Balancing Nutrition and Budgets: Socio-Ecological Impacts on Nutritional Environments of Families with Low Incomes

Abstract

Background.

Research on childhood nutritional environments, which are predictive of a variety of child and family health and wellbeing outcomes, has primarily focused on parenting behaviors and the home food environment. However, broader social and community factors play an important role in shaping nutritional environments during early childhood. Food security is key example that is closely linked to nutrition-related health disparities, which can arise from constrained financial resources and material deprivations. Understanding parent and caregiver lived experiences related to social and community components of family nutritional environments in the context of economic constraints could help to support multi-level nutritional practices that are optimal for healthy child development.

Method.

Semi-structured in-depth interviews were conducted using a narrative approach with parents (n=21) of pre-school aged children living near or below the poverty line. Participants were recruited from social and community service sites pertinent to maternal and child health in Philadelphia where health disparities are highly concentrated. Analysis was conducted using MAX QDA analytic software following a systematic approach for thematic analysis in narrative research.

Results.

Three themes describe the feeding and eating environments in the home and community context: 1) Food Procurement and Meal Planning; 2) Family Togetherness; 3) Creativity, Variety, and Flexibility. Creative decision making and food procurement strategies responsive to child preferences were balanced by shopping to save and visiting multiple stores for the best foods and savings. Logistical (e.g., transportation, childcare) and emotional supports facilitated food shopping habits and routines, while lack of trusted childcare, reliable transportation, and social support barriers challenged feeding and eating decisions.

Conclusion.

Strategies for improving cost and time-efficiencies could help support health-promoting nutritional environments of families with food insecurity. Building social and community capacity and facilitating connections to practical supports that include trustworthy childcare and peer support may be particularly important for this population.

Introduction

Nutritional environments in early childhood are predictive of significant short and long-term child health outcomes, including healthy growth and development, and establishment of risk factors for diet-related chronic disease (Demmelmair et al., 2006). Home eating environments, such as having a consistent time and place for meals and eating together as a family and parent feeding practices are major influences on child growth and development (Arlinghaus et al., 2018; O'Connor et al., 2019). In addition to the home environment, community and societal factors can influence the decisions parents make around how and when they structure feeding and eating environments at home (Bryant et al., 2020). The ecological model provides a theoretical framework for integrating understanding of how broader community, social, and economic factors impact early childhood nutritional environments (Bronfenbrenner, 2005, 2013; Davison & Birch, 2001). However, in-depth qualitative research on the impacts of broader community and social factors on home nutritional environments is lacking among families with food insecurity. A better understanding of interactions of proximal home environments and distal community and societal factors could help improve structural and systemic policies and programs designed to support growth and nutrition among families with young children in economically underserved communities. Because Philadelphia has the highest poverty rate of large US cities with 25.5% of Philadelphians with children reporting food insecurity as of 2021, (Feeding America, 2021), in-depth research is needed to better understand how to support food security in areas of concentrated poverty.

According to the ecological model for childhood obesity, a complex set of factors from multiple contexts (e.g., child, parent, community, and policy/macrosystem characteristics) interact with each other to influence child health and health behavior risks (Davison & Birch, 2001). The factors that impact child diet and nutrition are influenced by factors in the home environment (e.g., parent feeding and eating practices, foods available in the home), the community environment (e.g., quality, affordability, and accessibility of foods available in the community, reliable transportation), broader social (e.g., safety, trust, cohesion ) and political environments (e.g., efficiency/effectiveness of food assistance and safety net programs) and interactions of factors across these levels.

