-kin older neighbors contribute to neighborhood quality for children and families and potentially advance child well-being. We examined open-ended interview data from 400 parents who cared for at least one child under 18 years of age and resided in 20 neighborhoods in Cleveland, Ohio. A subsample of 113 parents connected older neighbors to neighborhood quality for families and children in their narratives. Our analysis identified three primary pathways through which parents positively linked older neighbors to neighborhood quality: older neighbors support parents and children, promote neighborhood safety, and contribute to neighborhood residential stability. These contributions are evidence of intergenerational closure, reciprocated exchange, and informal social control working together to create social capital in neighborhoods for children. It is by enhancing social capital that older neighbors potentially improve child well-being. We discuss the implications of our findings for neighborhood research and practice.

Grandmothers' care practices in areas of high deprivation of Scotland: the potential for health promotion

In many families grandparents play an essential role by providing secondary care for grandchildren. The family is a key setting for promoting children’s health; however, studies describing health initiatives with grandparents are rare. Grandparents could play an important role in promoting health for their grandchildren within their families and communities. The aim of this study was to examine the care practices of grandparents in families living in areas of high deprivation, and to consider the extent to which grandparents could be at the centre of health-promoting initiatives for children. A family practices approach was used to examine care practices within the framework of family resource (assets/capitals) use. In-depth interviews were carried out with grandmothers (n = 15) and mothers (n = 15) living in areas of high deprivation in Scotland. The results are presented as three economies of family living—political, moral and emotional. Grandparent care was described as a form of social capital, central to the wellbeing of the families, and enabled parents to access education and employment. Grandparent care was supported through families’ ability to access cultural amenities and green space (political). Grandparents’ care practices were described as either being responsible or fun (moral). Love appeared to be at the centre of grandparents’ care (emotional). The strengths and weaknesses of this framework were examined in relation to developing initiatives with grandparents. With further development work, grandparents could be the focus of health initiatives with their grandchildren with the support of appropriate policies and resources within their communities.

In many families, grandparents help by providing childcare. Children’s health is linked to their family’s overall wellbeing and there have been programmes to improve children’s health within the family. These programmes do not usually include grandparents. In this study, we spoke with 15 grandmothers and 15 mothers living in Scotland about the care that grandparents provide to their grandchildren. They described the different ways in which this care was managed in relation to other aspects of family life, like work. Grandmother care was described in two main ways—as either being responsible or as fun. The main driver of grandparent care was emotional—the love grandmothers held for their grandchildren. We consider the ways in which grandparents, with appropriate support from government at different levels, might help promote health in their grandchildren.

Supporting parents and healthy behaviours through parent-child meetings - a qualitative study in the Netherlands

Background

The first 2 years of a child’s life have been found to be crucial to healthy growth and development. Parent support groups can help parents to promote health-related behaviours during this crucial period. The aim of this study was to explore the experiences of parents who participated in a parent support group (Parent-Child Meetings) which promoted health-related behaviours of their children, and to determine whether and how these meetings supported them in promoting these behaviours.

Methods

We used a qualitative study design. The parent support group consisted of weekly Parent-Child Meetings organized in a multi-ethnic, relatively low-income neighbourhood in Amsterdam, the Netherlands. Data on the experiences of parents was collected through participatory observations, informal conversations (n = 30 sessions) and semi-structured interviews (n = 13) between April 2019 and March 2020. The data was analysed using thematic content analysis.

Results

Parents indicated that they experienced the parent-child meetings as enjoyable and as providing them with socio-emotional support. They reported that the meetings increased their parenting knowledge, skills and practices regarding healthy behaviours of their children and that they used this knowledge in their daily lives. They also appreciated the practical information and advice provided by experts in the meetings. Parents indicated that the positive attitude of the experts was crucial in accepting and adopting their advice. Additionally, parents valued the interactive and hands-on workshops, which integrated health-related behaviours and active play with children, as it enabled them to learn while they played with their children.

