Each focus group consisted of individuals of the same gender and ethnicity/race to help ensure participants would feel comfortable discussing issues that might vary based on gender, ethnicity, race, or related cultural dimensions. Race and ethnicity appear to be a factor in the obesity epidemic, with Hispanics and non-Hispanic African Americans at higher risk for obesity than non-Hispanic Caucasians (
Ogden et al., 2006). Therefore, the focus groups consisted of African American mothers (
n = 7) and fathers (
n = 3,
n = 6), Hispanic mothers (
n = 8) and fathers (
n = 6), and Caucasian mothers (
n = 7) and fathers (
n = 6).
As described above, aside from being parents, the participants (N = 43) were 18 years and older (M = 43, SD = 10.6). The participants’ reported that their children ranged in age from 5 months to 36 years. Some participants also had grandchildren. The children did not have to be living with the participant at the time of the focus group. Nearly 70% of the participants had some college (53.5%) or had completed a 2-year college program (16.3%). The remaining participants were high school graduates (25.6%) or had at least some high school (4.7%). Less than half (39.5%) of the participants were married; the rest were single (23.3%), living with a partner but unmarried (18.6%), divorced (14.0%), separated (2.3%), or widowed (2.3%).
In sum, within the 403 units, 4.2% of the units (17 of 403) contained none of the factors listed in , 21.1% contained one factor, and the rest contained multiple factors (
M = 2.64,
SD = 1.48, range = 0–7). Within the 386 units that contained one or more factors, attitudes were present in 171 units, subjective norms were present in 313 units, and perceived control was present in 288 units.
Ajzen (1991) suggests that although these three concepts are theoretically distinct, they covary and could be collapsed under a single concept (behavioral disposition); indeed, the results of this study suggest considerable overlap.
Our analysis of variance and means tests suggest that men were more likely than women to mention attitudes related to taste and preference, F(1, 402) = 9.65, p < .01, and less likely to invoke norms, F(1, 402) = 13.41, p < .001, or issues of control, F(1, 402) = 8.76, p < .01. In terms of ethnicity, the results suggest that African Americans were the least likely to mention control, whereas Hispanics were the most likely to mention it, F(2, 402) = 7.26, p < .01. Hispanics were also the most likely to mention norms, whereas Caucasians were the least likely to mention norms, F(2, 402) = 8.32, p < .001. The results also suggest that there were no significant differences for ethnicity by attitude F(2, 402) = 2.43.
The following section discusses the presence of each factor across the sample and offers examples of each. These results are framed qualitatively and joined with a narrative that offers observations made by the researchers as they read and analyzed data. The results are first grouped by TPB concept and then by the factors that emerged related to those concepts. Next, the factors are revisited and pieced together so the reader can see how they played out in unison in some of the more complex response units.
Attitudes Toward Healthy Eating
As mentioned above, attitudes were in evidence in 42% (171 of 403) of the response units. Attitudes were coded as present in a response if it contained at least one explicit reference to food-related taste(s) and/or preferences—whether positive or negative. In terms of healthy eating, respondents rarely expressed positive attitudes directly, but they frequently expressed negative attitudes toward unhealthy eating.
Attitudes were often revealed within the context of family relations, sometimes as points of conflict or affirmations of relationships. One husband said his wife “thought that [he] hated the way she cooked because [he] didn’t gorge out on a lot of food.” Some parents simply identified their children’s food preferences. Positive attitudes toward cooking also came up. One father explained, “With me, every chance I get to see Sam, my daughter, I love to cook.” A mother echoed that statement in relation to her daughter: “I love to cook and she’s picking up on it.”
Fast food was another frequently referenced topic. The belief that children favor fast foods was salient: “They like the little boxes, the juice boxes,” “the only thing that he likes is fast food,” and “the kids, they like the fast food.” Parents were overwhelmingly negative about their children’s preferences for fast foods, about fast foods in general, and about their spouses’ tendencies to indulge their children’s desire for fast food. A mother, who disapproved of her husband indulging their child’s appetite for fast food, complained their child consequently “gets upset when she doesn’t get McDonald’s.”
