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Discovering the eating habits in the multicultural school through the children's debates
Mª de los Angeles Merino Godoy1
1Licenciada en Enfermería y Doctora por la Universidad de Huelva. Hospital Juan Ramón Jiménez, Huelva, España

Mail delivery: C/ Miguel de Unamuno 12-2I, 21004 Huelva, España

Manuscript received by 05.12.2007
Manuscript accepted by 11.03.2008

Index de Enfermería [Index Enferm] 2008; 17(3):183-187

 

 

 

 

 

 

 

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Merino Godoy, Mª de los Angeles. Discovering the eating habits in the multicultural school through the children's debates. Index de Enfermería [Index Enferm] (digital edition) 2008; 17(3). In </index-enfermeria/v17n3/e6664.php> Consulted by

 

 

 

Abstract

Children obesity in Spain and its peak are becoming a great relevance health problem. The fasting, the fast food and the candy`s abuse are more and more popular habits, which generates nutritional disorders like obesity, anorexia or bulimia, which trigger chronic diseases from early ages. Andalusia is one of the autonomies with more prevalence of children obesity and it is also one of the communities with greater immigrant population, which is the reason why most of our schools are multicultural.
We have considered this cultural variability in our investigation; focus on children from three to eight. Our study aims to know pupils evaluations about healthy feeding and their own habits, as well as the respect of the nutritional customs from other cultures. The children debate is the selected instrument for this field study that is included in a wider investigation that analyzes the nutritional conduct in the childhood from all aspects: school canteens, families, administration and its policy. As result of these debates, we have discovered that pupils hardly have breakfast; they eat neither fish nor vegetables (because they say that they do not like them). They like fast food like pizzas and hamburgers, but they enjoy them more if sometimes they are made by their own mothers. They lack basic knowledge about eating, nevertheless they are perfectly capable of remember the songs that are played at TV Ads about food. They also lack the eating habits of their own culture, and that's why problems of contempt or intolerance have not been discovered.
Key-words: focus groups, feeding behaviour, preschool, cultural diversity.

 

 

 

 

 

 

 

