External influences on complementary feeding practices of caregivers of Native Hawaiian, Other Pacific Islander and/or Filipino infants residing on O‘ahu, Hawai‘i.
External influences on complementary feeding practices of caregivers of Native Hawaiian, Other Pacific Islander and/or Filipino infants residing on O‘ahu, Hawai‘i.
Date
2022
Authors
Kai, Jessie Sekiyo Matsuura Puahau
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Revilla, Marie K.F.
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Nutritional Sciences
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Abstract
The overall goal of this dissertation was to examine the complementary feeding practices and behaviors of caregivers of Native Hawaiian, Other Pacific Islander and Filipino infants residing on the island of Oʻahu. This knowledge is important in addressing childhood health and infant nutrition particularly in the Native Hawaiian, Other Pacific Islander and Filipino populations as they are under-researched and under-represented in the public health literature despite their health disparities. Prior to the “Exploring First Foods of Keiki on Oʻahu, Hawaiʻi” pilot project which collected data from 2018 – 2019, the last publication on complementary feeding pratices in Hawiʻi was published in 1995, in which a large proportion of mothers in Hawai‘i were observed to not meet the timing recommendation for the introduction of complementary foods. In the decades between the 1995 publication and the data collected in 2018 – 2019 for the pilot project, childhood obesity has increased in the Native Hawaiian, Other Pacific Islander and Filipino populations in Hawaiʻi. Thus, the aim of this dissertation was to fill the knowledge gap by investigating the influences shaping the complementary feeding practices of caregivers of these infants. Chapter one provides background on childhood obesity, infant diet and influences on complementary feeding. Chapter two presents findings from a review of the literature on health behavior theories used to explore reasons why caregiver complementary feed the way they choose too. Studies reviewed included nine obersvational epidimiological studies that included cohort and cross-sectional study designs; and three intervention studies. Health behavior theories from the individual (Theory of Planned Behavior, Stages of Change), interpersonal (Social Cognitive Theory, Culture Care Theory) and community (Social Ecological) suggest multiple constructs shape behavior, presenting potentially modifiable behavioral factors that influence complementary feeding decisions. A secondary analysis of data from a community-oriented pilot project was conducted for chapters three and four. Chapter three presents findings from interviews with caregivers of Native Hawaiian, Other Pacific Islander and Filipino infants, exploring the support caregivers perceive from their family, friends and within their community for their complementary feeding practices. This study found caregivers perceive support regardless of their feeding decisions. Chapter four presents findings from the same database to explore the association between caregiver’s cultural identity, the infant’s household membership, and diet quality; this study found no significant relationships among these variables.
Results from these three studies suggest caregiver complementary feeding practices and behaviors are influenced by many factors including the caregivers’ social relationships, cultural and physical environments, socio-economic and nutritional status of the caregivers. However, measuring the effects of these is complicated by the inconsistent health messaging caregivers received. This provides an opportunity for future research and health promotion efforts to increase the nutritional health of infants. Prevention is a recommended strategy for addressing adverse health conditions. Improving complementary feeding practices is one strategy to promote the nutrition and well-being of an individual in the first 1000 days of life.
Description
Keywords
Nutrition,
Complementary Infant Feeding,
Filipino,
Hawaii,
Native Hawaiian,
Nutrition,
Pacific Islander
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130 pages
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