The Impact of Parents' Perceptions of the Food Quality Within Their Neighborhood and Most Frequented Food Stores and the Distance to Food Stores on Children's Diet Quality

The Impact of Parents’ Perceptions of the Food Qual ity Within Their Neighborhood and Most Frequented Food Stores and the Distance to Food Sto res on Children’s Diet Quality Katharine Olivia Lutz Chair of Supervisory Committee: Brian E. Saelens, PhD Health Services, Pediatrics, and Psychiatry & Behav ior l Sciences Background: Childhood obesity has reached epidemic proportions n the United States, which could signal an unprecedented shift in lifespan, wi th the current generation living a short life than their parents. Although there are a variety of cont ribu ing factors, some of the largest gains in childhood obesity reduction could come from examini ng the relationship between the neighborhood food environment and children’s diet q uality (DQ). While many studies have investigated the influence of distance to supermark ets on adults’ DQ, few have examined the effects on young children. Further, studies have ra r ly considered parents’ perceptions of local food quality as a predictor of children’s DQ, nor h ave studies used the parents’ frequented food store (FFS) as the measure of exposure. Finally, th ere remains a need to assess if parents travel farther for food shopping when their perceptions of neighborhood food quality differ from their perceptions of food quality at their FFS, because t his additional travel burden may be prohibitive to healthy food procurement. Methods: Participants were 686 parent-child pairs from the N ighborhood Impact on Kids (NIK) Study. Parents’ perceptions of neighborhood a n FFS quality were assessed via survey. Children’s DQ was measured as adherence to the Diet ary Approaches to Stop Hypertension (DASH) eating plan’s overall and fruit and vegetabl e (F&V) recommendations through three, random 24-hour dietary recalls. FFSs were identifie d via survey and street network distances from home to the store were calculated via GIS. Lin ear regression analyses assessed the associations between parents’ perceptions and child DQ as well as distance to the FFS and child DQ. A paired t-test determined if parents held disc ordant views about food quality between their neighborhood and FFS, and Spearman rank correlation coefficients assessed the association between discordance and food shopping distance. Results: No statistically significant associations were foun d between parents’ perceptions of FFS quality and children’s overall DASH score in the ad justed analyses; however, the F&V component DASH score remained significant (p=.05). The adjusted models indicated that increasing distance to the parents’ FFS improved ch il ren’s overall and F&V component DASH scores. Parents’ views of food quality within their neighborhood versus FFS differed, with FFSs receiving more positive assessments. Discordant vie ws were weakly and significantly associated with distance to the FFS (r=-0.1, p=.01). Conclusions: Parents’ perceptions of the food quality at their F FS are only weakly associated with children’s DQ. This may be due to the fact tha t many factors impact food choice decisionmaking. The finding that children’s DQ improved wit h ncreasing distance to the FFS suggested that parents valued healthfulness and were willing to travel farther to procure healthy, affordable food. Additionally, restricting the focus to just t he relationship between the home and the FFS may have obscured the true nature of the food envir o ment-diet quality relationship, and future studies should include other common destinations in one’s daily activity space (e.g. work or school).