Introduction

    Childhood nutrition at home and in schools has evolved on a par with society. Traditional and natural foods, and even our own Mediterranean diet,1,2 have been replaced by fast, pre-prepared foods in response to the lack of time accompanying us in our daily lives. At the same time, the food industry continues to bombard children with false advertising through slogans such as "natural", "granny's cooking" or "just like homemade". These advertising slogans have a profound impact on families and children. Indeed, school children are perfectly capable of reciting from heart many of these television advertisements,3 which are targeted precisely at them.
    Junk food, the over-consumption of baked snacks and sweets, the absence of a complete breakfast and the consumption of carbonated soft drinks and dairy drinks instead of water are some of the nutritional habits that have led to a 16% increase in childhood obesity.
4 In turn, these habits trigger a number of chronic diseases such as diabetes or cardiovascular disorders at a very early age. A rise in anorexia, bulimia and other eating disorders have also been reported at an increasingly early age.5 In accordance with the guidelines set out by the Regional Ministry of Health and the Regional Ministry of Education of Andalusia,6 and with a view to mitigating these problems, many schools have decided to reduce or eliminate foodstuffs with a high sugar, fat or salt content from their school menus. Furthermore, many governments of other countries7 have recently proposed that labels be placed on these foods to warn consumers about health risks as well as increasing the price of these foodstuffs. Concern has also grown among politicians regarding the problems caused by unhealthy eating habits. In this line, the Spanish Ministry of Health and Consumption has developed the NAOS strategy8 (Nutrition, Physical Activity and Prevention of Obesity) whose aim is to raise citizens' awareness that leading a healthy lifestyle is both easy and fun.
    The aim of our research study is to hear the voice of school children and gain a better understanding of their dietary habits, their ideas and their concerns regarding healthy nutrition.
9 Following a review of general qualitative research methods (Patton 1980, 1987; Woods, 1989; Cook and Reichardt 1986; Goetz and Lecompte, 1988; Walker, 1989; Cohen and Manion, 1990; among others), we decided that focus groups with children were the best instrument for obtaining data that require dialogue and explanations among a population of this type.
    Methodologically, the focus groups were structured and organised in a similar manner to discussion groups, which have served as a basis for planning and developing this particular research instrument. According to Callejo,
10 "The current rise in group-oriented tasks has materialised into diverse practices, which in light of their different objectives and development, are difficult to assimilate. (...) Moreover, each of these denominations (group interviews, focus groups, etc.) often encompasses very diverse practices. This is what occurs with the so-called discussion groups; a name that entails a great diversity of techniques..." According to Colás, Buendía and Hernández Pina,11 "The school setting, be it in the classroom, seminars, departments or teacher meetings, contains spaces for human and social relations that produce a variety of discursive genres". Following this line, we have chosen focus groups with children as the most appropriate method for gathering data in relation to pupil-centred objectives since this study forms part of a wider research study12 that aims to analyse eating behaviours from a variety of viewpoints including the public administration, public policies, school administrators, school canteens and even nutritional habits within the home. In addition to examining numerous aspects related to eating behaviour, our research has also focused on the cultural diversity characterising our schools today.13,14 Indeed, given that a growing number of immigrants attend our schools, it is important to gain further insight into their eating habits.
    As regards the method used in our research study, Callejo argues: "At most this can be said to be a microsocial situation, a meeting with a macrosocial application. Accordingly, it must be emphasised that discussion groups are a means, but not an end, to gaining knowledge".
10 For this reason, we believe that focus groups with children are the most suitable qualitative instrument for conducting research among our study population, specifically preschoolers and first and second graders.
    The reasons that have lead us to choose this particular research tool derive from the need to explore how pupils assess this topic within the school setting. As mentioned above, the assessment described here forms part of a larger research study that has been carried out using a combination of quantitative instruments (three questionnaires for teachers, school administrators and families) and the qualitative instrument we have selected to use with the pupils, in addition to other qualitative methods such as observation, photographs and the analysis of documents. As Callejo argues, "The group is created as a complementary element to questionnaires. Its origin is related to the attempt to bring the survey-with-questionnaire situation closer in touch with real life".
10
    The use of this qualitative method has as its aim to examine pupils' opinions concerning healthy nutrition and the eating customs of other cultures, gain insight into their eating habits and determine the extent of their knowledge regarding this topic.

Methodology

Composition and selection of focus groups. The groups were homogeneous insofar as the members selected for each group belonged to the same context (the same school), and heterogeneous insofar as the members had different educational levels and cultural backgrounds. The aim of this diverse and heterogeneous composition was to encourage discussion among the groups that would allow us to gather as much information as possible. A total of four focus groups were recruited in two schools with canteens and early morning rooms. The schools were selected from among all of the schools participating in the broader research study. The two schools chosen for our study were the Príncipe de España Public School in Huelva and the Hermanos Pinzón Public School in Palos de la Frontera. We decided to choose a school located in the capital of the province of Huelva as well as an additional school in a peri-urban area outside the capital with a large number of culturally diverse pupils.
    The pupils were selected by contacting the head of each school by telephone. Following this initial contact, a personal meeting was held with the head of the school and with the preschool and first and second grade coordinators. During the meeting, the heads of the schools and the coordinators were informed about the objectives of the study. The coordinators were given an authorisation form to be signed by the pupils' parents to allow us to film the pupils while the focus groups were being conducted. The coordinators then asked the teachers to collaborate in selecting the pupils during staff meetings. We asked that the group be comprised of pupils who normally ate lunch in the school canteen, participated in class on a regular basis and were enrolled in different grades. We also requested that approximately 50% of those selected be of non-Spanish origin.
    In the month of November 2004, two focus groups were conducted at each school: one with preschoolers and another with first and second graders. We selected pupils from these grades given that this is the age at which children begin to form their eating habits and because this is the stage of schooling at which we must intervene before the pupils develop misconceptions concerning nutrition.
    The reason for forming four debate groups is as follows. We needed to select the most representative sample possible of preschoolers and first and second graders from public schools with canteens in the capital of Huelva and the peri-urban area who also had daily contact with pupils of other cultures. Given that Principe de España is the most culturally diverse school in the capital and Hermanos Pinzón is the most culturally diverse school outside the capital, a focus group with preschoolers and another with first and second graders were conducted in each of the schools. Regarding the number of focus groups, González del Río states: "The number of groups needed to conduct a research study needn't be very large, in fact, good research can be done with a relatively small number of groups. Two groups of similar composition lead to monotonous and redundant discourse: speech becomes saturated and the second group can add nothing to the first. Once the pertinent composition of the groups is established, one is sufficient".
15
    As regards group size, the exact number of pupils was left up to the grade coordinators, although we suggested that they select a total of six to eight pupils for each group. All of the groups included this number of participants, with the exception of the preschoolers from the Hermanos Pinzón School since the coordinator felt that the three non-Spanish members of the group would provide a large amount of information. Indeed, this was one of the groups in which the discussion flowed most freely. Note that the teachers were in charge of selecting the pupils given that they are directly responsible for them and had more information about their particular characteristics.

