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Title: Differences in maternal influences upon child weight between ethnic groups in the UK : a mixed methods study
Author: Korani, Murhaf F.
ISNI:       0000 0004 7967 4568
Awarding Body: Swansea University
Current Institution: Swansea University
Date of Award: 2019
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Childhood obesity has serious public health implications and is an economic burden. The National Child Measurement Programme in the UK has repeatedly highlighted ethnic differences in obesity during childhood, with children from Black and South Asian backgrounds being significantly more likely to be overweight compared to White Caucasians, with those from a Chinese background having further reduced rates. Limited research has considered how differences in genetics, nutrient intake and physical activity level between the ethnic groups may contribute to these differences but little research has been conducted from a UK perspective to understand how psychological, social, and cultural influences on child obesity may be affecting variation between groups. The aim of this thesis was therefore to explore how these aspects may explain patterns in childhood obesity between ethnic groups in the UK. Study one qualitatively explored the contributing factors from (n=37) professional viewpoints on what might be the reasons as to why differences in child overweight and obesity between ethnic groups exist. Eight themes emerged from the analysis, which fitted well with the Bronfenbrenner Ecological Systems Theory approach to understanding layers of social and cultural influences upon behaviour. This included multiple factors at the individual level that involve body composition or genetics, diet and exercise. Factors at the microsystem level included maternal child weight perceptions, feeding styles, and parenting interactions. The exosystem level of concerns include socioeconomic status. Other factors at the exosystem level involve wider family influences, and factors in and around the macrosystem level including the influence of a wider culture. Applying this to existing literature, the microsystem factors, e.g. maternal perceptions and behaviours, were identified as a particular gap in understanding the issue in a UK sample. Study two therefore quantitatively examined (n=659) whether differences in maternal perceptions of child weight, feeding interactions, and her own eating behaviour differed between the four main ethnic groups in the UK; White, Black, South Asian and Chinese. The findings identified that Black and South Asian mothers were more likely to show a preference for a larger child size than White and Chinese mothers, whilst South Asian mothers also used higher levels of pressurising and emotional feeding styles coupled with higher levels of their own emotional eating behaviour than other ethnic groups. Conversely, mothers from Chinese backgrounds adopted more restrictive approaches both for their children and their own eating behaviours. Study three used focus groups to further understand the pattern of findings found for South Asian mothers, exploring beliefs and practices around food, diet and mothering. The findings highlighted how embedded food and diet was within cultural and social norms, particularly feeding behaviour emphasising food sharing, identity formulation and an important part of tradition. Overall this thesis identified differences in maternal preferences, feeding interactions and their own eating behaviour between ethnic groups which may in part explain differences in child weight between ethnic groups. The data are discussed within a broader cultural context, considering how interventions to reduce child weight must be culturally appropriate, sensitive and acceptable. The findings will be of interest to those working both in research and practice in the area of childhood obesity, particularly in considering the importance of culturally appropriate interventions, recommendations and support.
Supervisor: Brown, Amy E. ; Rea, David M. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral