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Stressed Out! Examining family meal decisions in response to daily stressors via ecological momentary assessment in a racially/ethnically diverse population.

ABSTRACT: The impact various sources of stress have on family meal decisions and child health-related behaviors is an understudied area. For this study, 128 racially/ethnically diverse parent/child dyads were recruited from primary care clinics in the Twin Cities, Minnesota between 2015 and 2016. Parent participants completed eight days of ecological momentary assessment, which included end-of-day surveys where the parent reported on (1) sources of daily stress (e.g., family demands, work/school demands) and related family meal choices (e.g., fixed quick meal, skipped meal), (2) meal planning, and (3) parent and child health-related behaviors (e.g., watched TV, ate unhealthy snack). Adjusted generalized estimating equations were used to estimate marginal probabilities and 95% confidence intervals of outcomes by race/ethnicity. Results indicated that common meal-related choices as a result of being stressed varied from fixing a quick/easy meal, buying fast food, everyone fixing their own meal or skipping a meal, or none of the above. When parents reported family demands as the source of stress, children were three times more likely to eat an unhealthy snack. Additionally, children were more likely to eat an unhealthy snack with higher levels of parental stress or if families have not planned the meal the night before. Interventions to lower parental stress and support family meal planning may increase the healthfulness of the home food environment during moments of elevated stress.

SUBMITTER: Tate A

PROVIDER: S-EPMC7736971 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Stressed Out! Examining family meal decisions in response to daily stressors via ecological momentary assessment in a racially/ethnically diverse population.

Tate Allan A Telke Susan S Trofholz Amanda A Miner Michael M Berge Jerica M JM

Preventive medicine reports 20201125

The impact various sources of stress have on family meal decisions and child health-related behaviors is an understudied area. For this study, 128 racially/ethnically diverse parent/child dyads were recruited from primary care clinics in the Twin Cities, Minnesota between 2015 and 2016. Parent participants completed eight days of ecological momentary assessment, which included end-of-day surveys where the parent reported on (1) sources of daily stress (e.g., family demands, work/school demands) ...[more]

PMID: 33344147

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Project description:BACKGROUND:Current measures of parent feeding practices are typically survey-based and assessed as static/unchanging characteristics, failing to account for fluctuations in these behaviors across time and context. The current study uses ecological momentary assessment to examine variability of, and predictors of, parent feeding practices within a low-income, racially/ethnically diverse, and immigrant sample. METHODS:Children ages 5-7 years old and their parents (n?=?150 dyads) from six racial/ethnic groups (n?=?25 from each; Black/African American, Hispanic, Hmong, Native American, Somali, White) were recruited for this mixed-methods study through primary care clinics. RESULTS:Among parents who used restriction (49%) and pressure-to-eat (69%) feeding practices, these feeding practices were utilized about every other day. Contextual factors at the meal associated with parent feeding practices included: number of people at the meal, who prepared the meal, types of food served at meals (e.g., pre-prepared, homemade, fast food), meal setting (e.g., kitchen table, front room), and meal emotional atmosphere (p?<?0.05). Parents tended to restrict desserts, dairy, and vegetables and pressure children to eat fruits, vegetables, meat proteins, and refined grains (p?<?0.05). There were some differences by race/ethnicity across findings (p?<?0.01), with Hmong parents engaging in the highest levels of pressure-to-eat feeding practices. CONCLUSIONS:Parent feeding practices varied across the week, indicating feeding practices are more likely to be context-specific, or state-like than trait-like. There were some meal characteristics more strongly associated with engaging in restriction and pressure-to-eat feeding practices. Given that parent feeding practices appear to be state-like, future interventions and health care providers who work with parents and children may want to address contextual factors associated with parent feeding practices to decrease restriction and pressure-to-eat parent feeding practices.

Project description:BackgroundEcological momentary assessment (EMA) is an innovative tool for capturing in-the-moment health behaviors as people go about their daily lives. EMA is an ideal tool to measure weight-related behaviors, such as parental feeding practices, stress, and dietary intake, as these occur on a daily basis and vary across time and context. A recent systematic review recommended standardized reporting of EMA design for studies that address weight-related behaviors.ObjectiveTo answer the call for reporting study designs using EMA, this paper describes in detail the EMA design of the Family Matters study and how it was adapted over time to improve functionality and meet the needs of a racially, ethnically, and socioeconomically diverse sample.MethodsFamily Matters is an incremental, 2-phased, mixed methods study, conducted with a racially and ethnically diverse, immigrant and refugee sample from largely low-income households, designed to examine risk and protective factors for child weight and weight-related behaviors in the home environment. The Family Matters study intentionally recruited White, Black, Hmong, Latino, Native American, and Somali parents with young children. Parents in phase 1 of the study completed 8 days of EMA on their smartphones, which included signal-contingent surveys (eg, asking about the parent's stress at the time of the survey), event-contingent surveys (eg, descriptions of the meal the child ate), and end-of-day surveys (eg, overall assessment of the child's day).ResultsA detailed description of EMA strategies, protocols, and methods used in phase 1 of the Family Matters study is provided. Compliance with EMA surveys and participants' time spent completing EMA surveys are presented and stratified by race and ethnicity. In addition, lessons learned while conducting phase 1 EMA are shared to document how EMA methods were improved and expanded upon for phase 2 of the Family Matters study.ConclusionsThe results from this study provided an important next step in identifying best practices for EMA use in assessing weight-related behaviors in the home environment.International registered report identifier (irrid)DERR1-10.2196/30525.

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Dataset Information

Stressed Out! Examining family meal decisions in response to daily stressors via ecological momentary assessment in a racially/ethnically diverse population.

Publications

Stressed Out! Examining family meal decisions in response to daily stressors via ecological momentary assessment in a racially/ethnically diverse population.

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