Korean Journal of Community Nutrition

Research Article

[English]
Current Barriers of Obesity Management of Children Using Community Child Care Centers and Potential Possibility of Utilizing Mobile Phones: A Qualitative Study for Children and Caregivers: Bo Young Lee, Mi-Young Park, Kirang Kim, Jea Eun Shim, Ji-Yun Hwan; Korean J Community Nutr 2020;25(3):189-203. Published online June 30, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.3.189

Objectives
This study was performed to identify the current barriers of obesity management for children using Community Child Care Centers and their caregivers (parents and teachers working in the Centers). Further, this study explored the possibility of utilizing a mobile phone application for tailored obesity prevention and management programs to overcome the current difficulties associated with children's obesity management.
Methods
The qualitative data were collected through in-depth interviews with 20 obese and overweight children or children who wanted to participate in this study using Community Child Care Centers, 12 teachers working at the Centers, and a focus group interview with five parents of children using the Centers. Data were analyzed with a thematic approach categorizing themes and sub-themes based on the transcripts.
Results
The current barriers of obesity management of obese and overweight children using Community Child Care Centers were lack of self-directed motivation regarding obesity management (chronic obesity-induced lifestyles and reduced self-confidence due to stigma) and lack of support from households and Community Child Care Centers (latchkey child, inconsistency in dietary guidance between the Center and household, repetitive pressure to eat, and absence of regular nutrition education). Mobile phone applications may have potential to overcome the current barriers by providing handy and interesting obesity management based on visual media (real-time tracking of lifestyles using behavior records and social support using gamification), environmental support (supplementation of parental care and network-based education between the Community Child Care Center and household), and individualized intervention (encouragement of tailored and gradual changes in eating habits and tailored goal setting). It is predicted that the real-time mobile phone program will provide information for improving nutritional knowledge and behavioral skills as well as lead to sustainable children’s coping strategies regarding obesity management. In addition, it is expected that environmental factors may be improved by network-based education between the Community Child Care Centers and households using the characteristics of mobile phones, which are free from space and time constraints.
Conclusions
The tailored education program for children using Community Child Care Centers based on mobile phones may prevent and reduce childhood obesity by overcoming the current barriers of obesity management for children, providing environmental and individualized support to promote healthy lifestyles and quality of life in the future.

Citations

Citations to this article as recorded by

An Interactive Live and Online Cooking Program for Children in Vulnerable Families—An Exploratory Study
Jiyoung Park, Sein Hwang, Seolhyang Baek, Gill A. Ten Hoor
Healthcare.2022; 10(12): 2389. CrossRef

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Original Articles

[English]
Status of Children's Breakfast Skipping and Their Mothers' Needs for Breakfast Service at Child Care Centers: Kiwon Lee, Jihyun Yoon, Jae Eun Shim; Korean J Community Nutr 2008;13(5):682-692. Published online October 31, 2008

Abstract PDF: The purpose of this study was to investigate the status of children's breakfast skipping and their mothers' needs for breakfast service at child care centers. A survey was conducted with mothers of children aged 3 to 5 years and attending child care centers in Gwanak-gu, Seoul. Out of 960 questionnaires distributed to the caregivers at 32 child care centers, 633 were returned (66% response rate), and 449 were analyzed (47% analysis rate) after excluding data from the respondents not meeting the selection criteria for this study: mothers of children aged 3 to 5 years. Over 2/3 (69%) of children ate breakfast every weekday (Breakfast Eaters) and almost 1/3 (31%) of children skipped breakfast one time or more often on weekdays (Breakfast Skippers). The collected data were compared between Breakfast Eaters and Breakfast Skippers. The average Good Dietary Practice Score of Breakfast Skippers was significantly lower than that of Breakfast Eaters, implying poorer dietary habits. A higher percentage of mothers of Breakfast Skippers (62%) responded that breakfast service was 'necessary' or 'very necessary' at child care centers than those of Breakfast Eaters (27%). A multiple logistic regression analysis was conducted to determine factors affecting mothers' needs for breakfast service at child care centers. The result showed that the children's ages, mothers' occupational status, household monthly income, frequencies of eating breakfast on weekdays and satisfaction level with morning snack provided at child care centers affected mothers' needs for breakfast service at child care centers. In particular, mothers who had a full-time job (OR = 2.06) than housewives, mothers whose children did not eat breakfast at al (OR = 3.54), ate 1~2 times (OR = 5.50) or ate 3~4 times (OR = 3.80) on weekdays than those whose children ate breakfast every weekday were more likely to have needs for breakfast service at child care centers than housewives. In conclusion, Breakfast Skippers tended to have poorer dietary habits than Breakfast Eaters and Full-time working mothers had higher needs for breakfast service at child care centers. This study results suggest that child care centers consider serving breakfast to children as the number of working mothers increases.

