Factors influencing the food choices of urban Sri Lankan preschool children: Focus groups with parents and caregivers

Abstract

Poor diet places children at significant risk of over and under-nutrition including micronutrient deficiencies, which is a public health threat to a middle-income country like Sri Lanka. Understanding factors that influence food choices in early childhood is necessary to promote healthy food choices. As parents are the main gatekeepers of children's food environment, this study aimed to explore parents/caregivers' perspectives on the factors that influence their children's food choices. Thirteen focus groups adopting a partial nominal group technique were conducted with 110 parents/caregivers of children aged 2-6 years living in an urban area, Kurunegala District, Sri Lanka. Parents/caregivers were provided with 22 potential factors and asked to rank six most influential and choose six least influential factors on their child's food decisions. Responses were discussed as a group and audio recorded discussions underwent content analysis. Child food preference was ranked as the core driving factor in food decisions of preschool children. Family income, nutritional knowledge of the family, maternal control of food choices and household food preparation facilities were ranked as the next four most influential. Most frequent choices of least influential factors were: individual characteristics of child including sex and nutritional knowledge; and community (environmental) characteristics including seasonal food availability and community cultural food beliefs. Additional influential factors proposed were having a single child, a supportive family network and healthy menu suggestions by the preschool centres. Findings suggest that modifying the food preference of the child and the family characteristics need to be central for effective eating interventions.

Keywords: Child; Eating; Nominal group technique; Parental views; Sri Lanka; Urban population.