Most existing research on addressing nutrition and growth outcomes in childhood focus only on the individual or home and family components of the ecological framework. For example, research has centered on the structure of the meal and mealtime environment, the nutritional quality of foods served, reducing energy consumed, parent feeding behaviors, and increasing the frequency of meals cooked at home and eaten together as a family (Arlinghaus & Laska, 2021; Chu et al., 2018; Hevesi et al., 2024; Leung et al., 2022; Malaquias et al., 2015; Neumark-Sztainer et al., 2003; O'Connor et al., 2019; Puddephatt et al., 2020; Skeer et al., 2018). Individual parenting behaviors or practices, such as parent feeding practices, like having predictable rules and routines, minimizing distractions (e.g., TV watching), and maintaining family rituals have been found to help improve family dynamics and increase consumption of vegetables (Avery et al., 2017; Berge et al., 2013; Fiese et al., 2012; Wenhold & Harrison, 2018). Frequency of family meals at home has been associated with better family psychosocial wellbeing and enhanced family relationships (Chu et al., 2018; Ho et al., 2017), healthier weight status (Taveras et al., 2005), and greater consumption of fruits and vegetables (Neumark-Sztainer et al., 2003). In general, research suggests parents value teaching and promoting healthy decision-making through their feeding and eating routines, and having a regular, structured time to connect and bond regardless of their socioeconomic status (Arlinghaus & Laska, 2021; Hevesi et al., 2024).

Despite information gained from existing research on family systems and family stress theories that emphasize the role of parents’ decisions and parenting behaviors (Baxter et al., 2024; Ruggiero et al., 2024), several major gaps in our understanding of early childhood nutritional environments remain. Community and societal factors can influence decisions parents make around how and when they structure feeding and eating environments at home and these might differ among families experiencing food insecurity. A socio-ecological perspective can account for broader community and social factors that interact with parenting factors and elements of the home environment that can have big impact on childhood nutrition-related disparities (Davison & Birch, 2001). For example, poorer communities have a higher concentration of convenience and fast foods that tend to offer affordable, often highly processed, quick-to-serve foods (Reitzel et al., 2016). Living in high poverty, violent areas can limit walkability and feelings of safety shopping at community-based stores, which can in turn increase stress levels and have direct linkages to higher levels of food insecurity (Daundasekara et al., 2024). Further, the day to day lives of families living in high poverty can come with time constraints different from that of middle- and upper-class families who have access to more forms of reliable and convenient transportation, child care, and social support (Delgado, 2013; Roy et al., 2004). Heightened stressors and limited resources prevent parents from focusing on healthier lifestyles (e.g., housing insufficiency and insecurity, access to health care, transportation challenges, community safety), as these stressors require parents’ immediate attention and take time away from other things, like meal planning, food procurement, and cooking (Davison et al., 2013). Parents with low incomes, especially those who use food stamps and have limited access to reliable transportation are often forced to purchase staple foods in bulk that have a longer shelf-life (e.g., beans, canned goods), which tend to have additives, preservatives, and be more calorie-dense (Davison et al., 2013). Taken together, intensified financial challenges result in higher risks for food insecurity (Baidal et al., 2016; Kaur et al., 2015; Schuler, Bauer, et al., 2020), as well as limited time and resources to plan, organize, and prepare for meals (Roy et al., 2004). This in turn can reduce the likelihood of adequate nutritional intake optimal for the prevention of diet-related disease and contributes to trends in increasing health disparities (Hernandez et al., 2017; Seligman, Davis, et al., 2010; Seligman, Laraia, et al., 2010).

Although feeding (i.e., parental decisions around how and what to feed children) and eating (e.g., what children actually consume and have access to) environments are important predictors of the quality of nutrition in early childhood (Neumark-Sztainer et al., 2003), qualitative research on economically-driven disparities in diet and nutritional intake during early stages of child development do not typically account for the broader social and community environments of families experiencing food insecurity (Arlinghaus & Laska, 2021; Dietz, 2019; Hevesi et al., 2024; Leung et al., 2022; Moore et al., 2019; Puddephatt et al., 2020). Considering how food and nutrition are entangled with social justice issues, there is a clear need for a more in-depth understanding of how to improve the feeding and eating environments of households in communities with high concentrations of poverty with an explicit focus on interactions of proximal home environments and distal community and societal factors. An in-depth understanding of how to improve policies and programs designed to support growth and nutrition among families with young children in economically underserved communities can inform policies, programs, and research on how to move beyond individual level barriers and address the social structures that perpetuate oppression and limit access to resources for optimal health (Delgado, 2013).