Subjective Norms Related to Healthy Eating
Norms relate to perceived expectation or pressures felt from important others (friends, family, coworkers, nurses, doctors, and so on). In this context, which emphasized parenting, norms were expected to relate primarily to family and roles within the family. Normative beliefs were evidenced in 78% of the response units (313 of 403). The factors that were coded to capture these normative beliefs were nuclear family (including domestic partners and stepchildren), extended family (including the respondent’s own parents), race/ethnicity, and societal factors such as “society,” the media, restaurants, and schools. Norms were coded as present in a unit if one or more of these factors were noted. These factors were not mutually exclusive. Within the 313 units that contained evidence of normative beliefs, 243 contained a reference to nuclear family, 99 contained a reference to extended family, 29 contained a reference to race/ethnicity, and 97 contained reference to societal factors.
Nuclear Family
Nuclear family was the most salient context for normative beliefs. When talking about their nuclear families, parents often reflected on influence and roles, and related conflicts. (Sometimes the nuclear family was also the context for control beliefs, suggesting that parental roles and parental control are deeply intertwined—this will be touched on later.) One mother explained the normative influence parents have on their children this way: “A lot of it has to do with examples that we as parents set…because that’s the environment that they know.” Parents sometimes expressed awareness of their roles as influencers: “If I had been more adamant about it when he was younger, I think he’d have a lot better eating habits now,” a mother lamented. Roles of spouses were sometimes expressed matter-of-factly: “mom does the cooking,” “my wife takes care of the food,” and “I buy the food.” However, participants also said responsibilities for healthy eating are shared in their families (“I think my husband and I split it pretty well”), which reflects family norms in terms of shared roles.
Spousal conflict emerged when both men and women identified having competing roles as enforcers of good eating practices or enablers of bad eating practices or when role expectations were violated. These conflicts seemed less a result of traditional gender roles than the dynamics of individual families, where one spouse indulges their child’s sweet tooth and the other assumes the role of enforcer or denier. “They know to go to momma if they want to go to the candy store,” a father said. A mother similarly explained, “[My daughter is] like, ‘My daddy gave it to me.’ and I’m like, ‘I know your daddy gave it to you, but Mommy is not going to let you have it.’” That sentiment was echoed by another mother: “Daddy pumps them up with the sugar and Momma puts them to bed.” Such comments also relate clearly to perceptions of control and control-related struggles, suggesting that spousal relations is a key area to explore for better understanding the dynamics of normative and control beliefs in the healthy eating behaviors of families.
Interestingly, parents revealed that children sometimes play a positive role in shaping the family’s eating norms. One mother explained that her 8-year-old daughter is “very conscious…telling us, ‘no, that’s not healthy.’” Another parent described her 9-year-old daughter as a “health nut” who “encourages” other family members. Other parents said their children were involved in food preparation.
Extended Family
Another common theme within normative beliefs was the role of extended family in the eating norms of nuclear families. Some parents said they felt pressure to eat poorly when in the presence of extended family. One father said his extended family finds his buying organic chicken and milk “disrespectful.” Others mentioned feeling obligated to eat “all this food” at family gatherings where there is pressure not to “cook short…so it makes you overcook.” Another said that when around “in-laws or your family, they are always, ‘Oh, it won’t hurt [the children]—just let them have it.’” One mother complained of being criticized for “overreaching” when resisting such pressures. In addition to grandparents, others were cited as having a role. One mother explained, “I’ll take my kids to their uncle’s home, my brother’s house. They’ll eat chips, sodas all day long, candies.” Another mother said, “My sister is the same way. My kids will go to her house and from the moment we walk in the door, ‘what do you kids want to eat?’”
Subjective norms within extended families also emerged as the product of generational difference rather than family roles or relationships:
My kids are after me all the time. They say I eat too much meat. They are right. Partially, that’s the way I was raised. When I was a child, my parents believed that protein was a major part of nutrition. That’s no longer true.