Dimensions analysed. The method used was organised into dimensions in order to facilitate both the gathering of information and the subsequent analysis.

Construction and administration. Although this method features an open design, a series of circumstances arose that led us to prepare some well-defined and concrete questions beforehand in order to stimulate debate and discussion among the members of the groups. In this regard, the following aspects were taken into account: (1) the young age of the participants (3-8 years of age); (2) the focus group sessions were conducted in the early morning room which was full of toys that greatly distracted the pupils; (3) no teachers were present to direct or supervise the pupils; (4) those participating in the focus groups came from different classrooms and grades and did not know each other very well; and (5) the pupils were taken out of class in order to participate in the discussion group.
Table 1    These circumstances made it difficult to maintain the pupils' attention. Thus although there were no set topics to be discussed nor was there a pre-established order of ideas, we had to prepare a certain number of questions in order to hold their attention and encourage them to participate in the discussion. To overcome the above difficulties, we made use of several alternative techniques. First, the questions were posed as if we were playing a game. When we noticed that the pupils were not paying attention, we interrupted the discussion to play "I spy with my little eye". Second, we previously requested that the pupils' teacher or another teacher at the school remain in the room while the session was in progress. This was not possible, however, given that all of the teachers were occupied at the time the focus groups were being conducted. Third, in order to adapt to the pupils' grade level, we presented them with several types of foods (fruit, dairy drinks, pastries, chocolates, etc.) to gain their attention and allow them to see and touch the foods that they were actually talking about. Finally, the early morning room at one of the schools had an area without toys where we sat to run the session.

Interpretation and analysis. The information obtained through the discussions was explored in a three-stage process before coding and subsequent analysis. First, the data obtained was examined in a general manner. Once a general vision of the information was obtained, we examined the data again and made an initial draft of the categories taking into account the above-mentioned dimensions. After triangulating the categories with the aid of health education professionals, preschool and first and second grade teachers, we determined the final dimensions, categories and codes in order to analyse the content of the discussions.
    Following this procedure, we developed a final list of categories that included six dimensions. These dimensions were then subdivided into 22 categories. As shown in Table 1, each category was assigned a code. To analyse the data obtained from the focus groups, our category scheme followed the work of Rodríguez, Gil and García,
16 that is, it is based on thematic criteria.