Research Aims and Questions

The overarching purpose of this study was to obtain current information on the lived experiences of parents with young children living in resource-constrained environments using a narrative approach and ecological model as a guide. Specifically, our qualitative study aimed to gain an in depth understanding of the feeding and eating strategies, trends, and traditions used by parents to support healthy child development operating under high levels of poverty and food insecurity and how these decisions are impacted by broader social and community factors.

Methods

Approach

The narrative research approach was used to collect and analyze accounts of experiences as described by one primary caregiver of each household based on their lived and told stories (Creswell & Poth, 2016; Overcash, 2003). Narrative research is an effective qualitative approach that can lead to enhanced delivery of care (Overcash, 2003), providing contextual insights into caregivers' experiences, allowing researchers to understand the complexities of their roles and the challenges they face (McAdams, 2015; Riessman, 2008). In-depth semi-structured interviews were conducted on Zoom over a period of 6 months (July 2022–December 2022) due to COVID-19 precautions and to provide greater accessibility and convenience for parents with transportation barriers. The research team consisted of five members with backgrounds in public health and social work. All interviews were conducted by two members of the research team. Following the narrative framework, interviewers encouraged participants to share their stories in their own words, which helped to uncover themes related to identity, resilience, and support systems (Squire et al., 2014). By encouraging participants to share their personal stories, we gained insights into how individual decisions are influenced not only by immediate familial contexts but also by broader social and community factors, such as access to resources, cultural norms, and social support systems. This narrative lens enabled us to understand the complexity of their experiences and the interplay between personal choices and environmental constraints.

Data Collection Procedures and Setting

Setting.

To identify potential participants, the research team developed a list of nine social and community service sites pertinent to maternal and child health in low-income communities in Philadelphia where health disparities are highly concentrated (e.g., service agencies, organizations, churches, mutual aid groups) and who provide health or mental health services. After identifying sites for recruitment, the research team reached out to site directors to discuss the project and gain permission to recruit parents and primary caregivers, henceforth referred to as parents. Following permission, study information was distributed through electronic list-serves and flyers. Contact information of interested participants was shared with the research team by community partners and potential participants were contacted by a member of the study team via phone and text message. All recruitment was conducted virtually between July-October 2022. Institutional review board (IRB) approval was granted by the university’s review board.

Ecocultural Family Interview (EFI).

The EFI assesses environmental and cultural family resources and constraints, values, and adaptive efforts under adversity (Weisner, 2002). The EFI is a semi-structured qualitative interview guide that uses a mix of conversation and probing questions by trained interviewers using preplanned structured questions (Weisner, 1997). The EFI is designed to capture the interplay between family life and cultural contexts, and focuses on how families adapt their practices and strategies in response to their ecological environments, including social, economic, and cultural factors. The EFI aligns with the narrative approach to qualitative research by prioritizing personal stories and lived experiences to understand family dynamics. By inviting participants to share their narratives within the context of their cultural and ecological environments, this method reveals how families construct meaning around their daily practices and parenting strategies. Focusing on a parent’s lived experience allows researchers to uncover the rich, contextualized influences of social and environmental factors on family life. This integration of narrative elements enhances the depth of understanding regarding how cultural beliefs and ecological constraints shape parenting in diverse contexts and resource-constrained settings.

