Lauren K. Williams

Why do some socioeconomically disadvantaged women eat better than others? An investigation of the personal, social and environmental correlates of fruit and vegetable consumption☆

The purpose of this paper was to examine the contribution of individual, social and environmental factors to predicting fruit and vegetable consumption among women of low socioeconomic position (SEP). An Australian community sample of 355 women of low SEP provided survey data on sociodemographic information, diet (fruit and vegetable consumption), and various cognitive, behavioural, social and perceived environmental influences on healthy eating. Information on the availability and accessibility of major chain supermarkets and fruit and vegetable stores from participants residence was collected through objective audits. Women who were older, dieting to lose weight, had a greater taste preference for fruit and perceived the cost of fruit to be lower were more likely to be high fruit consumers. Women who had a high BMI were more likely to be high vegetable consumers. Women who perceived a greater availability of healthy foods in their neighbourhoods were more likely to be high fruit and vegetable consumers. Strategies aimed at increasing fruit and vegetable consumption among low SEP women should focus on modifying perceptions about the cost, availability and taste of fruits and vegetables. Tailoring nutrition interventions to accommodate differences in age, weight-control practices and weight status may also prove beneficial.

What helps children eat well? A qualitative exploration of resilience among disadvantaged families

It is well known that persons of low socioeconomic position consume generally a less healthy diet. Key determinants of unhealthy eating among disadvantaged individuals include aspects of the family and external environment. Much less is known about family and environmental determinants of healthy eating among social disadvantaged children. The aim of this study was to gain insight into the family and environmental factors underlying resilience to poor nutrition among children and their mothers living in disadvantaged neighbourhoods. Semi-structured interviews were conducted with 38 mother-child pairs (N = 76) from disadvantaged neighbourhoods. Children were selected if they were a healthy weight, consumed adequate intakes of fruit and vegetables and were physically active. Two main themes emerged from the interviews: active strategies from parents to promote healthy eating and external barriers and supports to healthy eating. Mothers believed that exercising control over access to unhealthy food, providing education and encouragement for consumption of healthy food and enabling healthy food options aided their child to eat well. Children did not perceive food advertisements to be major influences on their eating preferences or behaviour. The results of the current study offer insight into potential avenues for nutrition promotion among disadvantaged children.

Optimising women's diets. An examination of factors that promote healthy eating and reduce the likelihood of unhealthy eating.

The majority of nutrition promotion research that has examined the determinants of unhealthy or healthy dietary behaviours has focused on factors that promote consumption of these foods, rather than factors that may both promote healthy eating and buffer or protect consumption of unhealthy foods. The purpose of this paper is to identify factors that both promote healthy eating and also reduce the likelihood of eating unhealthily amongst women. A community sample of 1013 Australian women participated in a cross-sectional self-report survey that assessed factors associated with diet and obesity. Multiple logistic regressions were used to examine the associations between a range of individual, social and environmental factors and aspects of both healthy and unhealthy eating, whilst controlling for key covariates. Results indicated that women with high self efficacy for healthy eating, taste preferences for fruit and vegetables, family support for healthy eating and the absence of perceived barriers to healthy eating (time and cost) were more likely to consume components of a healthy diet and less likely to consume components of a unhealthy diet. Optimal benefits in overall diet quality amongst women may be achieved by targeting factors associated with both healthy and unhealthy eating in nutrition promotion efforts.

Behavioral side effects of pediatric acute lymphoblastic leukemia treatment: the role of parenting strategies.

Behavioral and emotional difficulties are a recognised side effect of childhood acute lymphoblastic leukemia (ALL) treatment. Modifiable factors, such as parenting strategies, may be an appropriate target for interventions to assist families with managing their childs behavior, potentially leading to improved psychosocial and clinical outcomes. This study examined whether parenting strategies are associated with child behavioral and emotional problems in a pediatric oncology context, with the aim of establishing whether parenting is a potential modifiable target for psychosocial intervention.

Parenting a child with cancer: Perceptions of adolescents and parents of adolescents and younger children following completion of childhood cancer treatment

Abstract Objective: Research examining the impact of childhood cancer on parenting is limited. This qualitative study explored perceptions from adolescents and parents of the impact of childhood cancer on parenting 2–5 years post-end of treatment. Methods: Fifty-seven semi-structured interviews were conducted with: (a) 14 parents of preadolescent children (the ‘parents of children’ group); and (b) 21 adolescents and 22 parents of adolescents (the ‘adolescents and their parents’ group; N = 43). Inductive thematic analysis was used to identify and interpret themes. Results: Six main themes emerged: (1) Parenting strategies: relaxing discipline, bribing and spoiling children; (2) Regressive parenting; (3) Structured parenting: keeping up a ‘normal’ routine; (4) Intimacy, closeness and emotional support; (5) Differential parenting; and (6) Parental protectiveness. Some themes were group specific, whilst other themes emerged for both the ‘parents of children’ and ‘adolescents and their parents’ groups. Some reports of parenting were associated with initial stages of cancer whereas other aspects of parenting attitudes and behaviours appeared to exist after the demands of diagnosis and treatment. This suggests that there is some overlap in the parenting strategies used during ‘active’ stages of the disease and survivorship. Conclusion: Our results highlight the importance of understanding parenting processes that can operate throughout the disease trajectory for families experiencing paediatric cancer. Parenting is an ongoing process and as such, parenting intervention efforts should not be limited to the active treatment phase of a child’s diagnosis.

