Background
Methods
Setting
Participant selection and recruitment
Data collection process
1. What do you think informal care is? What types of informal care have you used or given and why? | |
2. Carers: Can you describe your typical day with the child you look after? Parents: Can you describe a typical day your child will have with the carer? (Making special attention to Who? What? Where? When? Why?) | |
3. Do you receive/give any suggestions as to how the child should be looked after in relation to health or health behaviour? | |
4. Do you think that there is a problem with pre-school aged children being overweight? | |
5. What knowledge or support do informal caregivers need to help prevent obesity in the children they care for? | |
6. Moderator provides existing evidence on the relationship between informal childcare and obesity. Can you think of any possible explanations for this evidenced association? | |
7. What are parents and informal caregivers perceptions of potentially feasible and effective intervention targets and ideasa? (Making special attention to Who? What? Where? When/how often/how long? ) | |
8. What would be feasible ways to recruit suitable participants for future questionnaire surveys that aim to research this topic further? | |
9. Summary and closing |
Data analysis
Results
Birmingham | Edinburgh | |||
---|---|---|---|---|
Parent (n = 3) | Carer (n = 4) | Parent (n = 4) | Carer (n = 3) | |
Age | ||||
60 or older | 0 | 2 | 0 | 1 |
50–59 | 0 | 1 | 0 | 2 |
40–49 | 0 | 0 | 0 | 0 |
30–39 | 3 | 0 | 4 | 0 |
20–29 | 0 | 1 | 0 | 0 |
Gender | ||||
Female | 3 | 3 | 4 | 3 |
Male | 0 | 1 | 0 | 0 |
Ethnicity background | ||||
White | 3 | 3 | 4 | 3 |
Black | 0 | 0 | 0 | 0 |
Asian | 0 | 1 | 0 | 0 |
Employment | ||||
Full time | 0 | 1 | 0 | 0 |
Part time | 3 | 1 | 4 | 2 |
Unemployed | 0 | 0 | 0 | 0 |
Retired | 0 | 2 | 0 | 1 |
Annual household income | ||||
No income | 0 | 0 | 0 | 0 |
< 30 K | 0 | 2 | 0 | 0 |
30-60 K | 4 | 1 | 1 | |
60-100 K | 2 | 0 | 1 | 0 |
> 100 K | 0 | 0 | 0 | 0 |
Did not specify | 0 | 1 | 0 | 1 |
Level of education | ||||
University/College | 3 | 4 | 4 | 3 |
Secondary school | 0 | 0 | 0 | 0 |
Primary school | 0 | 0 | 0 | 0 |
Relationship of carer to child | ||||
Parent | 3 | 0 | 4 | 0 |
Grandparent | 0 | 3 | 0 | 2 |
Nanny | 0 | 1 | 0 | 0 |
Child-minder | 0 | 0 | 0 | 1 |
Age of the child (mean in years, range) | 2.70 (0.75–5.00) | 3.90 (2.00–5.00) | 2.90 (2.00–4.00) | 2.80 (2.25–4.50) |
Length of time the child was in informal care (mean in years, range) | 1.20 (0.25–2.25) | 3.20 (0.50–5.00) | 2 (0.50–4.00) | 2.40 (1.25–4.00) |
Number of days a week the child was in informal care (mean in days, range) | 1.00 (1.00) | 3.80 (1.00–7.00) | 1.20 (0.25–2.00) | 3.00 (2.00–5.00) |
Average number of hours a day the child was in informal care (mean in hours, range) | 8.00 (6.00–10.00) | 6.80 (3.00–10.00) | 6.30 (4.00–9.00) | 6.90 (5.00–9.50) |
Theme 1: The importance of informal care to families and society
“It was sort of to help with the cost if you’ve got 2 children we didn’t put them both into nursery for 3 days a week so my mum ended up having both children when I came back to work” (PG2M1).
“Certainly I wouldn’t be happy passing him to somebody I didn’t know and in a nursery that was one of my main concerns cos the staff turnover can be quite high” (PG1M3).
“I didn’t mind cos I prefer to look after her and know that she’s being looked after properly and being treated properly and happy” (CG1G1).
“Oh no I wouldn’t miss it [caring for her grandchild] for the world” (CG1G2).
“Grandparents care of children… is worth about fourteen point seven billion to the state every year because people are able to work and all that type of thing, we are a really useful resource” (CG1G3).
Theme 2: Practical and emotional roles of informal carers
“I get the children dressed” (CG2G4).
“They’ve got gymnastics class booked so granny takes (name of daughter) to that” (PG1M1).
“No mum’s gonna go for me because ((laughs)) so my informal child carer is going to go to his 27 month check, so that’ll be quite good” (PG1M4).
“They were well looked after and I didn’t have to worry” (CG1G1).
“It’s to enable them to continue their careers when they really needed to work just to pay their mortgage” (CG2G1).
“With my mum even though she wasn’t there all the time she’d phone me and I was upset ‘oh is she still not sleeping just give her some baby rice’” (PG2M2).
