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How and where parents of infants and young children want to receive nutrition information.

INTRODUCTION

Health information, including nutrition, is of interest to parents of infants and young children [1, 2]. Public health professionals (HPs) have many modes for delivering information. In-person nutrition classes are offered by public health dietitians in Alberta as a way to reach parents of infants and young children (children [less than or equal to] 5 years old). Public health dietitians also support nurses working at community health centres (CHCs) with professional training. All children residing in Alberta are eligible to attend CHCs for free well-child visits, which include 6 routine vaccinations between 2 months and 4 years of age. Nutrition is discussed if concerns arise. Nutrition handouts and classes are also provided at CHCs.

At times, programming decisions may be based on past practices and not on current evaluation literature [3]. It was unknown how parents prefer to learn about nutrition. Elsewhere parents reported interest in learning about nutrition through various formats such as printed booklets, online, and in-person classes; however, preferred locations were not explored [2].

In 2013, a provincial parenting resource, available online and in print, was released in Alberta. The free resource covers a variety of topics, including nutrition, related to pregnancy/ birth and children [less than or equal to] 5 years old. Internal evaluation results were positive; however, the evaluation did not assess if parents seeking nutrition information were aware of or used this resource.

The following research questions were developed to evaluate current practices and develop future recommendations for public health nutrition in a large city (and surrounding rural areas) in Alberta, Canada: How do parents of young children prefer to receive nutrition information? Where do parents of young children prefer to receive nutrition information?

METHODS

The authors developed a short survey and pilot tested it with parents at 2 community agencies and subsequently revised it after each test. The final survey was 1 page with 7 questions; answer options included "yes/no" and "select from list." Space for written comments was available (survey available from authors upon request).

The voluntary survey was distributed at CHCs within Calgary, Alberta (n = 7), and surrounding rural areas (n = 11) for 1 week in July 2015. At 16 CHCs, administrative staff offered a paper survey to parents when they checked in for their child's ( [less than or equal to] 5 years old) appointment. The primary author and a dietetic intern conducted in-person verbal interviews (same questions as paper survey) at 2 CHCs with a high number of English language learner families. No identifiers were recorded. The survey data were entered into Microsoft Office Excel 2007.

This study was classified as a "minimal risk quality improvement project" under Alberta Research Ethics Community Consensus Initiative, and therefore considered exempt from research ethics board review [4].

RESULTS

Surveys were completed by 529 parents, including rural (n = 169) and urban (n = 360) respondents. There were 114 in-person surveys completed. Although not specifically prompted, 213 respondents used a comment section on the survey to share where they currently access nutrition information. The top 3 themes from comments were: internet (n = 114), HPs (n = 53), and reading (n = 42).

How parents want to learn about nutrition

Table 1 depicts respondents' preferred learning method. With 8 options, each respondent selected their top 2 choices. Online reading (79.2%) and handouts (38.6%) were the first and second preference, respectively, at all CHC locations. Almost all (99.4%) respondents reported having access to the internet.

Most respondents were aware (82.0%) and had a copy (64.1%) of the provincial parenting resource. Fewer than half had visited the website (40.1%) or used the resource to learn about nutrition (49.2%).

Where parents want to learn about nutrition

Table 2 depicts respondents' preferred learning location. With 8 options, each respondent selected their top 2 choices. Home (86.0%) was the preferred location for respondents to receive nutrition information, followed by doctor's office (33.8%) and CHC (28.5%).

DISCUSSION

According to survey results, some methods utilized in Alberta (in-person classes and handouts) are less preferred than online reading. Although respondents preferred to receive nutrition information through online reading, fewer than half reported visiting the provincial online resource. A limitation of the survey is that it did not ask parents to identify their main source of nutrition information. Considering the respondents' preference for online reading, access to internet, and additional comments on internet utilization, one could assume that parents are already using the internet to learn about nutrition. Based on these findings, an emphasis on promoting current online resources will be incorporated into public health nutrition programs and professional training within Calgary, Alberta.

It should be noted that 1 strategy would be unlikely to meet all parents' needs. Although parents may seek online information, it is unknown if, or how often, they utilize this information. Moseley et al. [5] reported parents often seek child health information from both the internet and doctors, but are more likely to utilize information from the latter. Another study found that 21% of parents seeking child health information online were doing so to prepare for a discussion with their child's HP [6]. HPs should be aware that parents likely seek online health information. An open dialogue with parents may help uncover underlying assumptions and provide an opportunity to clarify misconceptions and provide evidence-based information [6].

In this study, the doctor's office or CHCs were identified as preferred locations to receive nutrition information by 62.3% of respondents. This emphasizes the need for consistent health information to be provided by all HPs offering care to young children.

