Maternal perspectives on growth and nutrition counseling provided at preschool well-child visits.
BACKGROUND
The inclusion of growth assessment and nutrition-related anticipatory guidance in all well-child visits is recommended. Although prior studies have assessed whether these topics are discussed, the content of the discussions has not been explored from the maternal perspective.


OBJECTIVE
To explore what mothers of preschoolers recall and understand about growth assessment and nutrition anticipatory guidance provided at their child's most recent well-child visit.


METHODS
Qualitative, semistructured telephone interviews were performed with 20 mothers of preschoolers recruited from a Head Start program. Interviews were recorded and transcribed. Themes were identified and refined in an iterative process.


RESULTS
Three main findings emerged: 1) although mothers generally recalled the use of growth charts and often recalled their child's height and weight percentiles, they were generally unable to articulate the meaning of these percentiles; 2) most mothers stated that their nutrition-related decisions were not influenced by growth chart findings. However, when growth chart findings were interpreted as positive, mothers found them reassuring. Conversely, when growth chart findings were interpreted as negative, mothers discounted the growth chart in favor of other comparisons of growth; 3) a considerable proportion of mothers reported that nutrition was not discussed at the most recent well-child visit, which mothers commonly attributed to a lack of weight or feeding problems for their child.


CONCLUSIONS
Among the low-income mothers studied, growth chart use and findings were memorable but frequently misunderstood, while nutrition-related anticipatory guidance was not consistently recalled. These findings suggest opportunities to improve physician-patient communication regarding these topics.
Woolford
Susan J
SJ
Divisionsof General Pediatrics, University of Michigan, Ann Arbor, MI 48109-0456, USA. swoolfor@med.umich.edu
Clark
Sarah J
SJ
Lumeng
Julie C
JC
Williams
David R
DR
Davis
Matthew M
MM
D000328:Adult; D001835:Body Weight; D002656:Child Day Care Centers; D002657:Child Development; D002662:Child Health Services; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003142:Communication; D003376:Counseling; D018479:Early Intervention, Educational; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D009752:Nutritional Status; D011368:Professional-Family Relations; D036301:Qualitative Research; D014481:United States