What about the children? The experience of families involved in an adult-focused diabetes intervention.
OBJECTIVE
Among adults with diabetes attempting to change their own diets, we explored how these adults approached providing food for their children and how their children reacted to dietary changes in the household.


METHODS
The research design used semi-structured parallel individual interviews of adults and a child (aged 10-17 years) in their home. Interviews were audio-taped, transcribed, coded and analysed for themes.


METHODS
Subjects included families in which one inner-city African American or Latino adult with diabetes had completed a diabetes intervention promoting healthy dietary behaviours.


RESULTS
We completed 29 interviews (14 adult-child pairs and one child). Adults approached making dietary changes for themselves and also providing food for their family in different ways, ranging from expecting everyone to eat the same thing to preparing two separate meals. Many children resisted dietary changes while fewer acquiesced. Among children who went along with changes, some reported resisting initially then adjusting, while others did not resist because the food still tasted good or they could obtain preferred foods outside the house. The intersection of adults' meal strategies and children's reactions to the changes can be used to categorise families into different patterns. These patterns highlight the tension between an adult who must make dietary changes to control diabetes and a child who is not necessarily motivated to change.


CONCLUSIONS
From this framework we suggest hypotheses about how these patterns might influence dietary behaviour in adults and children. Understanding these patterns could guide interventions to assist parents in successfully including children in their dietary changes.
Division of General Medicine, Department of Internal Medicine, University of Iowa, VA Medical Center mailstop 152, Iowa City, IA 52246, USA. Helena-laroche@uiowa.edu
Helena H
HH
Laroche
Matthew M
MM
Davis
Jane
J
Forman
Gloria
G
Palmisano
Michele
M
Heisler
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000523:psychology; D010287:Parent-Child Relations; D016896:Treatment Outcome; D015431:Weight Loss