Cultural adaptation of a text message library designed to support diet, activity and weight management behaviour in the postpartum period in the UK: the Supporting MumS (SMS) Study

The Supporting MumS library of text messages was developed with extensive personal and public involvement (PPI) to help with postpartum weight management and was successfully tested in a feasibility study in Northern Ireland. Before conducting an effectiveness trial, further PPI work was needed to ensure that the dietary and lifestyle advice offered within the SMS text message library was acceptable and culturally relevant for a wide range of women across the United Kingdom (UK). Recruitment was facilitated by existing community networks that helped capture a culturally diverse group of postpartum women who have struggled with their weight. Nineteen women took part in the PPI exercise: n = 4 African–Caribbean (living in London), n = 8 Asian (Bradford), n = 7 white (Scotland). The PPI work followed an iterative process with initial online group discussions, where selected text messages were reviewed and feedback was sought on their language, tone and cultural relevance. This was followed by message adaptation and re-review. Following initial group discussions to understand the main areas for adaptation, PPI work was carried out with individual mums who reviewed the entire library of text messages and provided feedback on all adaptations. Mums liked the humour and the supportive tone of the messages and approximately 15% of the messages were left unchanged. Suggested edits to ensure the messages were acceptable and relevant to women from a range of cultural backgrounds were minor in nature. Suggestions provided by PPI representatives were mainly in relation to broadening the relevance of snack ideas, recipes, food preparation advice, shopping habits (e.g., click and collect services) and workout ideas. Additional feedback included removing colloquialisms and idioms, the meaning of which may be confusing for somebody not familiar with them or a non-native English speaker (e.g., ‘run out of steam’). Personal and Public Involvement provided helpful suggestions for the cultural and regional adaptation of a lifestyle text message intervention in the postpartum period. The effectiveness and cost-effectiveness of the Supporting MumS study will be tested in a UK-wide trial

An online survey of dietary quality during complementary feeding; associations with maternal feeding self-efficacy and adherence to dietary recommendations

Additional file 3. Supplementary table - Infant Behaviour Questionnaire Revised – Short Form (IBQ-R): scale used to assess infant temperament (only 3 domains of the scale included)

A qualitative exploration of the impact of COVID-19 on food decisions of economically disadvantaged families in Northern Ireland

BACKGROUND: The first UK-wide lockdown to prevent the spread of COVID-19 had a serious financial impact on low-income households, a population already in higher risk of food insecurity and poor dietary choices. Qualitative data on the impact of COVID-19 lockdown on food decisions of UK families are scarce. This study aimed to explore how the measures to control the spread of COVID-19 influenced the food-related decisions of socioeconomically deprived families in Northern Ireland. METHODS: A qualitative study captured data from online individual interviews. Participation was open for parents of children 2–17 years old living on a tight budget in urban and rural areas of Northern Ireland. A sampling matrix enabled equal representation of single- and two-parent households, as well as parents of younger children (<12y) and adolescents (≥12y). Data were collected by using the methods of Photovoice and mapping exercise. Data were analysed through a thematic approach. RESULTS: Twelve online interviews were conducted and five distinct themes were identified reflecting families’ food-related decisions that were affected by the COVID-19 lockdown: 1) food planning; 2) food purchasing; 3) meal preparation; 4) eating and feeding behaviours and 5) eating food prepared outside the house. CONCLUSIONS: The restrictions put in place to inhibit the spread of COVID-19 influenced all aspects of dietary decisions of low-income families. Changes observed during this period included frequent consumption of homemade meals, but also increased unhealthy snacking. Infrequent food shopping encouraged good meal planning, but was also a barrier to securing adequate fresh food. Food-related support including school meal assistance contributed to families’ food security, particularly those of single parents. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12307-1

Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence

BACKGROUND: The food environment within and surrounding homes influences family dietary habits with socio-economic areas at a nutritional disadvantage. Families’ perception of the food environment and how it influences their food decisions is less clear. This rapid review aimed to synthesise qualitative evidence of parental perspectives of the food environment and their influence on food decisions among disadvantaged families. METHOD: Qualitative and mixed-methods peer-reviewed journal articles published after 2000, that explored the perspectives of low-income parents in relation to their food environment and how this impacted food decisions for families with children aged 2-17 years, were included in this review. Embase, Scopus and PsycINFO were the databases chosen for this review. Search strategies included seven concepts related to family, food, perceptions, influences, environment, socio-economic status and study type. Two independent reviewers screened sixty-four studies. Thematic synthesis was employed. RESULTS: Two thousand one hundred and forty five results were identified through database searching and 1,650 were screened. Fourteen articles that originated from the US, Australia and the UK were included in this review. No articles were excluded following quality appraisal. Child preferences, financial and time constraints, and location and access to food outlets were barriers to accessing healthy food. Parental nutrition education and feeding approaches varied but positive outcomes from interventions to address these behaviours will be short-lived if inequities in health caused by poverty and access to affordable and healthy food are not addressed. The reliance on social support from families or government sources played an important role for families but are likely to be short-term solutions to health and nutritional inequities. CONCLUSIONS: This qualitative evidence synthesis provides an insight into the perceptions of low-income parents on the factors influencing food decisions. Findings have implications for public health and the development of effective strategies to improve the dietary habits of children of disadvantaged families. Sustainable changes to dietary habits for families on low-income requires policy responses to low income, food access and to the high cost of healthy foods

Exploring the world of food: the perspective of low income families on factors influencing their food choices

Abstract Objective: The aim of this study was to investigate the social and environmental factors involved in the food decision-making processes of families living on lower incomes on the Island of Ireland. Design: A qualitative design was employed for this study, using photovoice and creative mapping methods. Parents were requested to take photos and draw maps of their food environments. Interviews were then conducted with parents, using the materials produced by parents as a cue to discuss their food environments, influences and decision-making processes around food choices. Setting: Participants were interviewed online via Microsoft Teams. Participants: Participants were parents or guardians of children between the ages of 2 and 18 who self-defined as ‘living on a tight budget.’ Results: Twenty-eight participants were recruited and interviewed for this study, including 12 parents in Northern Ireland and 16 in the Republic of Ireland. The findings were mapped on to Bronfenbrenner’s Ecological Systems Theory and showed that multiple, overlapping and intersecting factors at the individual, micro-, meso-, exo-, macro- and chrono-system were implicated in family food choices. Upstream factors in particular, including structural, policy and commercial determinants, appear to be significant drivers of behaviour. Conclusions: While the findings suggest that a complex range of factors are involved in family food choices, it is clear that policy measures and regulations are needed to stave off the impacts of rising social inequality and food poverty. Health promoters should strive to find non-stigmatising interventions to bridge the nutritional divide experienced by lower-income families