Theme 3: Potential explanations for the link between childhood obesity and informal care
“I would definitely tell my mum how I’d want them to be fed especially when they were younger only because we had different views about weaning and stuff like that” (PG2M1).
“Cos we did baby led weaning that was a bit controversial with both grandmas so particularly my mum there was a lot of ‘well shall I just give him some puree that I bought from the shop’ and (the participant replied) ‘I’d rather you didn’t’ sort of thing” (PG2M3).
“My mum actually encouraged me to wean early which I think a lot of mums do because (name of daughter) was struggling and she wasn’t sleeping… so I did start a little bit early” (PG2M2).
“My mum was like ‘well give him some baby rice give him some baby rice’ and I remember at 5 months I was pushed that hard that I offered him baby rice and he didn’t want it and I was like ‘see he doesn’t want it’” (PG2M1).
“No my mother-in-law was the same yeh she didn’t agree with breastfeeding at all… it was really hard cos she was the only other person I had as support apart from my husband” (PG2M2).
“I think with her it’s because she bottle fed me and my sister and I think she felt it was a bit of a personal well are you saying it wasn’t good enough what I did” (PG2M3).
“And it’s really hard cos you don’t trust your own instincts do you… I used to have to have a book to sort of back it up… because otherwise you do feel so peer-pressured that you have to justify yourself don’t you as to why you do things” (PG2M1).
“Do you know what that’s quite interesting cos my mum’s not English, no my mums Dutch and they are very forthright people and she is less respectful of my opinions than my mother-in-law who is English” (PG2M3).
“I don’t think she (referring to her mother) does believe that bottle feeding is much better but that it is a lot easier, it means she could have helped so like especially when I used to have it really rough in the nights” (PG2M5).
“Yeh rock the boat or be too critical, it’s the relationship that is there as well as the kind of helping you yeh giving you care so it would be very difficult” (PG1M4).
“You know my mum is doing me a huge favour by helping me out with this I can’t really say to her ‘come on down and I’ve got something stuck to the wall” (PG1M3, referring to an intervention suggestion given by another parent in the focus group).
“Yeh find that easier to say to someone I’m paying for it, but when it is a favour yeh to help you out its harder to say what you really want maybe” (PG1M1).
“I know that she wouldn’t leave him crying because she knows that I don’t and it’s not her child and she is very good like that so maybe that does actually come from working with other people’s children and being used to that advice” (PG2M3).
“Certainly if grandparents as they are shortening their working day but they’re still at work to look after the kids then I think they’re probably knackered” (CG1G3).
“I think as people get older they do get tireder and looking after kids as you get older is harder work you are more likely not to play with them you are more likely to… say ‘go and watch the tv or what about your computer or even do some drawing’ rather than playing outside” (CG1G3).
“You wouldn’t have those hours where they would be sat down” (PG1M1).
“I think when it’s your grandchildren they say ‘please granny can I have it’ it’s very hard to not to be totally sort of ‘nope’” (CG2G1).
“Well I must say I always had to prevent granddad buying packets of sweets… he would be thinking he was being kind” (CG2G2).
Theme 4: Potential intervention opportunities and strategies
“People will argue ‘oh well you’ve done it already because you had your own kids’ but actually society and we’ve talked about the screens and so on has changed so much” (CG1G3).
“Yeh there’s always different sort of nutritional advice changing and it’s always handy to know the up to date information” (PG1M2).
“It’s almost like back up you say ‘this is the way I want you to do it, this (imitating a leaflet) is where I got the information from’ it might be quite helpful” (PG2M2).
“New recipes… to help people think of different things to do for their children” (CG2G1).
“Say random days out and things to do” (PG1M1).
“Healthy snacks is always a good thing, I think carers, not in my case, they’re the ones that ‘oh well give him a biscuit give him a bag of crisps’ you know cos you just run out of ideas sometimes” (PG2M2).
“And like about the drinks and stuff and… sugar in drinks” (PG2M1).
“Once they get to sort of from 3 to 5 I think you really need to focus on steering away from like tablets which are an easy thing to do” (PG2M1).
“Even like a little leaflet book and it’s actually for carers outside parents so that you could give it to them and they could flick through it in their own time” (PG2M1).
“Make it friendly and not as if they’re being criticised” (CG2C1).
“I think it kind of would make it less awkward to approach my mother if ‘oh (name of son) got this at nursery and it’s for grandparents’” (PG1M3).
“I think if it’s somebody like a health care professional or somebody that is sort of qualified at the children’s centre I think they’re more likely to take what they say is the right thing” (PG2M1).
“The health visitor could say oh you know ‘who’s going to look after your child’… so that could be through a health visiting situation they could feed out you know because they would be talking to them hopefully… but you know if people are maybe thinking about going back to work just feed that into the information that’s available from a year on if you are going to have (an informal carer} these are the packs you can get” (CG2C1: Carer Group 2 Child-minder 1).