Low-income families have increased risks for cancer, cardiovascular disease (CVD) obesity and diabetes related to adverse diets especially low in fruit and vegetable intake (FVI). Various caregiver (CG) attitudes and behaviors including feeding practices relate to child and CG FVI. The organizational structure of these CG influences has not been specified in low-income families in diverse race/ethnic groups. We propose a cognitive mapping approach to define CG perceptions of FVI barriers and facilitators and to model how these and CG feeding practices, availability and accessibility relate to CG and child FVI in Non-Hispanic White (W), Non-Hispanic African-American (AA) and Hispanic (H) primary CG and their children from Head Start districts in Houston, Texas and Alabama.
The specific aims are to: (1) identify CG-derived barriers and facilitators to family FVI using Nominal Group Technique (NGT) structured focus groups; (2) examine the organization of these CG attitudes using card sorts of these CG issues and to weight these from individual CG perceived ratings of their personal importance and confidence for making adaptive changes; (3) assess child and CG FVI and BMI, caregiver feeding practices and FV availability and accessibility; (4) model CG and child FVI as functions of these psychosocial assessments and the weighted clusters of barriers and facilitators; (5) describe family groups differing in these relevant correlates of FVI; and (6) translate the relevant correlates to performance objectives for a future tailored intervention to increase low income family FVI. In each aim, we will examine potential differences by race/ethnicity. Our multidisciplinary team has expertise and experience working in Head Start districts, assessing correlates of FVI in children and adults, CG cognitive mapping and intervention development. This proposal addresses important unanswered questions that when answered will permit the development of effective interventions tailored to specific CG characteristics.
