title: Nutritional strategies of Latino farmworker families with preschool children: identifying leverage points for obesity prevention.
abstract: Obesity and overweight are significant problems for children in the US, particularly for Hispanic children. This paper focuses on the children in families of immigrant Hispanic farmworkers, as farm work is the portal though which many immigrants come to the US. This paper (1) describes a model of the nutritional strategies of child feeding in farmworker families; and (2) uses this model to identify leverage points for efforts to improve the nutritional status of these children. In-depth interviews were conducted in Spanish with 33 mothers of 2-5 year old children in farmworker families recruited in North Carolina in 2010-2011. The purposive sample was balanced by farmworker status (migrant or seasonal), child age, and child gender. Interviews were transcribed and translated. Multiple coders and a team approach to analysis were used. Nutritional strategies centered on domains of procuring food, using food, and maintaining food security. The content of these domains reflected environmental factors (e.g., rural isolation, shared housing), contextual factors (e.g., beliefs about appropriate food, parenting style), and available resources (e.g., income, government programs). Environmental isolation and limited access to resources decrease the amount and diversity of household food supplies. Parental actions (parental sacrifices, reduced dietary variety) attempt to buffer children. Use of government food sources is valuable for eligible families. Leverage points are suggested that would change nutritional strategy components and lower the risk of overweight and obesity. Further prospective research is needed to verify the nutritional strategy identified and to test the ability of leverage points to prevent childhood obesity in this vulnerable population.
authors.affiliation: Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. Electronic address: squandt@wakehealth.edu.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Department of Human Development and Family Science, Oklahoma State University, Tulsa, OK 74106, USA.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Grzywacz
authors.affiliation: Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
authors.forename: Grisel
authors.initials: G
authors.lastname: Trejo
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
mesh_terms: D000383:Agriculture; D002675:Child, Preschool; D004032:Diet; D005192:Family Health; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D009657:North Carolina; D063766:Pediatric Obesity / Q000517:prevention & control*; D036301:Qualitative Research
keywords: Acculturation; Food security; Household nutritional strategies; Immigrant; Social Ecological Theory; USA