The EFI is a question bank in which there are recommended topics and questions, not a set list of questions required for every interview. Instead, the EFI is a flexible framework that guides the interview process. Researchers are encouraged to adapt and tailor the questions based on the specific context and responses of the families being interviewed. This approach allows for deeper exploration of relevant themes and ensures that the interview remains conversational and responsive to the unique experiences of each family. This approach also fits well with the narrative approach as it allows caregivers to guide the discussion and craft their stories through the sharing of their experiences. For this study, questions were selected based on standard topics found to be applicable to daily family routines, work and subsistence, and family networks. This involves asking the family to walk us through a typical day, to describe their daily activities, with probing questions about goals, values, and preferences behind parent’s routines as well as their resources and constraints (Weisner, 1997). These items are designed to allow families to construct a picture of their daily lives, accounting for how other forces shape their and their child’s experiences, including schools, childcare centers, peers, religious communities, the neighborhood-built environment, and government policies. Relevant items were drawn from the EFI domains on work, health and demographic circumstances, community safety, the division of work by age and gender, children’s participation in routines, organization of childcare, social networks and peers, social and community support resources, the role of fathers, and other cultural influences on children (Weisner, 1997). Probes within the EFI were modified to include a focus on their daily routines related to health behaviors (e.g., sleep, eating, exercise), mealtime routines, food shopping routines, and daily stressors (e.g., financial constraints, adverse childhood experiences). The measure was piloted among a representative sample of five parents and revised to reflect community-specific priorities for healthy child growth centered on the ecocultural framework. Three primary topics were used to guide the EFI, sub questions, and probing questions (see Table 1): 1) Caregiver/Family Characteristics, Health Behaviors and Routines, 2) Goals for parent/child Health behavior/routines, and 3) Food Related Community/Societal Characteristics. Modified items for this study are listed in Table 1 in bold.

Table 1.

Ecocultural Interview Topics and Example Items

1. Home and Food Environment
Caregiver/Family Characteristics, Health Behaviors and Routines	Describe “a day in the life of” you and your family. Tell me about who handles major household responsibilities, like preparing meals, getting kids ready for the day, and getting ready for sleep? What do you/your child like to eat and why? If you prepare foods at home, what kinds of things do you like to prepare? Are mealtimes important to you/your family? Why or why not? Can you tell me what mealtime was like when you were a child? What are your favorite things or things you’re most proud of about your mealtimes and food habits as a family? Can you tell me why they are your favorite things? Describe what a “typical” meal is like for you & your family. Describe what a “special” meal looks like for you & your family.
Goals for parent/child Health behavior/routines	If your goal was to make the best choices, however you define this, for you and your children re: eating, what would your ideal day look like to support these goals or choices? Are there things you do together as a family that are important to you? If so, can you tell me more about those things or experiences? Is there anything you could change about your mealtimes or food habits as a family? Can you say more about why you would change these things?
Food Related Community/Societ al Characteristics	Where do you usually buy your food or meals from? Why? Have you experienced any hardships (barriers) to purchasing your food/meals? If so, can you say more about these hardships? Are there any places you do not like to go to buy food? Why? Are there places you wish you could go to buy food? Why? What prevents you from accessing that place/those places?

To enhance rigor and vigor of the qualitative design, researchers were trained following effective strategies focused on developing interviewing and coding competencies, building a sense of team connectedness, and increasing responsiveness and sensitivity to the study populations. Reliability checks for shared understanding were conducted in weekly team meetings. A Stakeholder Committee including 3 parents and 3 service providers from the community and including social workers provided oversight for finalizing the interview guide and the construction of culturally-appropriate interview questions through an iterative process and series of meetings to review revisions. All interviews were conducted or supervised by a licensed, masters or PhD level social worker.

Data Analysis

Interviews lasted approximately 70 minutes, on average. All interviews were audio-recorded and transcribed verbatim. Analysis was conducted using qualitative analytic software (MaxQDA v.20) through an ongoing, iterative process following a systematic approach recommended for narrative research (Butina, 2015). The approach includes: 1) using the text to gain an overall understanding and identify overarching emergent themes, 2) developing and applying a formal system of coding to a subset of transcripts to organize data and understand thematic linkages, followed by coding of all transcripts according to overall themes until thematic saturation is reached, and (3) finalizing and applying the coding structure to the full set of transcripts (Bradley et al., 2007). Coding was conducted independently by the PI and a trained PhD-level research assistant in consultation with an external qualitative research assistant to prevent researcher interpretive bias. Similarities and discrepancies in coding were reviewed and resolved in consultation with the research team comprised of social workers and public health researchers, students, parents, and service providers until inter-rater agreement was achieved before applying codes to the full set of transcripts.