Is maternal nutrition knowledge more strongly associated with the diets of mothers or their school-aged children?

OBJECTIVE Maternal nutrition knowledge has frequently been identified as an important target for nutrition promotion interventions. The aim of the present study was to investigate whether maternal nutrition knowledge is more strongly associated with the mothers own diet or that of her child. DESIGN Cross-sectional multivariate linear regression with interactions analyses of survey data. SETTING Socio-economically disadvantaged neighbourhoods in Victoria, Australia. SUBJECTS Five hundred and twenty-three mothers and their children who participated in the Resilience for Eating and Physical Activity Despite Inequality (READI) study, a cross-sectional survey study conducted in 2009 among women and their children residing in socio-economically disadvantaged neighbourhoods. RESULTS In adjusted models, for three (vegetable, chocolate/lollies and soft drink consumption) out of the seven dietary outcomes assessed, there was a significant association between maternal nutrition knowledge and maternal diet, whereas for the childrens diets none of the seven outcomes were associated with maternal nutrition knowledge. Statistical comparison of regression coefficients showed no difference between the maternal nutrition knowledge-maternal diet association and the maternal nutrition knowledge-child diet association. CONCLUSIONS Promoting maternal nutrition knowledge may represent an important avenue for improving diet in mothers from socio-economically disadvantaged neighbourhoods, but more information is needed on how and when this knowledge is translated to benefits for their childrens diet.

A review of factors associated with mental health in siblings of children with chronic illness

This article reviews the literature on modifiable factors associated with mental health in siblings of children with chronic illness. Three clinical databases were searched. A total of 17 studies met the inclusion criteria. Several key themes emerged from the review. Better sibling mental health was associated with camp attendance, perceived parent/peer support, illness education and enhancing control through cognitive coping strategies and routine. Parental and sibling psychoeducation interventions and social support may enhance children’s mental health when their sibling has a chronic illness.

Improving perceptions of healthy food affordability: results from a pilot intervention

BackgroundDespite strong empirical support for the association between perceived food affordability and dietary intake amongst families with a lower socioeconomic position (SEP), there is limited evidence of the most effective strategies for promoting more positive perceptions of healthy food affordability among this group. This paper reports findings from a pilot intervention that aimed to improve perceptions of healthy food affordability amongst mothers.FindingsParticipants were 66 mothers who were the parents of children recruited from primary schools located in socioeconomically disadvantaged suburbs. Intervention group participants viewed a slideshow focussed on healthy snack food affordability that illustrated cheaper healthier alternatives to common snack foods as well as food budgeting tips and price comparison education. A mixed between-within ANCOVA was conducted to examine group differences in perceived affordability of healthy food across three time points. Results revealed no difference in perceived affordability of healthy food between the two groups at baseline whereas at post-intervention and follow-up, mothers in the intervention group perceived healthy food as more affordable than the control group.ConclusionsFocussing on education-based interventions to improve perceptions of healthy food affordability may be a promising approach that complements existing nutrition promotion strategies.

Screening for Psychological Well-Being in Childhood Cancer Survivors: A Preliminary Assessment of the Feasibility of the Strength and Difficulties Questionnaire as a Parent-Proxy Report

This article describes the feasibility of utilizing the Strengths and Difficulties Questionnaire (SDQ) as a brief psychosocial screener among survivors of pediatric cancer. Participants were parents of a child/adolescent diagnosed with cancer who were off treatment (n = 35) and a subset of adolescents (n = 14). Parent-proxy report using the SDQ was significantly associated with the Child Health Questionnaire. Parents who self-reported long-term uncertainty about their childs illness were more likely to report child psychosocial difficulties. A trend for concordance between patient and parent-proxy report of the SDQ was observed. These preliminary results highlight the potential utility of the SDQ as a screening tool for detection of child/adolescent psychosocial well-being. Further research, with larger samples, is needed to support these results.

Associations Between Education and Personal Income With Body Mass Index Among Australian Women Residing in Disadvantaged Neighborhoods

Purpose. The aims of the current study were to (1) determine the association between personal income and body mass index (BMI) and between individual education and BMI, and (2) examine the association between education and BMI across strata of personal income among women. Design. The design of the study was a quantitative analysis of data from self-report questionnaires. Setting. The study setting was socioeconomically disadvantaged neighborhoods in Victoria, Australia. Subjects. The study included 4065 nonpregnant women (ages 18–45 years) living in socioeconomically disadvantaged areas. Measures. The study used a self report questionnaire measuring sociodemographic characteristics known to be associated with BMI. Analysis. Multiple linear regressions with imputation were used to assess the association between education level, personal income, and BMI, while controlling for covariates. Results. Mean (SD) observed BMI was 26.0 (6.1) kg/m2. Compared with women with low education, women with medium (b = −0.81; 95% confidence interval, −1.30 to −0.27; p = .004) and high (b = −1.71; 95% confidence interval, −2.34 to −1.09; p < .001) education had statistically significantly lower BMI values. No differences in BMI were observed between income categories. Stratified analyses suggested that the education-BMI association may be stronger in low-income than higher-income women. Conclusion. Our data show that among women living in socioeconomically disadvantaged areas, high education level rather than personal income may be protective against overweight/obesity. High personal income, however, may buffer the effects of low education on BMI. Obesity prevention efforts should target women with amplified disadvantage.