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[English]
The Effectiveness of Nutrition Education Provided by Dietitians in Child Care Centers: Hyeja Chang, Eunseon Ko; Korean J Community Nutr 2007;12(3):299-309. Published online June 30, 2007

Abstract PDF: The purpose of this study was to evaluate the effectiveness of nutrition education with nutrition services provided by dietitians who were placed in child care facilities from the Korean Dietetic Association. For this, we investigated the levels of nutrition knowledge and dietary intakes of children who attended child-care centers as well as dietary practices of children assessed by their parents. The treatment for children consisted of nutrition education and food service activities that are provided by the dietitian who have 3 to 5 years experience. Nutrition education was implemented during 10 weeks, 20 times, and a total 400 min and it's effectiveness was evaluated by questionnaire. Data were obtained for 123 children aged 4 to 5 years old who attended four child-care centers, one for a control group and 3 for intervention groups. Dietary intakes were investigated by measuring one-serving size and plate waste a of child for one-day dietary records before and after nutrition education. The levels of nutrition knowledge of children improved showing 70.80 points before to 83.45 points after nutrition education (p < 0.001). Dietary intakes of the children after nutrition service increased significantly on cooked rice (133.66 g), Kimchi (19.41 g), side dish of meat/fish (48.40 g), and side dish of vegetables (24.88 g). Dietary practices of children after treatment also improved especially 'eat diverse meat, fish, egg, and bean' and 'never leave plate waste'. To summarize, this study pointed out that nutrition service and nutrition education provided by dietitians had influences on increases of the nutrition knowledge, dietary intake, and dietary practices. Therefore, placement of dietitians needs to extend to child care facilities from the 100 persons-over-capacity facility to the 50 persons-over-capacity facility, for providing professional service such as nutrition education and nutrition counseling.

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[English]
Assessment of Foodservice Management Performance at Child Care Centers: Mee Sook Lee, Jae Yeon Lee, Sun Hwa Yoon; Korean J Community Nutr 2006;11(2):229-239. Published online April 30, 2006

Abstract PDF: This study was carried out to investigate foodservice management practices of 100 child care centers nationwide, and to provide background information for developing foodservice management policies at child care centers. Approximately 20% of the child care centers had a separate dining room; most of the centers were vulnerable to sanitation or safety problems. The percentage of the centers that planned menus was about 60% and 10% established standardized recipes. Fourteen percent of the centers kept records for distribution and menu evaluation and 33% kept sanitation management records. Since only 7% of the centers employed a dietitian, foodservice in most centers were not managed by professionals. The results of menu assessment revealed that 56.5% of the national/public child care centers received 19 points or higher out of 21 points, whereas 5.6% of the private child care centers received the same scores. Proper usage and storage of raw food, sanitary management of equipment and facilities, waste management/leftover food treatment, and basic facility of cooking zones were performed well by many centers. The overall scores of foodservice performance were only 31.2 out of 60 points, representing relatively poor safety management, food procurement management, and facilities and equipment management. These results indicate that the foodservice management of the child care centers are in a relatively poor state. Since nutrition management of the most centers was performed by non-professionals, it may not be possible to provide proper nutrition for health and normal growth of preschool children and to perform efficient nutrition education programs. The following suggestions are strongly recommended in order to improve foodservice performance at child care centers. First, foodservice administration should be performed by a dietitian, and second, efforts should be focused on strengthening nutrition and sanitation management.

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[English]
A Study of Early Child Care Center Teachers' Attitudes for Meal and Snack Guidance between Sweden and Korea: You Mi Han, Young Hwan Yee, Jin Sook Lee, Youn Joo Oh, Jeong Yoon Kwon, Kyung On An, Eun Sook Park; Korean J Community Nutr 2004;9(6):706-715. Published online December 31, 2004

Abstract PDF: The objective of this study was to compare early child care center teachers' attitudes for meal and snack guidance between Sweden and Korea. Participants were 251 early child care center teachers (Sweden: 134, Korea: 117) working in Goetebory, Sweden, and Seoul, Korea. The survey was conducted from December in 2003 to February in 2004. SPSS programme was used for statistical analysis. Sixty five point eight percent of the Korean early child care center teachers provided a certain amount of foods for children. But 20.9% of Swedish provided a certain amount of foods for children, 79.1% of them provided the amount a child wanted. Sixty one point seven percent of Korean teachers allowed a child leave foods on the plate, but 95.5% of Swedish teachers asked a child eat all food on the plate. When a child didn't want to eat, 61.1% of the Korean teachers fed him/her, but 11.0% of the Swedish teachers did. Only 42.4% of the Swedish teachers allowed a children eat sweets, but 92.9% of Korean did. The Swedish teachers' perception for food guidance were eating by child himself/herself > washing hands before eating > having appropriate table manner > eating as talking with friends > not playing during the meal time, while the Korean teachers' was taking various food > having appropriate table manner > eating by child himself/herself, not playing during the meal time > washing hands before eating. The Swedish teachers thought 'eating as talking with friends' and 'eating by child himself/herself' is important, where as the Korean's did 'eating without making noise', 'not playing during the mealtime' in the eating behavior. For 'brushing teeth after meal' the Swedish teachers' score (1.5) was lower than the Korean (4.2). The results is necessary to improve meal and snack guidance for Korean early child care center teachers' education.

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