Barriers and Facilitators of Parent Engagement With Health Promotion in Child Care: A Mixed-Methods Evaluation

Courtney T. Luecking, Phillip Dobson, Dianne S. Ward

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: Early care and education providers cite lack of parent engagement as a central barrier to promoting healthy behaviors among young children. However, little research exists about factors influencing parent engagement with promoting healthy eating and activity behaviors in the this setting. Aims: This study aimed to address this gap by examining low and high parent engagement with the Healthy Me, Healthy We campaign to identify barriers and facilitators of parent engagement with the intervention. Method: This comparative case study used an explanatory sequential mixed-methods approach. We created center-level parent engagement scores using process evaluation data from the effectiveness trial of Healthy Me, Healthy We. Recruitment focused on centers with the five lowest and five highest scores. Twenty-eight adults (7 directors, 9 teachers, 12 parents) from seven centers (3 low engagement, 4 high engagement) completed semistructured interviews and the Family and Provider/Teacher Relationship Quality measure. Analytic approaches included descriptive statistical analyses for surveys and a framework-informed thematic analysis for interviews. Results: Prominent contrasts between low- and high-engagement groups involved center culture for parent engagement and health promotion, practices for fostering networks and communication within centers, and communication between centers and parents. Personal attributes of providers (e.g., attitudes) also differentially influenced practices for engaging parents. Discussion and Conclusion: Organizational characteristics and individual practices can facilitate or impede parent engagement with health promotion efforts. Assessing organizational context, gaining input from all stakeholders, and conducting capacity-building interventions may be critical for laying the foundation for positive relationships that support parent engagement in implementation of health promotion programs and beyond.

Original languageEnglish
Pages (from-to)914-926
Number of pages13
JournalHealth Education and Behavior
Volume47
Issue number6
DOIs
StatePublished - Dec 1 2020

Bibliographical note

Funding Information:
We would like to thank Rachel Bartlett, Mikayla Bowen, and Rachel Banawa for their contributions to identifying the sample for this study, transcribing interviews, and analyzing data. We are grateful for the guidance from Paul Mihas and Lorin Bruckner at the Odom Institute at the University of North Carolina at Chapel Hill regarding mixed methods and data visualization software. We would also like to thank Dr. Alice Ammerman, Dr. Kimberly Truesdale, Dr. Byron Powell, and Dr. Deborah Tate for their review of early versions of this manuscript. Finally, we would like to thank the early care and education providers and parents who volunteered their time for this project. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The National Heart, Lung, and Blood Institute of the National Institutes of Health (R01HL120969) supported this work. The project was conducted out of the University of North Carolina at Chapel Hill at the Center for Health Promotion and Disease Prevention, a Prevention Research Center funded through a cooperative agreement with the Centers for Disease Control and Prevention (1U48DP005017).

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The National Heart, Lung, and Blood Institute of the National Institutes of Health (R01HL120969) supported this work. The project was conducted out of the University of North Carolina at Chapel Hill at the Center for Health Promotion and Disease Prevention, a Prevention Research Center funded through a cooperative agreement with the Centers for Disease Control and Prevention (1U48DP005017).

Publisher Copyright:
© 2020 Society for Public Health Education.

Keywords

  • early care and education
  • family
  • implementation
  • mixed methods
  • nutrition
  • physical activity

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Public Health, Environmental and Occupational Health

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