Results-discussion

    Firstly, as regards the limitations to our method, we would like to highlight that this particular method involves the risk of pupils not responding in a sincere manner. This is especially true given that children of this age have a very vivid imagination and tend to repeat what their classmates say out of fear of making mistakes. Moreover, prior to the discussion, the teachers had told the pupils that the researcher was a teacher who was going to spend some time with them in another class.
    It is also important to note that although a video camera was set up on a tripod in the corner of the classroom to film the participants, it did not seem to interfere in their responses. In the beginning, when the pupils asked what the camera was for, they were told that it was to take their pictures. After posing for the picture, they forgot that a camera was in the room.
    In what follows, we provide some insight and draw some conclusions regarding the results of the method using the dimensions described above. Some of these dimensions are explained in greater depth than others due to the fact that although all of the data may be significant, certain data were considered to be more relevant than others.

a) Breakfast. Some of the pupils eat no breakfast at all and many others only have a glass of chocolate milk, although a few do eat something a bit more solid for breakfast. The pupils state that their parents do not insist that they have a more complete breakfast. The majority usually has dinner around 9:00 p.m. and goes to bed early, meaning that they could get up early enough to have a more complete breakfast. As the pupils have reported, they usually have breakfast alone or with their mothers, indicating that they eat a quick breakfast while their parents are getting ready to go to work; a stressful lifestyle that is being transmitted to children.
    Families should dedicate more time to breakfast. It is the responsibility of parents to ensure that the day begins in a calm manner and that the family enjoys the most important meal of the day together, especially when pupils must work hard in the morning and are in the process of growing.

b) Eating habits. The majority does not like fish because they say it has bones. Moreover, they prefer fruit to vegetables. Almost all of the pupils love pizza, hamburgers and chips. They usually eat while sitting in front of the television. The majority make reference to their mothers, suggesting that mothers continue to be responsible for what their children eat in spite of the fact that almost all of them work outside the home. Although the children are very keen on sweets, they are fully aware that sweets are bad for their teeth and eat them with precaution. The pupils also state that they mostly eat sweets when they are with their grandparents.

c) Knowledge about healthy eating habits. For purposes of clarity, we explained to the pupils that there are not healthy and unhealthy foods, but everything can be eaten in moderation. When asked about healthy foods, the pupils did not know how to define them, but instead provided an example (for instance, mandarin oranges). When we insisted that they explain why a particular food was healthy, they responded by saying that a healthy food is one which helps them to grow and has vitamins. Very few said that someone has taught them what constitutes a healthy diet,17 except in a few cases in which they made reference to their mothers. However, the pupils were incapable of classifying foods into their corresponding groups (fruits, vegetables, etc). Given that much of the knowledge regarding nutrition is based on families' eating practices and attitudes towards food, some mothers may take advantage of mealtimes to teach their children about nutrition, thus transmitting good eating habits and behaviour.

d) Advertising. Although the pupils in our study do not yet know how to read or are just beginning to read and write, they are quick to identify the brand names of foods by their packaging (Puleva, Actimel, etc.). They are also perfectly capable of repeating advertising slogans such as "contains milk" or "has vitamins that make you grow". They are familiar with food brands such as Telepizza, Burger King or McDonald's, but when they speak about these particular brands they mention the toys that they get when they eat them. We were also surprised to find that they prefer hamburgers and pizzas prepared by their own mothers, although their mothers do not prepare these foods very often.

e) Cultural diversity. The children of non-Spanish parents state that they have travelled on several occasions to their country of origin to visit family members. However, they are unable to find differences between the foods and dishes of Spain and those of their country of origin, expect for a few cases in which the pupils mentioned a typical dish from their country that is not usually eaten in Spain (for example, couscous). The same thing occurs among the pupils of Spanish origin insofar as they find no differences between their own diet and the diet of their non-Spanish classmates. However, they do notice when a classmate does not eat a particular food item (for example, pork in the case of Muslim pupils) and explain that the reason for this is because their classmate does not like it. The same thing occurs with classmates who suffer from food allergies. The pupils believe that the reason they do not eat a particular food item is because they do not like it.
    In the schools where the focus groups were conducted, we found that the non-Spanish pupils were perfectly integrated, although it should be noted that the objective of our study was not to determine their level of adaptation. Thus this data should be further analysed through other instruments. In sum, no differences were found in terms of the eating habits or knowledge about nutrition between Spanish and non-Spanish pupils.

