Parent perspectives on preschoolers’ movement and dietary behaviours: a qualitative study in Soweto, South Africa

Abstract

Objective: Childhood obesity is of increasing concern in South Africa, and interventions to promote healthy behaviours related to obesity in children are needed. Young children in urban low-income settings are particularly at risk of excess adiposity. The current study aimed to describe how parents of preschool children in an urban South African township view children’s movement and dietary behaviours, and associated barriers and facilitators. Design: A contextualist qualitative design was utilised with in-depth interviews conducted in the home setting and analysed using reflexive thematic analysis. Field notes were used to contextualise findings. Setting: Four neighbourhoods in a predominantly low-income urban township. Participants: Sixteen parents (fourteen mothers, two fathers) of preschool-age children were recruited via preschools. Results: Four themes were developed: children’s autonomy and the limits of parental control; balancing trust and fears; the appeal of screens; and aspirations and pressures of parenthood. Barriers to healthy behaviours included children’s food preferences, aspirations and pressures to consume unhealthy foods, other adults giving children snacks, lack of safe places to play, unhealthy food environments and underlying structural factors. Facilitators included set routines, the preschool environment, safe places to play and availability of healthy foods. Conclusions: Low-income families in Soweto face many structural challenges that cannot easily be addressed through public health interventions, but there may be opportunities for behavioural interventions targeting interpersonal and organisational aspects, such as bedtime routines and preschool snacks, to achieve positive changes. More research on preschoolers’ movement and dietary behaviours, and related interventions, is needed in South Africa.

“Must you make an app?” A qualitative exploration of socio-technical challenges and opportunities for designing digital maternal and child health solutions in Soweto, South Africa

“…The findings also echo previous qualitative research from Soweto in that health concerns, especially any future or relatively abstract health issues, must be seen against the background of more urgent personal needs, such as welfare and income, and underlying structural factors that health interventions rarely address [22,35,36]. Coping as parents was a common concern with multiple dimensions such as financial, emotional and practical coping.…”

Influence of Neighborhood Built Environments on the Outdoor Free Play of Young Children: a Systematic, Mixed-Studies Review and Thematic Synthesis

“…n = 145 Quantitative, cross-sectional: to identify neighborhood features perceived as relevant to preschoolers’ active play, parents’ active recreation, and their coactivity; to determine whether features considered relevant differed between activity domains and to determine whether relevant features differed by household income Parental perception of relevance of destinations (parks, dog parks, playgrounds, schools, sports fields, courts, arenas/ice rinks, community hall, river valley/ravine), design (main roads, cul-de-sacs, quiet streets, block length, trails, sidewalks), social factors (friends/family, child’s friends, other people walking/exercising, other children playing outside, knowing neighbors, trusting people in neighborhood), safety (street lighting, low crime, low vehicle traffic, daylight, sidewalk maintenance, pedestrian crosswalks), aesthetics (cleanliness, no graffiti, attractive houses, natural features, landscaped features) and child’s active play, parent/child coactivity ** Kabisch and Kraemer [ 36 ] Germany Visitors to two closely situated parks with different characteristics in Leipzig, during the 1-week study period, Children 0–6 years, n = 253 groups Quantitative, descriptive, cross-sectional: to examine which park characteristics attract children and older people and whether users adapt their behaviors under conditions of summer heat? Physical environments of two different parks including: size, vegetation, facilities and surrounding conditions Descriptive statistics on characteristics of two parks and user ages, observed places of activity during the 7 day observation period with temperatures ranging from < 25 to above 29.6 °C **** Kimbro et al [ 69 ] USA Sub-sample of birth cohort that, when weighted is, representative of all births in large US cities, 1998–1999.Children, 3–5 years, n = 1822 Quantitative, cross-sectional: to examine if outdoor play and television viewing are associated with 5-year-old’s weight status and whether subjective and objective measures of residential contexts are associated with activity patterns Residential context, neighborhood poverty, residential tenure, neighborhood collective efficacy, physical disorder, physical decay measures Hours of weekday outdoor play ***** Klingberg et al [ 75 ] South Africa Socio-economically diverse parents of 3–5-year-old children in Soweto. n = 16 parents Qualitative: to describe how parents of pre-school-age view children’s health behaviors and to situate these perspectives in the context of preschoolers’ homes and wider environments Parent perspectives on preschoolers’ movement behaviors (including barriers and facilitators to physical activity and outdoor play behaviors) …”

Perceptions of the South African 24-Hour Movement Guidelines for Birth to 5 Years: A Qualitative Study

“…[13][14][15] While there are constraints to changing these behaviors in low-income, urban households, the findings presented in this paper align with other research, which has found that caregivers of young children in these settings are generally receptive to attempting to implement these changes, particularly if the focus is on child health and development in a more holistic sensenot just obesity prevention. [16][17][18] In terms of potential intervention strategies, CBOs already working with caregivers and practitioners (ECD and health related) to promote any aspect of young children's health and development should be encouraged to incorporate input on screen time and sleep, in order to address these as priority behaviors. Strategies can use the infographic as a visual aid but should not be limited to the mere provision of a printed resource without an explanation and the opportunity to ask questions to stimulate understanding.…”