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

Abstract

<bold>Background</bold>: Childhood obesity has reached epidemic proportions in the United States, which could signal an unprecedented shift in lifespan, with the current generation living a short life than their parents. Although there are a variety of contributing factors, some of the largest gains in childhood obesity reduction could come from examining the relationship between the neighborhood food environment and children's diet quality (DQ). While many studies have investigated the influence of distance to supermarkets on adults' DQ, few have examined the effects on young children. Further, studies have rarely considered parents' perceptions of local food quality as a predictor of children's DQ, nor have studies used the parents' frequented food store (FFS) as the measure of exposure. Finally, there 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 this additional travel burden may be prohibitive to healthy food procurement. <bold>Methods</bold>: Participants were 686 parent-child pairs from the Neighborhood Impact on Kids (NIK) Study. Parents' perceptions of neighborhood and FFS quality were assessed via survey. Children's DQ was measured as adherence to the Dietary Approaches to Stop Hypertension (DASH) eating plan's overall and fruit and vegetable (F&V) recommendations through three, random 24-hour dietary recalls. FFSs were identified via survey and street network distances from home to the store were calculated via GIS. Linear 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 discordant views about food quality between their neighborhood and FFS, and Spearman rank correlation coefficients assessed the association between discordance and food shopping distance. <bold>Results</bold>: No statistically significant associations were found between parents' perceptions of FFS quality and children's overall DASH score in the adjusted analyses; however, the F&V component DASH score remained significant (p=.05). The adjusted models indicated that increasing distance to the parents' FFS improved children'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 views were weakly and significantly associated with distance to the FFS (r=-0.1, p=.01). <bold>Conclusions</bold>: Parents' perceptions of the food quality at their FFS are only weakly associated with children's DQ. This may be due to the fact that many factors impact food choice decision-making. The finding that children's DQ improved with increasing 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 the relationship between the home and the FFS may have obscured the true nature of the food environment-diet quality relationship, and future studies should include other common destinations in one's daily activity space (e.g. work or school).