Conclusion

This study indicated that parent-child meetings contributed to enhancing parental knowledge, skills and practices regarding healthy behaviours of their children. This could potentially benefit the health of children during the first 2 years of their lives. In particular, the peer support of other parents, the hands-on workshops, and the concrete advice and information provided in an informal setting were highly valued by parents. Future parent support groups could use these findings to improve their meetings or to start meetings that better suit the needs of parents with young children.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11248-z.

[Family influences on maternal feeding practices of preschool children from vulnerable families in the Metropolitan Region of Chile]

Objetivo

Explorar las influencias de integrantes del grupo familiar en las prácticas de alimentación de madres hacia preescolares, en familias de barrios vulnerables en la Región Metropolitana de Santiago, Chile.

Diseño

Estudio cualitativo.

Lugar

Nueve jardines infantiles de la Región Metropolitana, Santiago, Chile.

Participantes

Veinticuatro madres y un padre de hijos preescolares.

Método

Se realizaron 25 entrevistas semiestructuradas con técnica de foto-elicitación y su posterior análisis temático inductivo de las influencias familiares.

Resultados

Las participantes describieron que las influencias familiares sobre las prácticas de alimentación que aplicaban en sus hijos preescolares dependían de la estructura familiar y de la cercanía entre familiares. Algunas de estas influencias afectan directamente la conducta alimentaria del niño, especialmente en familiares que cohabitan juntos, mientras que otras estaban mediadas por las relaciones generadas entre padres y otros miembros de la familia. El padre, en familias biparentales, y abuelos del preescolar son los familiares más influyentes. Los padres participan en la alimentación del niño y generalmente se alinean a las prácticas de alimentación con la madre. Los abuelos enriquecen la experiencia alimentaria de preescolares ofreciendo preparaciones caseras, expresando afecto con los alimentos, incluso opciones poco saludables, y apoyando a padres a diversificar y estructurar la alimentación del niño.

Conclusiones

El impacto de familiares y sus dinámicas en las prácticas alimentarias parentales y la alimentación de preescolares varían según la cercanía o cohabitación entre familiares. El desarrollo de estrategias de prevención y tratamiento de obesidad infantil debería considerar un enfoque familiar en familias vulnerables.

Associations of mothers' source of feeding information with longitudinal trajectories of sugar-sweetened beverage intake, 100% juice intake and adiposity in early childhood

BACKGROUND

There remains a need to understand how information sources can promote young children's healthy beverage consumption and prevent obesity.

OBJECTIVES

To examine associations of mothers' primary feeding information source with children's sugar-sweetened beverage (SSB) intake, 100% juice intake and adiposity between ages 3 and 7 years.

METHODS

We analyzed data from a prospective cohort study (n = 371 children; 13 visits). Mothers reported their primary feeding information source at baseline and completed child 3-day dietary records each visit. Child adiposity indicators were calculated from repeated height/weight measurements and dual-energy X-ray absorptiometry. Longitudinal models examined beverage intakes and adiposity over time by source.

RESULTS

Primary feeding information sources included doctors (48.2%), mothers (17.5%), grandmothers (13.5%), other healthcare professionals (11.3%) and other family/friends (9.4%). Children's juice intake with age differed by source (P interaction = 0.03), with steepest and slightest intake decreases in the doctor (-19.7% each year; 95% CI: -23.7%, -15.5%) and grandmother (-5.0%; -14.5%, 5.5%) subgroups, respectively. Children's SSB intake did not differ by source, but increased annually by 7.1% (4.5%, 9.8%) overall. The grandmother subgroup had the greatest child adiposity over time.

CONCLUSIONS

Mothers' primary feeding information source may have important, yet heterogeneous, influences on young children's beverage intakes and adiposity over time. Consistent evidence-based messages are likely needed.