f) Canteen. With few exceptions, the majority eats in the canteen because both parents usually work outside the home. Some of the pupils like eating in the canteen because they can play with their classmates after lunch. Others, however, complain that the food is cold or that they have to wait a long time before being able to return home and rest.
    With the exception of two cases, the pupils who participated in the discussions generally have very little knowledge about nutrition. Lack of time and a fast-paced lifestyle mean that parents resort to fast foods and do not educate their children about healthy eating habits.
    Our research into the aspects that have an impact on eating behaviour in both homes and school canteens have permitted us to design an educational project in this line. The aim of this project is to raise awareness about the importance of developing healthy eating habits among all the spheres of the educational community including the administration, schools and of course, families.
18,19

References

1. De Cos AI. Dieta Mediterránea: ¿patrón alimentario de referencia en población infantil? (PhD thesis) Madrid: Universidad Autónoma de Madrid, 2001.
2. Asociación para la promoción del consumo de frutas y hortalizas. 5 al día. Available at: <https://www.5aldia.com/> [Consulted 20/09/2007].
3 Buckingham D. Crecer en la era de los medios electrónicos. Madrid: Morata, 2002.
4. Se espera que aumenten las tasas de obesidad infantil para 2010. Available at: <https://www.fundaciondiabetes.org/adjuntos/03_2006%5C13.pdf> [Consulted 20/09/2007].
5. Hawks SR. A Cross-cultural Comparison of Health Promoting Behaviors among College Pupils. The International Electronic Journal of Health Education, 2000; 5: 84-92. Available at: <https://www.iejhe.org> [Consulted 20/09/2007].
6. Regional Government of Andalusia. Instructions of the Department for Educational Orientation and Solidarity concerning the organisation, operation and management of school canteens for the 2004/2005 academic year. Huelva: Photocopied material, 2004.
7. WHO. Process for a strategy on diet, physical activity and health. Geneva: WHO, 2002.
8. Spanish Ministry of Health and Consumption. NAOS Strategy (Strategy for nutrition, physical activity and prevention of obesity). Madrid: Ministerio de Sanidad y Consumo, 2004. Available at: <https://www.aesa.msc.es/aesa/web/AesaPageServer?idpage=9&idcontent=5672> [Consulted 20/09/2007].
9. Brea M. La EpS en los centros docentes. A Tu Salud, 1995; 10: 18-23.
10. Callejo J. El grupo de discusión: introducción a una práctica de investigación. Barcelona: Ariel Practicum, 2001.
11. Colás P. Métodos y técnicas cualitativas de investigación en psicopedagogía. En: Buendía L, Colás P Hernández F, coordinadores. Métodos de Investigación en Psicopedagogía. Madrid: McGraw-Hill, 1997: 251-254.
12. Merino MA. La promoción de la alimentación saludable en la infancia desde una perspectiva intercultural. Index de Enfermería, 2006; 55: 54-58.
13. Brea M, Castro B. Hacia la EpS desde una perspectiva multicultural. En: Serrano González MI, coordinador. La EpS del Siglo XXI. Comunicación y Salud. 2nd ed. Madrid: Díaz de Santos 2002: 463-472.
14. Serra ME. Aproximación a los hábitos alimentarios de la población inmigrante de origen africano, residente en Mataró. Revista Española de Nutrición Comunitaria, 1998; 4(3): 143-146.
15. González del Río MJ. Metodología de la investigación de datos. Técnicas de recolección de datos. Alicante: Amalgama, 1997.
16. Rodríguez G, Gil J, García E. Metodología de la investigación cualitativa. Málaga: Aljibe, 1996.
17. González Lucini F. Educación en valores y transversalidad: Un nuevo reto para la educación contemporánea. En Serrano MI, coordinadora. La EpS del siglo XXI. Madrid: Díaz de Santos, 1998: 137-140.
18. Dixey R. Healthy Eating for Young People in Europe. A school-based nutrition education guide. Madrid: Translated into Spanish and adapted by CIDE, 2000.
19. ENHPS: European Network of Health Promoting Schools. Available in Spanish at: <https://www.mec.es/cide/jsp/plantilla.jsp?id=reeps01b> [Consulted 15/09/2007].

 

 

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