Feeding decision-making among first generation Latinas living in non-metropolitan and small metro areas.

Background: Worldwide, overweight and obesity rates have more than tripled over the past three decades. Overweight and obesity rates are particularly high among Latinos. In order to determine some of the potential reasons, it is imperative to investigate how first-generation Latina mothers living in non-metropolitan and small metro areas decide how and what to feed their children. Using the Socio-Ecological Model, this study aimed to understand how Latina immigrant mothers make feeding decisions for their children.

Methods: A total of 29 semi-structured interviews were conducted with a purposive sample of immigrant mothers from Latin American countries whose preschoolers were enrolled in a Women, Infant, and Children supplemental nutrition program located in non-metropolitan and small metro areas. All interviews were recorded and transcribed verbatim in Spanish, and analyzed by a bilingual team.

Results: Multi-stage qualitative analysis was employed to analyze the data. Nineteen participants originated from Mexico, four from Central America, and six from South America. Five themes emerged that helped illuminate mother's decision-making around feeding choices: 1) culture as all-encompassing, 2) location and access to fresh and traditional foods, 3) disjunction between health provider advice and cultural knowledge 4) responsiveness to family needs and wants as determinants of food choices, 5) intrapersonal conflict stemming from childhood poverty and food insufficiency.

Conclusion: Findings suggest that Latina immigrant mothers engage in a difficult and even conflicting process when deciding how to feed their children. Future interventions should focus on implementing hands-on activities that can help consolidate, promote, and encourage healthy feeding choices.