Trustworthiness and Credibility.

To enhance the trustworthiness of the data and interpretations, key validation criteria were incorporated into the study design (Lincoln & Guba, 1985; Whittemore et al., 2001). All aspects of the study design were critically appraised by conducting a series of expert audit reviews with external qualitative research experts and community stakeholder experts who have extensive experience working in social work and public health programs with children and families from underserved communities at high risk for health disparities. To conduct the audits, a researcher who did not conduct the interview reviewed the recorded interviews alongside transcripts, noting areas of consistency and divergence and provided feedback on the coding process, ensuring that the themes identified accurately reflected the participants' experiences. Additionally, the researcher offered insights on the contextual relevance of the findings, enhancing the overall rigor of the analysis and ensuring that interpretations were grounded in both the data and the community context.

Study integrity was preserved by using field notes and weekly debriefings to discuss researcher bias and self-criticism (Butina, 2015; Whittemore et al., 2001). Researcher bias was addressed through processing of interviewer field notes after completion of the interview. This provided an opportunity to discuss the bias that the researchers brought to the study and how that may have impacted study design, data, or interpretations of study findings. We openly and honestly discussed our biases, including past experiences, assumptions, and orientations that may have shaped the interview or interpretation of research findings.

Results

Sample Characteristics

A total of N=21 parents were interviewed. Parents were female (n=19, 90%) and 33 years-old, on average (range 22 to 75 years). Most parents were mothers (n=16, 76%). Most reported being married or cohabiting with a partner (n=14, 67%). All parents identified as Black/African American (n=11, 52%) or Hispanic (n=8, 38%), and the remaining participants did not disclose their race or ethnicity. Almost half reporting some college, advanced training, or a college degree (n=10, 48%). Most parents were employed full time or part time (n=14, 70%). All participants had low-incomes, with all reporting eligibility for at least 1 means-tested government benefit (i.e., WIC, SNAP, Temporary Assistance for Needy Families [TANF]).

Major Themes

Our analysis revealed three overarching themes characterizing the importance of food and mealtimes as well as the strategies used for shopping and maintaining mealtime routines. Parents discussed: 1) Food Procurement and Meal Planning, 2) Family Togetherness, and 3) Creativity, Variety, and Flexibility. These themes encompassed the day-to-day family stressors around food such as budgeting, planning, and balancing the competing needs of children, while maintaining family mealtimes. This also included the importance of varied and convenient foods that were easy to prepare or eat on the go. The families were creative with their decision making and while there was obvious stress in the choices they had to make, almost all of the participants discussed this as a regular part of raising children.

Food Procurement and Meal Planning

Many parents provided a thorough and detailed process for how and why they obtain food for their household, how they decide what to eat, and how they prepare for meals. Many used strategies that combined convenience, cost-savings, and family-member food preferences. Regardless of where families purchased food almost all the families relied on grocery stores that were close to their homes and offered the best savings. With few exceptions, most families relied on more than one store to meet their grocery and budgetary needs (e.g., both to buy healthy food within their budget and to purchase foods in line with child preferences). The stores typically used included budget shops (e.g., Save-A-Lot or Aldi’s) as well as online stores for convenience and to avoid the lines and crowds (e.g., Amazon Subscribe and Save) and wholesale stores (e.g., Sam’s Club). For families without a personal vehicle or with multiple children, there was a stronger reliance on convenience shops or places within walking distance such as Dollar Stores. For example, one mother who recently separated from her children’s father and had two children under the age of 3 in her care often utilized stores she could walk to, “Right now everything I do is walking…so there’s food store and a dollar store, so I kind of hit both at one shot.” She used her youngest child’s stroller to help carry some items, but she also found she had to make multiple trips per week to closer, more expensive shops, because taking the bus was too difficult.

