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Evidence based nursing research: Low Income Mothers and Their Overweight Preschoolers

Lynda Chase

Ferris State University

Evidence based nursing research: Low Income Mothers and Their Overweight Preschoolers

Descriptive Summary

Article 4

This research article addressed how low-income mothers perceived their overweight preschool children. Biologic mothers were chosen because they were more likely to have been the ones directly involved with the nutrition of the child. Many themes were generated by this study on how these mothers explained their rationale for not considering their children to be overweight.

Appraisal of Evidence

Article 4

Research design/data collection

There was a wide range in age of mothers that were interviewed from the ages of 18-42 years. Interviews were done with 21 mothers who were enrolled in Kentucky’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) (C. Hughes, S. Sherman, and R.C. Whitaker, 2010, p. 465). Being a federally funded program, the mothers and children must meet certain criteria to qualify for the program that provides supplemental food and nutritional counseling. The WIC program, which is administered through states, is highly accessible to those who are income eligible (Besharov & Germanis, 2001). For example, those receiving benefits from other social services programs, such as Medicaid, automatically meet the income-eligibility criteria (USDA, 2009). This program requires parents to participate in nutrition sessions. Even though this is a requirement, parents enroll in the WIC program primarily for the benefit of food assistance, not the counseling.

The study included seven African American (Goodell et al., 2008; Jain et al., 2001; Rich et al., 2005; Sherry et al., 2004), Latino (Crawford et al., 2004; Goodell et al., 2008; Kaufman & Karpati, 2007; Rich et al., 2005; Sherry et al., 2004), and fourteen white mothers (Jain et al., 2001; rich et al., 2005; Sherry et al., 2004) living in rural (Crawford et al., 2004), suburban (Crawford et al., 2004), and urban (Crawford et al., 2004; Goodell et al., 2008; Jain t al., 2001; Kaufman and Karpati, 2007; Rich et al., 2005; Sherry et al., 2004) settings. There were eleven mothers that were currently considered to be obese, three to be overweight, seven were normal weight and one was underweight. Thirty to sixty month was age range for the children of these mothers. There were nine boys and twelve girls. Fifteen children and a BMI >95th percentile and all had a BMI and weight-for-height >90th percentile (C. Hughes, S. Sherman, and R.C. Whitaker, 2010, p. 467).

Data analysis/study results

A semi-structured interview was used to converse with 21 mothers of overweight preschool children. These mothers didn’t perceive their children as overweight, they were concerned about their children’s weight, and specifically as it how it was related to their emotional well-being. These worries about obesity were reflected in three central tensions that shaped the way mothers perceived their children’s weight and informed maternal feeding strategies: (a) nature vs. nurture, (b) medical authority vs. lived experience, and (c) relieving immediate stress vs. preventing long-term consequences. Acknowledging mothers’ concerns and tensions might help clinicians communicate more effectively with them about obesity (C. Hughes, S. Sherman, and R.C. Whitaker, 2010, p. 465). Electronic data files from the Kentucky WIC program were used to identify mothers of overweight children.

Almost all of the mothers believed that heredity or genetics played an important role in their children weight. They believed that parents play a huge role in what environment is created for their children and that this is a contributing factor in their obesity. This is why many parents feel responsible and blamed themselves for their children’s obesity. Many mothers chose to relieve their own personal stress and not to think about the long term consequences of obesity in their child. One mother chose to give her child sweets just so she would calm down and stop her outrageous behavior. This mother did realize that her daughter would continue this behavior to seek a “sweet” reward. Mothers also experienced tension between their own life experiences or past experiences, their personal family experiences, and what medical authorities recommend. Mothers would often go with what their family would recommend in fear of creating conflict within the family.

Study limitations

Several limitations were identified in this study. The interview data was collected ten years prior to this study so the information might not reflect the current thoughts of low-income mothers in the WIC program. Immediately reviewing the data might have changed the interpretation as opposed to relying on recall. Current data was incorporated into the study which was beneficial. Verbal and nonverbal information may have been lost since two of the people who analyzed the information did not conduct interviews. Ethnographic methods or data collected from extended kin (Kaufman & Karpati, 2007), friends, or preschool teachers (Thompson & Story, 2003, all of which could have strengthened the study by adding perspectives of other caregivers of young children (C. Hughes, S. Sherman, and R.C. Whitaker, 2010, p. 475).

References

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