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. 2020 Jul;16(3):e12974.
doi: 10.1111/mcn.12974. Epub 2020 Feb 14.

Piloting a food photo sorting activity in Samoa to assess maternal beliefs and their role in child diet

Veeraya K Tanawattanacharoen  1 , Courtney C Choy  2 , Trevor J Anesi  3 , Take Naseri  2   3 , Christina Soti-Ulberg  3 , Muagututia S Reupena  4 , Nicola L Hawley  1   5
Affiliations

Piloting a food photo sorting activity in Samoa to assess maternal beliefs and their role in child diet

Veeraya K Tanawattanacharoen et al. Matern Child Nutr. 2020 Jul.

Abstract

Eating habits begin forming early in life when parental beliefs and behaviours often play a major role in shaping dietary intake. We aimed to assess maternal beliefs about the cost, social status, and nutritional value of foods in Samoa-a setting with an alarming burden of childhood obesity-and to determine how those beliefs may be related to child dietary intake. Samoan mothers (n = 44) sorted photographs of 26 foods commonly consumed in children in Samoa by cost, social status, and nutritional value (healthfulness). Responses were then assessed for their association with child dietary intake (reported using a food frequency questionnaire) using Pearson correlations. Mothers indicated that traditional Samoan foods were healthier, of higher social status, and lower cost compared with non-traditional/imported food items. Compared with nutritional experts and a market survey of food prices, mothers demonstrated strong nutritional (r = .87, 95% CI [0.68, 0.95], p < .001) and consumer (r = .84, 95% CI [0.68, 0.93], p < .001) knowledge. The perceived cost of food was more strongly associated (r = -.37, 95% CI [-0.66, 0.02], p = .06) with child dietary intake than either healthfulness or social status, with decreasing consumption reported with increasing food cost. Our findings contradicted the notion that the high social status of imported foods may be contributing to increased intake and rising prevalence of childhood obesity in this developing country setting. Despite their nutritional knowledge, Samoan mothers may need additional support in applying their knowledge/beliefs to provide a healthy child diet, including support for access to reasonably priced healthy foods.

Keywords: Samoa; child diet; child nutrition; food sorting activity; maternal beliefs; nutrition knowledge.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The average of mother's (n = 44) rankings of each food item in each sorting scheme are plotted. The trend line represents the correlation between average mother's (a) health and social status ranking (r = .87, 95% CI [0.72, 0.94], p < .001), (b) health and cost rankings (r = −.45, 95% CI [−0.71, −0.09], p = .02), and (c) social status and cost rankings (r = −.17, 95% CI [−0.51, 0.23], p = .41)
Figure 2
Figure 2
(a) Correlation between average mother's (n = 44) and average expert's (n = 8) health rankings (r = .87, 95% CI [0.68, 0.95], p < .001). (b) Correlation between average mother's (n = 44) food cost rankings and a cost by volume (grams) ranking determined by market survey (r = .84, 95% CI [0.68, 0.93], p < .001)
Figure 3
Figure 3
(a) Correlation between average mother's (n = 44) health rankings (r = −.10, 95% CI [−0.40, 0.38], p = .95), (b) social status rankings (r = −.25, 95% CI [−0.58, 0.15], p = .21), and (c) cost rankings (r = −.37, 95% CI [−0.66, 0.02], p = .06) and average child's (n = 44) weekly frequency of food intake
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