Another father said his mother called him “a kook” after telling her he was on a “vegetarian diet.” Until he “learned otherwise,” he explained, he too once believed in “her concept” of healthy eating.
Parents also had positive things to say, although less frequently, about getting support from extended family. One father explained that his parents “respect” his nuclear family’s choice to avoid meat, “so it’s not a problem.” A mother said “it took that extra support” from extended family to make changes to “our menu,” without which “it probably wouldn’t have happened.” That same mother also recognized how her sister’s focus on “health and nutrition” helped them “all realize so much more” about their diet.
Race/Ethnicity
As noted earlier, race and ethnicity arose solely in the context of social norms, which was only in about 7% of the response units. For example, one father said, “Hispanics, we do a lot of parties, a lot of fiestas. A lot of food.” Another member of that group concurred, “I think food and Hispanic culture goes hand in hand, regardless of whether some of us want to eat healthy or not.” In the African American female group, one woman remarked that “Black people love fried foods.” However, another woman in the same group suggested that that norm can be changed: “If you are like me and you are living in a predominantly black neighborhood…there was a time when we ate all the greasy foods, the fried foods, the fatty foods.” She went on to explain how she had been able to add more vegetables to her family’s diet despite those cultural norms. Conversely, a Hispanic father explained how living in Mexico, as opposed to the United States, facilitated a healthier diet: “Basically we grew up with a lot of vegetables and a lot of fruits.”
References to race and ethnicity also came up in the context of body image for African American women. One African American mother told the group how her 17-year-old daughter is unhappy with her body: “She’ll go all day without eating anything and just drink apple juice. She’s thinking I have to have this certain body, this image.” Another mother in the group raised similar issues: “I went through that with my two daughters who are big boned and they didn’t think they looked how you are suppose to look.”
Society
Normative beliefs were also expressed in reference to larger societal influences such as the presence of fast food (and convenience foods) and mass media. Despite parents’ negative attitudes about their children’s preferences for fast food, they perceived a strong pressure on themselves, their families, and their children to eat fast foods or accept the eating of fast foods as normative practice. Comments such as, “Our fast paced society is geared to fast food,” “we are definitely a fast-food nation,” and “the opportunity to eat poorly is everywhere” demonstrated the belief that fast food is a ubiquitous and influential component of American life and culture. McDonald’s was invoked far more frequently than any other fast-food chain. In one example, a parent stated, “ he is at an age right now where he is interested in the toy, and the toy is what is basically driving him to McDonald’s.” On this topic, some comments suggest parents believe that the pressure to eat McDonald’s is reinforced by a matrix of subjective norms that involve children’s food tastes, family norms, and media and advertising: One mother said her “daughter and her husband are influenced” by “the overall culture, media, McDonald’s, fast food, T.V… Kids, they want McDonald’s, quick, fast, and in a hurry.” Other parents believe that “advertising for fast food and junk food” has a “big effect if you let your kids watch a lot of TV.”
Control Beliefs About Healthy Eating
Control beliefs were present in 72% of the response units (288 of 403), making it the second most common TPB construct to emerge in the responses after subjective norms. The control factors were coded via internal control (self-efficacy), external control related to money, and external control related to time. Control was noted in a unit if one or more of these factors were present. These factors were not mutually exclusive. Internal control was the most common variable to emerge (244 of 288), followed by external control related to money (56 or 288) and time (46 of 288). As mentioned above, the control factors and normative factors were often intertwined such that one phrase contained evidence of both. This overlap will be discussed in more depth later.