Grandparental care and sleep disturbances in preschool children: a population-based prospective cohort study

OBJECTIVES

Sleep disturbances are common in preschoolers, and profoundly affected by parenting. Grandparents are increasingly involved in childcare and have attracted worldwide attention for their potential impacts on child well-being. However, no studies have explored child sleep health within the context of grandparental care. We aimed to explore the association between grandparents as primary caregivers and children's sleep disturbances.

METHODS

Participants included 20,324 preschoolers from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) in Shanghai, China. They were initially assessed in November 2016 and were reassessed in April 2018 and April 2019. Children's primary caregivers were collected at each survey. Sleep disturbances were assessed by the Children's Sleep Habits Questionnaire (CSHQ).

RESULTS

At baseline, 84.4% of children had global sleep disturbances (CSHQ total score >41). Compared with parents, random-effects model indicated that grandparents as primary caregivers increased the adjusted odds ratio (OR) for children's global sleep disturbances by 30% (OR [95%CI]: 1.30 [1.21, 1.40]). To the specific domains of CSHQ, two-way repeated-measures ANOVA showed significant "caregiver transition" group × wave interaction in the behavioral sleep disturbances, such as "Bedtime Resistance" (p < 0.001). At each survey, children with grandparents as primary caregivers demonstrated significant higher behavioral sleep disturbances than their counterparts with parental care.

CONCLUSIONS

Grandparental care is associated with increased sleep disturbances, particularly behavioral sleep disturbances, in preschoolers. Future studies should explore the underlying mechanisms and whether sleep programs targeting grandparents can decrease children's sleep disturbances.

Grandparental dietary provision, feeding practices and feeding styles when caring for preschool-aged grandchildren: A systematic mixed methods review

Grandparents are frequently relied upon to care for their preschool-aged grandchildren. These early years are a crucial age in the development of dietary habits and preferences. This review aims to determine grandparental dietary provision, feeding practices and feeding styles when caring for their preschool-aged grandchildren. Medline, PsycInfo and Web of Science were searched in January 2020. A systematic mixed methods approach was used to synthesize the qualitative (n = 13) and quantitative (n = 7) articles describing grandparents' feeding styles (n = 9), feeding practices (n = 14) and dietary provision (n = 18). Grandparents are serving large portion sizes and encouraging their grandchildren to eat frequently. Results are mixed for the types of foods provided; grandparents provide discretionary foods high in sugar and fat, and some also choose more expensive core foods as treats (e.g., berries). Grandparents engage in feeding practices that promote healthy eating (e.g., creating a healthy feeding environment) and promote autonomy and independence (e.g., considering their grandchild's preferences). However, they also use some coercive feeding practices (e.g., using food as a reward) and may be using indulgent feeding styles, which can be conducive to obesogenic dietary intakes. Interventions targeting grandparents could be an effective way to improve dietary-related health outcomes in young children.

Grandparents' perceptions of the barriers and strategies to providing their grandchildren with a healthy diet: A qualitative study

Grandparents are playing an increasingly important role in shaping their grandchildren's nutritional environment. Evidence-based interventions tailored to grandparents thus constitute a potential means of promoting healthy eating among children. For such interventions to be effective, they must account for the unique issues encountered by grandparents. However, research examining the potential needs of grandparents is limited. The present study thus explored (i) grandparents' perceptions of the barriers to providing their grandchildren with healthy food and minimizing consumption of unhealthy food and (ii) the strategies grandparents believe help increase their grandchildren's consumption of healthy food and reduce intake of unhealthy food. Seventy-nine grandparents, each of whom provided care to at least one grandchild aged 3-12 years, participated in one of ten focus groups. Transcripts from each of the groups were imported into NVivo for qualitative coding and semantic thematic analysis. The food preferences of their grandchildren, the promotion of unhealthy food consumption by their grandchildren's parents, advertising of unhealthy food, and peer pressure were the most frequently cited barriers to healthy food consumption. Grandparents reported using multiple strategies to increase their grandchildren's fruit and vegetable consumption and minimize unhealthy food intake. The most common were disguising vegetables, making fruit and vegetables appealing, managing child eating (e.g., limiting access to unhealthy food), saying no to requests for unhealthy food, involving grandchildren in meal planning and cooking, and using rewards. Findings suggest that grandparents may need support with managing food preferences and navigating and negotiating complex relations with parents regarding child feeding.