Because many families used more than one shop, some opted to buy vegetables and fruits one to two times per week whereas they stocked up on protein and non-perishable items on a weekly or bi-weekly basis. Grocery store purchases centered on child preferences and what was on sale, in part of reducing food waste and in part as a way of being responsive to their child’s preferences. Parents talked about grocery store sales to get the foods they like and want, like name-brand items. Overall, parents expressed an interest and desire to have healthy food items and healthy snacks (e.g., yogurt). Although the parents preferred to have healthier meals (i.e., more vegetables and less processed food) they typically opted to purchase what they knew their children would eat, “I buy, you know, the little, they’re like pasta packets. Like the packages that you just make. But sometimes I have like broccoli with our meals, or like, the cans, like the corn.”

There was less emphasis on eating out, though many families did this at least once a week. Instead, families cooked their meals at home using a traditional three-meal approach. Breakfast often included items like cereals, eggs, and frozen items such as waffles. Lunches varied but parents primarily used items that were quick to prepare such as hot dogs, macaroni and cheese, and frozen items like pizza rolls and chicken fingers. Almost all parents, likely as a result of their children’s ages, focused on snack time. Yet the snacks chosen were somewhat universal. There was a heavy reliance on a variety of easy to grab items including whole foods and grains such as fruit, cheese, and crackers, as well as easy and convenient but less nutrient dense snacks such as to-go yogurts and gummy snacks.

Trusted childcare was another important topic to parents. Several parents did not trust childcare centers in the community and did not think the center was equipped to support their child’s needs. Often, parents were not comfortable with childcare that was not a trusted family member or close friend, even though they expressed needing help. Several parents did not want to burden others by asking them for help with childcare. To ensure their support network is not burdened and that their child receives adequate food, some parents go out of their way to supply food when their children are out of the house. For example, one parent expressed:

That's where I mostly need help, in childcare, because even if I'm in, I'm at, at my house, as you see, I'm talking to you, but I'm still trying to focus on taking care of them…This was my first time ever leaving my kids ever with someone to say, "Okay, you can babysit them," that was not my mom, my sister, his own dad, myself, like a family, like right here…It wasn't relaxing. And I brought them food… because, I'm just not a person that depends on other people either to tell like, you know, "Here's my kid. But bring him food."

Another important element of meal planning participants discussed was time management and maintaining their monthly budgets. Although most said they were able to stretch their money and food benefits to last throughout the month there were some challenges for a few families:

…because like, food stamps, they are really helpful. It's just that lately, the food has been really expensive. Um, I mean more expensive than it's ever been. Like I used to, I used to bake. Um, I had to stop baking because like, before, [because] the box of eggs of 60 I used to buy for $3.00. The price went up to like $6.50. Okay, it like doubled a little bit. We've actually been spending more money, like cash on food, so, when we just haven't been getting as much like food and stuff lately like we used to.

Menu planning in advance of shopping helped some families adhere to a predetermined budget. However, very few families answered that they did this on a routine basis. For the families that did use a menu plan, they discussed the time it saved in preparing food. One parent said they had never considered using a menu plan but, “I probably need to start doing that. That probably would help (laughs).” (125) Related to time management, parents discussed the length of time it took for the mealtime process (around 2 hours for dinnertime) but described this process as a way to nurture their children, rather than “time consuming and tiring.”

Family Togetherness

Due to variations in schedules such as children in different age groups as well as significant others with opposite work hours, many families saw mealtime as the opportunity to connect with each other:

It is very important for me and my family, especially because we make it our business to at least try to eat at the dinner table with each other four times out of a five-day week. I’m very busy, my wife can be very, very busy, and [child’s name] is just as busy.