Internal Control
The topic of self-efficacy came up in many different contexts and in reference to how parents guide their families’ healthy eating behaviors. Self-efficacy was sometimes invoked when parents explained their agency in determining food choices. A mother recounted how she takes action against her daughter’s sweet tooth: “No more candy,” she tells her. “I’m putting it up high. You are getting no more candy.’” Another mother explained how she controlled her infant son’s diet: “I didn’t give him the fruit first. I started giving him vegetables because I was told that [if you give them fruit]…they are going to want sweets.” One father explained that when his children are with him, “they eat what I eat.” Parents sometimes touted their resourcefulness as food providers as a point of pride and self-empowerment: “I will make you a meal that they serve in a five star restaurant out of whatever is in your cupboard.” A father said, “In my backyard, I started growing a garden…it feeds them better and it makes me feel better.” Claims such as, “I think I instilled that,” “I had to teach my daughter better eating habits,” and “you just do it” are other examples of self-efficacy. However, parents also admitted their influence was not always positive: “I’m usually the corruptor,” said a mother, and a father explained how his own food preferences “make it really hard” to affect his children’s diets positively.
Money and Time
The most salient perceptions of external control were limited time and money. The comment, “without time and money, forget it,” sums up the common belief that parents simply lack the time to prepare healthy foods or the money to buy them:
I wish I had the time. I work 6 days a week…So it’s really challenging to be able to go to the grocery stores that are healthy [and purchase food] that you can make really quick that don’t cost a lot of money.
The quote below is another good example:
It’s hard to find nutritious food that is quick and healthy. Like in my case I’m a full-time student and I work and with my kids in swimming…you come home, it’s late. The best thing is to pop in a frozen pizza.
Parents conveyed a sense of helplessness in the face of such constraints, giving in to the temptation of “quick, easy dinners” or “fast food” when healthy alternatives are perceived to be too time consuming. As these comments reveal, parents perceive “working long hours” and having “hectic … hours all over the place” as barriers to eating healthier diets. Parents also view healthy food as prohibitively expensive, whereas unhealthy foods were viewed as the only alternative because of the perception that they are invariably less expensive. Some examples include the following: “The fruits and vegetables at the store are outrageous,” “good nutrition is going to cost you more than the other frozen meats and hotdogs, and white bread,” “it’s difficult to eat well when you have financial issues…and the cheapest thing is…pork chop, ground beef,” “a gallon of milk at [the grocery store] may be $3.75, but for a gallon of organic milk it like $5.39.”
Interplay Among Factors
Although the above factors could be coded independently, still more insight comes from how these factors often surfaced simultaneously and in mutually reinforcing ways. For example, in many cases, spousal relations were viewed as both subjective norms and control beliefs. Some participants said their ability to get their children to eat healthier was restricted by either their spouse’s behavior or by their own perception of the social norms governing their roles and responsibilities as domestic partners or as husbands and wives. One husband, for example, expressed reluctance to confront his wife about needing to change the diet for their child “because the whole idea of being in a marriage and trying to support and trying to get used to how she was brought up, how she was raised to eat.” This unit invokes nuclear family norms (his wife and children, marriage), extended family norms (how she was raised), and self-efficacy (trying to support his wife). As a result, this husband expresses a degree of confusion about his choices that could lead to a diminished sense of self-efficacy.
Another complex relationship to surface was that between attitudes and control in parents’ views that children tend to dislike healthy foods. In some cases, children’s food tastes were viewed as innate. One mother explained that although her son’s “palette is such that everything tastes good to him,” her daughter’s “palette is such that she has never liked anything green.” Another mother discussed how her efforts to slow her son’s natural affinity for sweets were thwarted by her mother-in-law. Although this unit was excerpted above, it is offered in entirety here:
When I was first introducing foods to my son…I started giving him vegetables because I was told that giving them the fruit has more of a sweet taste to it so they are going to want sweets more than they are going to want their food. I was brought up dinner first, then sweets come next, because they spoil the appetite or they don’t want to eat the dinner. My mother-in-law was always “he can have it, it’s fine. He’ll be ok.” No he’s not. I didn’t like the fact that she did that. She should respect that.
