Are Food Swamps Linked to Parents’ Food Shopping Behaviors & their Young Children’s Diet Quality?: Implications for Policy & Environmental Interventions

Obesity disparities among young children are widening. These disparities may be related to exposure to food swamp environments (i.e., neighborhoods where unhealthy food retail environments inundate healthier alternatives). Yet, little is known about the mechanisms linking neighborhood food environments to child diet and obesity disparities. To fill this gap, we propose a community-based participatory research (CBPR) project utilizing mixed methods to explore the relationships between food swamp environments and parents’ food and beverage shopping habits, parents’ perceptions of unhealthy vs. healthy food and beverage access, and diet quality and food preferences among young children (ages 2- 5). In phase 1, we will use an explanatory sequential mixed methods design and complete objective assessments of neighborhood food environments in 6 Hartford communities using both secondary data and primary food store audits, followed by short interviews with community stakeholders to solicit feedback. This phase of the project will result in the level of food swamp exposure scores and GIS maps at the census block group-level. In phase 2, we will survey parents with young children (n=300) to assess their food and beverage shopping habits, the home food environment, child food and beverage preferences and intake, plus parents’ perceptions of their food environment, and their level of support for Policy, Systems, and Environmental (PSE) strategies to alleviate dietary disparities among children. Then, to contextualize key findings from quantitative survey data, we will conduct focus groups with parents (n=40) of young children, followed by the application of novel mixed-methods GIS mapping techniques. We will take a convergent mixed methods approach and analyze/interpret Phase 2 quantitative and qualitative data together using joint displays. The final phase (Phase 3) involves drawing from Phase 1 and 2 findings to co-develop a community-based PSE intervention trial with a Community Advisory Board. We will solicit feedback on the draft intervention plan from resident parents (N=20) via focus groups. The proposed research will improve our understanding of neighborhood factors (i.e., food access) as determinants of early childhood diet quality. This K01 award will allow Dr. Cooksey Stowers to obtain the necessary training and mentorship to develop a unique, independent research program that integrates CBPR, GIS, Mixed Methods, and Intervention Development (i.e., PSE strategies). Findings from this work will inform the PI's future R01 application focused on implementing a community-based RCT evaluating a PSE intervention targeting the neighborhood food environment. This K01 award will also allow the PI to obtain training and mentorship to develop a unique, independent research program that integrates CBPR, nutrition disparities, geospatial analytic techniques, and mixed methods with the ultimate goal of improving poor diet quality and obesity among young children.