Dinner was also the one meal where there was wide variation in what was prepared. Often parents chose foods that were special to their families such as sausage and cabbage, barbeque chicken, and salmon, rice and peas, and sweet yams. Many families had a special family meal at least once a week. These meals were also ones the children looked forward to because there was conversation and camaraderie that occurred. For some children it was the only time when parents, siblings, and other family members would be together:

Our dinner time is where we sit and, you know, sit and talk. We’ll joke around with each other. I really like being in a comfortable [place where I] talk to my kids, tell them how much I love them, talk to my sons about school or just different areas [in their lives].

For this family, the importance of mealtimes was more evident during other times of the day because dinnertime wasn’t always the most practical or feasible meal to have together. For example, the same family quoted above carved out special time to have breakfast together, especially on weekends.

I like to cook breakfast when I can. Like, um, I like breakfast. I think breakfast is the important meal of the deal. But because, like, my work schedule and their school schedule, we’re out the door. So, usually, like, on the weekends, like, um, we’ll do, like, a big breakfast.

Overall, the families in our study strived to develop a structure for food shopping and meals while simultaneously meeting the food demands of their young children. The parents regularly scheduled at least three meals a day with a special emphasis on breakfast and dinnertime. Because of varying schedules and days that were busy, parents also described the importance of connecting through winding down during mealtimes while simultaneously keeping the kids entertained. For example, one family paired their favorite tv-shows with dinnertime and described bonding over both shared activities at the end of the day to encourage eating and connection while keeping the children focused on eating rather than distracted by other things.

I know we are not supposed to be doing this, but we’re actually sitting in front of the TV watching a movie. I had ordered the Disney app, so that’s kind of like been my best friend. So all the little old movies that they might not have seen or things like that we’re kind of like doing. And you know, they’re actually sitting down for a movie. Like before, you’d probably put something on and then they’re like off and doing something else in the next two minutes. But that’s kind of been our little girl thing where we have movie night and things like that. Um, so yeah, if we’re not at the dining room table, then we are on the couch watching. Right. And so that’s how it’s been recently. You know, you do a little dinner and a movie, everybody kind of sets together.

Creativity, Variety, and Flexibility

Given the tight budgets that many of the families had to work within, the parents optimized time and resources creatively, balanced with having options for their child to choose from. Providing a variety of options, flexibility, and encouraging children to choose was important for parents whose children are picky eaters. This often included a selection of fresh fruits and vegetables, yogurt, and pre-made processed proteins. Choices varied based on the timing and nature of food shopping as well as food storage and dining space. Almost all the families utilized some type of benefit, primarily Supplemental Nutrition Assistance Program (SNAP), Women, Infants, and Children (WIC), or both. These limited resources often determined when families went shopping and where they shopped. For example, one family would bulk shop at the beginning of the month and fill the freezer with meats and vegetables to last until the end of the month. Yet there are difficulties with bulk shopping and storage for low-income families as not all families have the capacity to bulk shop and store foods.

In terms of transportation, many families did not have their own vehicle, especially in single-parent homes. Several parents relied on social support by carpooling with a friend or family member while others utilized options such as Uber. Others depended on partners or other family members to share the food shopping responsibilities. For example, one mother scheduled a time to shop with her cousin, who had a car, for bi-weekly grocery trips. When people mentioned having cars, they had more options and preferences for where, when, and how they liked to shop. This impacted their food selection, shopping frequency, and purchasing, such as perishable items, like fruits and vegetables, versus items with a longer shelf life.

Another area where families would get creative was with eating spaces. Most parents rented their homes, sometimes with less space than desired. A few families used separate tables for the adults and the children to maximize space. Some families opted to keep their little ones at the table rather than use a highchair for sake of simplicity. A final area of creativity in terms of mealtime and preparation was batch cooking. Many families were short on time but wanted to make sure their children still ate at regularly scheduled intervals. It was mostly mothers who opted to do the cooking, and several would prepare all or parts of a meal that would stretch into the week:

I will put [the food] in Ziploc bags, I season it differently so then the next day I can cook it and then you have your meat ready, but it’s already seasoned. And then in the week, I make enough rice [and] have rice twice that week. If I make enough pasta, [we] can have pasta twice that week and I have a different meat for the next day.