Parental Perspectives and Experiences in Relation to Lifestyle-Related Practices in the First Two Years of a Child's Life: A Qualitative Study in a Disadvantaged Neighborhood in The Netherlands

The first two years of a child's life are a critical period in preventing several lifestyle-related health problems. A qualitative study was conducted to explore parental experiences and perspectives in relation to lifestyle-related child-rearing practices in order to minimize risk factors at an early stage. Data were collected through interviews (n = 25) and focus groups (n = 4) with parents of children aged 0-2 years, in a disadvantaged neighborhood in Amsterdam, the Netherlands. Results showed that parents were often uncertain about a number of lifestyle-related practices. Ambiguity also appeared regarding the parents' intentions to engage in certain practices and what they were able to achieve in everyday life. In addition, parents experienced strong sociocultural influences from their family, which interfered with their ability to make their own decisions on lifestyle-related practices. Parents also expressed a need for peer-support and confirmation of their practices. Future studies should focus on supporting parents in their parental practices during the first two years of their child's life. Any such study should take into account the specific sociocultural context accompanying lifestyle-related parental practices.

An Overview of the Sociological and Environmental Factors Influencing Eating Food Behavior in Canada

This review extensively discusses various socio environmental factors affecting eating behavior of the general public within Canada including the development and implementation of national policies. A framework representing the determinants of healthy eating can be grouped into four categories i.e., the individual determinants, the economic environment, the social environment and the physical environment. This framework allowed for addressing food insecurity and social economic ecosystem of Canadians. Lastly, we investigate the role in which biotechnology plays in improving food security and addresses the significant impact biotechnology has contributed toward on agriculture and the food market. Overall, this review using such sources as Web of Science, Pub Med and Scopus provides significant contribution toward understanding the social economic environment and eating behavior of people living in Canada. In conclusion, this has led to identify a research gap as there is a significant need to address the development and implementation of policies in the food and nutrition environment.

Exploring Determinants of Parent Behaviors During Eating Episodes

OBJECTIVE

To develop a conceptual model of determinants of parent feeding behaviors with preschoolers.

DESIGN

Semistructured in-depth interviews were collected and transcribed verbatim.

SETTING

University of Houston.

PARTICIPANTS

Parents of preschool-aged children (aged 2-5 years).

PHENOMENON OF INTEREST

Determinants of parent behaviors during eating episodes with preschoolers.

ANALYSIS

Trained coders conducted thematic analysis with constant comparison of all interviews.

RESULTS

The final sample (n = 20) included predominantly white (60%), married (70%) mothers (75%) from middle socioeconomic conditions (100% had at least some college education; 70% had a household income >$50,000). Five categories of themes emerged: child behaviors, proactive parent behaviors, reactive parent behaviors, contextual factors, and parent beliefs. The themes were organized into a conceptual model to describe how parents and children influenced each other's behaviors depending on the context and parent beliefs of themselves and their child.

CONCLUSIONS AND IMPLICATIONS

A conceptual model outlining several determinants of parent feeding behaviors among preschoolers was developed. Next steps in the research are to validate the conceptual model identified in this qualitative study on a large, nationally representative sample.

Fathers' Perceptions of Their Role in Family Mealtimes: A Grounded Theory Study

OBJECTIVE

This study examines how fathers negotiate the role of feeding with other family members, and how this both impacts and is shaped by the structure of mealtimes.

DESIGN

Six separate focus groups.

SETTING

South East Queensland, Australia.

PARTICIPANTS

Fathers (N = 27) of children aged ≤12 years employed in blue-collar occupations or service industries.