The presence of attitudes (wanting sweets), nuclear-family norms (mother–son relationship), extended-family norms (mother-in-law), and control (the mother describes her self-efficacy) shows a complex web of factors at play. In addition, there is an implication that the mother-in-law’s beliefs about healthy eating may be a barrier the mother must confront on an interpersonal level and within the dynamic of nuclear- and extended-family relationships.
Sometimes parents sympathized with extended family members’ attempts to “help” despite the fact that it often works against parents’ intentions and sense of self-efficacy. One father’s narrative illustrates this complexity and its demands on spousal negotiation:
So Mom will walk in and say “what are you feeding, bread? Why you feeding tortillas? He needs to eat vegetables.” And then her mother comes out and says “look at this guy. He needs a piece of steak,” you know?…In that situation, my wife, my self, we just put that on the side. and that was just for the kids, for the health of the kids…So we had to talk about it and say you know we just have to ignore that.
Other parents who described ways of resisting such pressure still complained of its prevalence and the difficulty of dealing with it. One mother said it is socially awkward to decline unhealthy food when offered to her children because “you still have to follow social rules for being nice and saying thank you when someone gives you something.”
Another factor that demands attention for its presence across beliefs and constructs is fast foods. Parents complained that fast food is a barrier because children have such a strong appetite for it and such a strong resistance to healthier alternatives; fast foods are inexpensive and accessible, and parents may have to confront family norms that deem fast foods acceptable. A mother’s narrative illustrates some of these dynamics:
[My daughter says] “Let’s go to McDonald’s.” and I’m like “no,” I’m like “you are going to sit here and you are going to eat your dinner here.” “No my daddy is going to take me to McDonald’s and I’m going to get a toy.” and I’ll be like, “no you have tons of toys here. You don’t need to go to McDonald’s.” Then she’ll start crying and stuff.
Another parent questioned whether it is “worth the fight” to resist her kids’ demands. Those who did express some degree of control typically acknowledged the difficulty of rebuffing children’s demands or the perception of easy access: “My kids and I seldom ate out and seldom ate fast food, which doesn’t mean they didn’t want it or ask for it all the time…It would have been nice to have fewer McDonald’s around for them to beg to go to. The prevalence is overwhelming.”
Ethnicity and culture also surfaced in combination with lack of control due to time, self-efficacy, and norms related to the nuclear family. As one mother explained:
That’s another thing Black people do, they sit back and say “oh it’s hard, I can’t do it. Show me how to do it.” You just do it. I’m a single mother of five, full-time student, and I work without getting paid. I work to pay my childcare. And we are eating at home as a family almost every night at the table.
This relationship between normative beliefs about eating and time and money frequently overlaps with family eating traditions that participants inherited and later passed on as parents of their own families, whether or not race or ethnicity was explicitly mentioned. One participant said that when she was a child, her mother sometimes had to feed a “family of six” on a budget of $25 for the entire week. As a consequence, she remarked, “you surely were not getting fruits and vegetables.” The excerpt below also suggests how lack of money can shape family norms:
We had to feed 9, 10 people on my dad’s salary. So it was always about what was cheap. Well it’s cheap to make tortillas. It was cheap to make arroz and frijoles…I don’t think I knew what nonground beef was until I was a teenager.
Some participants showed a sense of pride in the accomplishment of feeding a family with very limited means. One mother reveals this pride in her ability to feed many children with few dollars.
If you’ve got four children and you are trying to raise them and even though you may have a two-income family, you’ve got bills, you make too much for any assistance, you don’t make enough for assistance you may need. So that’s why I was called the queen of the one-pot meals.
The heroic ability to feed children on a tight budget could sometimes be seen to transcend the question of whether the diet was healthy. One participant reflected that her mother’s ability to feed her kids was an act of love: “for my mother, she didn’t work; she didn’t make her own money. That’s what she could give to her kids…was enough food to satisfy you.” Another parent responded to that point but took it in a different direction: “I think those are foods we all grew up with and we associate with comfort and love, but to be able to cook it in a healthier way and still maintain that tie, would be helpful.”
The publisher's final edited version of this article is available at 