Future research could determine where, what, why, and when parents access online nutrition information; their ability to discern its credibility; and its effectiveness compared with other methods such as handouts and classes.

RELEVANCE TO PRACTICE

HPs developing/delivering public resources and programs may have misconceptions of how and where their target audience prefers to obtain nutrition information. The target audience should be engaged at all stages of program and resource development to understand their needs and to ensure new resources and programs meet those needs.

Frontline HPs should have open conversations with parents about nutrition information parents have accessed online. This may support understanding and acceptance of evidence-based nutrition recommendations provided by HPs.

Acknowledgements

This study was made possible through research and support from Nutrition Services, Alberta Health Services. No external funding was received. Special acknowledgement is given to Community Health Centre management, staff and parents who participated in this research. Authors would also like to thank Tanis Fenton and Rebecca Lai (dietetic intern) for their involvement and support.

Conflict of interest: The authors declare that they have no competing interests.

References

[1.] Devolin M, Phelps D, Duhaney T, Benzies K, Hildebrandt C, Rikhy S, et al. Information and support needs among parents of young children in a region of Canada: a cross-sectional survey. Public Health Nurs. 2012;30 (3):193-201. doi: 10.1m/phn.12002.

[2.] Hart LM, Damiano SR, Cornell C, Paxton SJ. What parents know and want to learn about healthy eating and body image in preschool children: a triangulated qualitative study with parents and Early Childhood Professionals. BMC Public Health 2015;15:596. doi: 10.1186/s12889-015-1865-4.

[3.] International Conference on Public Policy. Barriers and facilitators to evaluation of health policies and programs: policymaker and researcher perspectives. 2013, [cited 2016 Jan 27]. Available from: http://www.icpublicpolicy.org/IMG/pdf/panel_15_s2_huckel_schneider_etal.pdf

[4.] Alberta Innovates--Health Solutions. ARECCI guidelines and screening tool. 2015, [cited2016 Jan 27].Availablefrom:http://www.aihealthsolutions. ca/initiatives-partnerships/arecci-a-project-ethics-community-consensus-initiative/tools-and-resources/

[5.] Moseley KL, Freed GL, Goold SD. Which sources of child health advice do parents follow? Clin Pediatr 2011;50(1):50-56. doi: 10.1177/ 0009922810379905.

[6.] Sebelefsky C, Karner D, Voitl J, Klein F, Voitl P, Bock A. Internet health seeking behaviour of parents attending a general paediatric outpatient clinic: a cross-sectional observational study. J Telemed Telecare 2015;21(7): 400-407. doi: 10.1177/1357633X15583431.

BRIA DEXTER, MPH, RD (a); SARAH FRANK, MPH, RD (a); LOUISE SEGUIN, MEd, RD (a)

(a) Nutrition Services, Alberta Health Services, Calgary, AB
Table 1. Preferred learning method of
nutrition information for parents.

                                      Paper      In-person
Method                  No. (%)     rank (no.)   rank (no.)

Online reading         419 (79.2)    1 (339)       1 (80)

Handouts               204 (38.6)    2 (175)       2 (29)

Social media           98 (18.5)      3 (92)       5 (6)

Parent and child       80 (15.1)      4 (72)       4 (8)
drop-in (no sign-up)

Health Link (a)        67 (12.7)      5 (57)       3 (10)

In-person class        56 (10.6)      6 (50)       5 (6)
(sign-up/register)

Online class            43 (8.1)      7 (40)       8 (3)

Other                   17 (3.2)      8 (13)       7 (4)

(a) Health Link is Alberta's toll free and informatiline
that connects callers with a registered nurse 24 hours
a day.

Table 2. Preferred location to receive nutrition information
for parents.

                                     Paper      In-person
Location               No. (%)     rank (no.)   rank (no.)

Home (for online or   455 (86.0)     1 (362)       1 (93)
handouts)

Doctor's office       179 (33.8)     2 (162)       3 (17)

Community health      151 (28.5)     3 (133)       2 (18)
centre

Community centre      57 (10.8)       4 (56)         6(1)

Library               55 (10.4)       5 (49)        4 (6)

Health fair            12 (2.3)       6 (11)         6(1)

Other                  10 (1.9)        7 (8)        5 (2)

Community kitchen       8 (1.5)        8 (7)         6(1)
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Article Details
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Title Annotation:Report/Rapport
Author:Dexter, Bria; Frank, Sarah; Seguin, Louise
Publication:Canadian Journal of Dietetic Practice and Research
Article Type:Survey
Geographic Code:1CANA
Date:Dec 1, 2016
Words:1553
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