PHENOMENON OF INTEREST

Fathers' perceptions of their role in family feeding.

ANALYSIS

Grounded theory.

RESULTS

Two major themes were identified: (1) mealtime structure, reflecting various arrangements and management procedures that give ultimate shape to mealtimes; and (2) division of labor, reflecting the work required to bring about such arrangements and how this work is allocated. These themes were interrelated and harmonized to create family mealtimes. Fathers felt that labor was assigned pragmatically; designated roles around feeding within the family facilitated structured mealtimes.

CONCLUSIONS AND IMPLICATIONS

Fathers' roles in balancing the labor and structured mealtimes to feed the family require further research attention, particularly across different family structures, to enhance their engagement in and contribution to the family meal environment. Offering cooking programs and meal planning education to fathers may support them in their different roles and enhance efficiency.

How do grandparents influence child health and development? A systematic review

Grandparents are often a key source of care provision for their grandchildren, yet they are sidelined in caregiving research and policy decisions. We conducted a global, systematic review of the literature to examine the scope and quality of studies to date (PROSPERO database CRD42019133894). We screened 12,699 abstracts across 7 databases, and identified 206 studies that examined how grandparents influence child health and development. Indicators of grandparent involvement were contact, caregiving behaviors, and financial support. Our review focused on two research questions: how do grandparents influence child health and development outcomes, and what range of child outcomes is reported globally? We examined study design, sample characteristics, key findings, and outcomes pertaining to grandchildren's physical health, socio-emotional and behavioral health, and cognitive and educational development.  Our search captured studies featuring grandparent custodial care (n = 35), multigenerational care (n = 154), and both types of care (n = 17). We found substantial heterogeneity in the data provided on co-residence, caregiving roles, resources invested, outcomes, and mechanisms through which "grandparent effects" are manifested. We identified two important issues, related to operationalizing indicators of grandparent involvement and conceptualizing potential mechanisms, leading to gaps in the evidence base. Currently, our understanding of the pathways through which grandparents exert their influence is constrained by limited data on what grandparents actually do and insufficient attention given to interpersonal and structural contexts. We present a conceptual framework to explicitly measure and theorize pathways of care, with a view to inform research design and policy implementation. We underscore the need for more robust data on three indicators of caregiver involvement-contact, behavior, and support-and for careful description of structural and interpersonal contexts in caregiving research.

Feeding-Related Knowledge, Attitudes, and Practices among Grandparents in Singapore

Childhood obesity is a growing concern worldwide. Though multifactorial, the family environment exerts significant influence on children’s eating habits. Grandparents are increasingly involved as caregivers and they can significantly influence their grandchildren’s eating habits. Yet, literature on this topic is lacking. This exploratory sequential mixed methods study (qualitative interview and interviewer-administered questionnaire) aims to understand grandparents’ knowledge, attitudes, and practices on the feeding of their grandchildren in Singapore. A total of 11 interview participants and 396 questionnaire respondents with at least one grandchild, aged 12 years and below were included. Qualitative interviews informed the questionnaire development. Responses to interview questions about knowledge, attitudes, and practices revealed sub-themes such as knowledge on the impact of feeding, attitude toward feeding role, and challenges to feeding. Of the 396 participants, 35% were primary caregivers (defined as the person who spends the most time with the grandchild and performs most of the caregiving tasks). Nutritional knowledge was fair (median score 5/8), with misconceptions centered around healthy feeding practices. Grandparents who were primary caregivers, female, Malay, and younger than 70 years old believed that they played an important role in feeding their grandchild (p < 0.05). Overall, 47.2% of the grandparents rarely or never set a maximum limit on the amount of unhealthy food eaten, of which 77.1% are non-primary caregivers. In comparison, primary caregivers tend to set a maximum limit to the amount of unhealthy food their grandchildren eat and choose a wide variety of food (p < 0.05). These findings support the need for further improvement of grandparents’ feeding knowledge and practices as part of tackling childhood obesity.