Promotion of healthful beverage practices by parents of children (6-12 years)

Abstract

Background: The prevalence of obesity among children (6-11 years) in the U.S. has increased from 7% to 20% in the past 30 years. Sugar-sweetened beverage (SSB) intake has been associated with weight gain among children. Energy imbalance and excessive weight gain from SSB consumption could lead to adverse health consequences in childhood and later in adulthood. Parents exert a strong influence on dietary intake of children based on the example they provide and the foods and beverages they make available at home. This dissertation investigated beverage parenting practices of parents of children (6-12 years) in three studies. Methods and Results: Parent and child participants for the three studies were recruited at the Minnesota State Fair in 2014, 2015 and 2016 at the Driven to Discover Building, a building that houses University of Minnesota research studies. The same home beverage availability and parent beverage intake questionnaires that were previously evaluated for validity and reliability were used in all three studies. Beverage intake among children: associations with parent and home-related factors (Study 1) The first study was a cross-sectional study with parents and their early adolescent children (9-12 years). The purpose was to determine associations between beverage intakes among early adolescent children (9-12 years) and home- and parent-related factors. A survey was administered to 194 parents to assess usual beverage intake, home beverage availability and beverage nutrition knowledge. Early adolescents completed a survey to assess usual beverage intake. Home availability of dairy beverages and parent dairy intake were positively associated with child dairy beverage intake. Home availability of SSBs was positively correlated with child SSB intake. Parent beverage knowledge about sugar was related to child dairy beverage intake. Results indicated that parental knowledge and parenting practices including managing beverage availability and role modeling may influence child beverage intake. Gain-framed messages motivate sugar-sweetened beverage parenting practices more than loss-framed messages (Study 2) The second study was a cross-sectional study with parents of children (6-12 years) that tested the effects of message framing (gain- vs. loss-framed) on behavioral intention of parents to role model healthful beverage intake and make healthful beverages available in the home for children (6-12 years). A survey was administered to 380 parents to assess usual beverage intake and home beverage availability. The survey included questions to test the effectiveness of message framing on behavioral intention to control home beverage availability and role model beverage intake. Gain-framed messages produced significantly greater intention to make healthful beverages available in the home and to role model healthful beverage intake than loss-framed messages. Effectiveness of an online newsletter/text message intervention promoting beverage-related parenting practices: pilot test results (Study 3) The third study was a single group, pre-post pilot intervention study. A 4-week, newsletter/text message intervention was developed and tested for parents of children (6-12 years) to improve home availability of healthful beverages and parental role modeling of healthful beverage intake. A survey (pre-test) was administered to parents (n=197) to assess usual parent beverage intake, home availability of beverages, and parent-reported child beverage intake. Parents received 3-weekly online newsletters as an email attachment in 2 formats (Pdf and an image) using gain-framed messages to promote healthful beverage parenting practices. They also received 6 text messages in the 3-week period consistent with the newsletter themes. One-hundred and seven parents completed the post-test survey with 100 parents having usable pre-post survey data. Positive effects were observed regarding parent beverage intake, parent-reported child beverage intake, and home beverage availability. Conclusions: In the first study, making healthful beverages available in the home and role modeling healthful beverage intake were identified as strategic intervention targets for parents to decrease child SSB intake. Gain-framed messages were found to be more effective in the second study compared to loss-framed messages in motivating parents to engage in positive beverage parenting practices. In the third study, a brief newsletter/text message intervention was identified as a potentially useful method to promote positive beverage parenting practices.