Big hearts, small hands: a focus group study exploring parental food portion behaviours

Abstract

BackgroundThe development of healthy food portion sizes among families is deemed critical to childhood weight management; yet little is known about the interacting factors influencing parents’ portion control behaviours. This study aimed to use two synergistic theoretical models of behaviour: the COM-B model (Capability, Opportunity, Motivation – Behaviour) and Theoretical Domains Framework (TDF) to identify a broad spectrum of theoretically derived influences on parents’ portion control behaviours including examination of affective and habitual influences often excluded from prevailing theories of behaviour change.MethodsSix focus groups exploring family weight management comprised of one with caseworkers (n = 4), four with parents of overweight children (n = 14) and one with parents of healthy weight children (n = 8). A thematic analysis was performed across the dataset where the TDF/COM-B were used as coding frameworks.ResultsTo achieve the target behaviour, the behavioural analysis revealed the need for eliciting change in all three COM-B domains and nine associated TDF domains. Findings suggest parents’ internal processes such as their emotional responses, habits and beliefs, along with social influences from partners and grandparents, and environmental influences relating to items such as household objects, interact to influence portion size behaviours within the home environment.ConclusionThis is the first study underpinned by COM-B/TDF frameworks applied to childhood weight management and provides new targets for intervention development and the opportunity for future research to explore the mediating and moderating effects of these variables on one another.

Australian parents' experiences when discussing their child's overweight and obesity with the Maternal and Child Health nurse: A qualitative study

“…Parents felt that nurses assumed parental knowledge on BMI and childhood overweight management and that parental understanding on the issue was rarely examined. The findings of this study are supported by Curtis, Atkins, and Brown () who suggest that parents find it difficult to quantify portion sizes for children and lack knowledge and skills in this area. This highlights the need for greater nurse understanding of parental health literacy on this topic and how poor parental, family and community health literacy impacts on child health outcomes (Nutbeam, ), including childhood obesity (Chari, Warsh, Ketterer, Hossain, & Sharif, ).…”

The portion size effect and overconsumption – towards downsizing solutions for children and adolescents

“…In previous research, parents struggled with quantifying appropriate portions for children and adjusting portions was considered effortful and inconvenient (Curtis et al . ). Evidence from a qualitative study by Blake et al .…”

“…It will be interesting to discover whether these strategies are acceptable. In previous research, parents struggled with quantifying appropriate portions for children and adjusting portions was considered effortful and inconvenient (Curtis et al 2017). Evidence from a qualitative study by Blake et al (2015) of 60 low-income families found that portion size control strategies used by parents included using small containers and measuring cups to subdivide large portions and purchasing small pre-packaged snacks.…”

The portion size effect and overconsumption – towards downsizing solutions for children and adolescents – An update

“…However, parents also describe these efforts as inconvenient, often relying on pre‐packaged items to determine the appropriate amount to serve children (Curtis et al . ). As packages for HED snacks are generally developed with adults in mind, an appropriate portion size for a child may indeed involve downsizing the contents of the pack.…”