"I try, I do": Child feeding practices of motivated, low-income parents reflect trade-offs between psychosocial- and nutrition-oriented goals.

Although there is increased focus on behavior change programs targeting parents to promote healthy child feeding, success of these programs has been limited. To close this gap, we sought to understand parents' goals for child feeding and their motivations, abilities, and contextual environment that challenged or enabled goal achievement, with a focus on parents' own childhood food experiences. We conducted semi-structured qualitative interviews (n = 21) with low-income parents of at least one child aged 3-11 years in three semi-rural counties in upstate New York to explore their emic perspectives on child feeding goals and practices. Transcripts were coded by at least two researchers using the constant comparative approach. Emergent themes were identified and interpreted in the context of the Motivation-Ability-Opportunity framework. Low-income parents articulated and were clearly motivated to achieve both nutrition- and psychosocial-oriented goals. Salient psychosocial goals (e.g., family meals to promote family relationships, help child feel secure), often led to different child feeding practices than indicated by parents' nutrition-oriented child feeding goals (e.g., nutritious diet, healthful relationship with food). Sometimes these psychosocial goals were in conflict with the nutrition-oriented goals; for example, some parents gave into child food preferences to avoid conflict or hesitated to introduce changes in diets of overweight children to preserve child self-esteem. Prominent contextual barriers included child preferences, life disruptions, and the inflexible time and financial restrictions of poverty. Parents exhibited awareness and motivation to achieve healthy eating goals but success was often thwarted by the salience of psychosocial goals that often motivated less-healthy practices. Thus, behavior change programs should acknowledge the value and relevance of both types of goals and help parents develop strategies to address the tensions between them.