1. Food and Drink Free Lists Document Home Environments and Create Content for Messages to Parents of Middle-School Children
Erin Green, RD; Alisha Gaines, PhD; Tisa Fontaine Hill, MPH; Jamie S Dollahite, PhD
“Water or Kool-Aid and we only have pop on special occasions.” (c6)
My plate: Dark-green vegetables
bok choy
broccoli
collard greens
dark green leafy lettuce
kale
mesclun
mustard greens
romaine lettuce
spinach
turnip greens
watercress
Objective
Results
Discussion
These data include a wider variety of foods and beverages than anticipated based on formative work in focus groups with parents of middle school children. This suggests that more foods and drinks may be acceptable to families, and this will be taken into account when developing content for forthcoming messages to parents.
Additional information was collected during free listing regarding seasonality, cost, and child preferences with both parents and middle school children. These detail a range of influences on the home food environment that will directly inform message refinement in order to make information more relevant for both parents and their children.
This study was exploratory with a small sample size that limits generalizability, but there are current plans established to expand data collection.
Results from focus groups with parents of middle school children (n= 46 parents in 7 focus groups) in Fall 2013 and Spring 2014 suggests that parents find getting children to try new vegetables and fruits, eat a variety of vegetables, and choose water over sugar-sweetened beverages particularly challenging. To provide parents with relevant information and feasible strategies to support children in making healthful choices, a better understanding of current food and drink exposure is needed. The objective was to explore reported fruit, vegetable, and drink variety at home using modified free lists with parents and middle-school children.
Most Common Fruits, Vegetables, & Drinks
(Mentioned by more than half of participants)
Children Parents
“ I would like to have a strawberry too, but it’s so expensive and it doesn’t taste very well in this time of the year.”
(parent, 34 years old)
“Are yams a vegetable?”
(child; 13 years old)
“Does lettuce count?”
(child; 11 years old)
methods
One-on-one interviews conducted from 11/2014 – 03/2015.
Cornell Cooperative Extension staff recruited participants through programming, s, and flyers.
Inclusion Criteria: Parents >18 years; Children in 6th-8th grade in a New York State public school; English speaking.
Semi-structured interviews were conducted that included a modified free listing technique to record current fruits, vegetables, and drinks available to respondents in their home environments.
The total number of items in each category for each participant’s free list was calculated, with most common (listed by > ½ participants) and group ranges determined.
For analysis, milk products were classified as one item with flavored milks excluded. Leafy greens were classified as one item, informed by commonly eaten “dark-green vegetables” from ChooseMyPlate.gov. This category included collard greens, kale, mustard greens, lettuce, bok choy, and spinach, all mentioned during free listing.
Example free list interview questions include:
Parents: “Please list the fruits you and your family eat every week.”
Child: “Can you list the fruits you usually eat? What fruits do you have at home?”
Children (n = 21)
Parents (n = 17)
Sex
11 male/10 female
1 male/16 female
Area
10 rural/11 urban
7 rural, 10 urban
Race
Black/AA (n= 4)
Caucasian (n= 12)
Native American (n= 1)
Other (n= 4)
Black/AA (n= 2)
Caucasian (n= 15)
Age
11 yrs old (n= 6)
12 yrs old (n= 8)
13 yrs old (n= 7)
< 30 yrs old (n= 1)
30-39 yrs old (n= 7)
40-49 yrs old(n= 7)
> 50 yrs old(n= 2)
conclusions
These results (1) provide insights about the home food environment and (2) the variety of fruits, vegetables, and drinks that middle-school children are currently exposed to in the home.
Results will help inform parent messages targeted at improving eating behaviors among middle-school children by recognizing current challenges, child preferences, and providing appropriate food and drink recommendations and recipes to parents based on free list results.
“Well my mom doesn’t allow pop in the house unless it’s for her and my dad, and my brothers like Kool-Aid, but I don’t, so I usually just drink milk or water. “
(child; 12 years old)
“What I like to do is cook up a lot of kale or spinach and that might be like a side dish with dinner, but then, I have extra and I like to make eggs mixed up with veggies in the morning.” (parent, 48 years old)
Table 1: Participant Information
Implications
Using free listing as a component of one-on-one interviews with parents and middle-school children is an effective technique for providing participants with opportunities to express valuable opinions and insights without extensive probing and follow up questioning by the interviewer.
Asking children in this age range to create free lists at the beginning of an interview may be especially valuable because:
It represents is a non-threatening way to start interviews.
Free lists may mentally prepare children for a more in-depth discussion and open-ended questions, which may be more challenging for a middle school child.
Beginning the interview with free lists may also help to root the child in their own experience rather than what they think the interviewer wants to hear.
Ranges for Each Free List Category
(based on total number of fruits, vegetable, & drink listed by participants)
Free List Category
Children
Parents
Fruits
2-12
2-23
Vegetables
2-14
3-21
Drinks
3-15
5-13
Table 2: Ranges for Free Lists Categories
Current free list results indicate that the variety of fruits, vegetables, and drinks listed by parents as being available at home is potentially greater than that suggested by recent formative focus groups with parents of middle school children.
Free list results also indicate that although the variety of fruits, vegetables, and drinks listed by children is generally smaller when compared to parents, a large range still exists for children for each free list category.
This material is based upon work supported by U.S. Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the USDA | Cornell Cooperative Extension provides equal program and employment opportunities.