However, this was not practical for all parents, particularly those who preferred to cook and plan fresh foods more frequently and those living in shared spaces with constraints and limitations on storage options.

Given budget, time, and space constraints, the families interviewed shared different and creative ways to maximize their resources. This included sharing information regarding sales and parenting resources (e.g., sales and giveaways on school supplies, shoes, clothing, free child-friendly community events). with other families via a localized Facebook community group. Parents also discussed the need for supports that were practical in nature and could help make their day-to-day household management tasks easier such as having additional childcare, getting a car, or having a house with a backyard for their children to have a safe place to play.

Discussion

Our results describe three distinct themes found in the data that represent both the home and community feeding and nutritional environments: 1) Food Procurement and Meal Planning, 2) Family Togetherness, and 3) Creativity, Variety, Flexibility. Interpreted and synthesized through the interpersonal level of the ecological framework, the family-level findings demonstrate parents’ desire to be responsive to children in the home feeding and eating environment, while prioritizing bonding and structure in feeding and mealtimes, consistent with prior research (Herman et al., 2012). At broader community and societal levels of the ecological framework, time constraints, proximity to stores, access to childcare, tight budgets, and limited transportation influenced feeding and eating environments.

The family system is dynamic and requires flexibility to meet the needs and preferences of various family members. At the family and child level, parents were creative with their decision making and food procurement strategies based on their environmental access and transportation options. Consistent with prior research, flexibility in feeding and eating practices supported parents in establishing daily feeding and eating routines (Berge et al., 2018). Although there was obvious stress in the choices they had to make, almost all participants discussed this as an anticipated part of raising children. Parents described having structured mealtimes, with most preferring a traditional three meal approach with added flexibility for household members with varying and non-standard work schedules. There was discussion about preparing meals at home more often and choosing to eat out less often, only for special occasions for cost-savings and health reasons (i.e., because cooking at home was perceived to be healthier). This finding was in contrast to prior research that suggests due to the cost of healthy foods and the benefits of convenience foods, families with limited financial resources have preferences for lower cost, convenient options that could be more calorie-dense and less nutrient dense (Petrunoff et al., 2014). This difference in findings could be due to increases in the costs of food and eating out and trends in consuming more meals at home during the COVID-19 pandemic (O’Connell et al., 2022). Although parents talked about the inflated cost of food in the past year and choosing to cook more at home to save money, parents did not discuss or express experiencing food insecurity, even though all of them met income-eligibility guidelines to qualify for government food and nutrition programs (WIC/SNAP). Though several parents described the importance of shopping for good sales and deals on food items, there was little discussion of feeling restricted in buying things they wanted. This was unexpected given the economic constraints all families were operating under. However, it is possible that parents prioritize food and nutrition in their budget so that their children are never lacking. Such priorities are common for parents who have experienced food insecurity during their childhood.

Consistent with prior research (Fisher et al., 2015), we observed that snack foods and items that kids could choose from were a regular part of a child’s nutritional make up (Baughcum et al., 1998). Prior research has also found that parents rely on snack food as an important parenting tool to reward good behaviors, help make children content, and stop unwanted behaviors (Herman et al., 2012). Adhering to dietary requests from children was a particularly relevant theme for families in our study, as many parents made a concerted effort to ensure that their children were not deprived (Davison et al., 2013; Herman et al., 2012) and had things to choose from that they liked.

There was also variation in what is prepared and served, as well as regular structured family meals. Like many families, parents with low incomes also make strategic decisions to prioritize family togetherness. Consistent with prior research on family meals, mealtime is an opportunity to connect (Berge et al., 2018; Fulkerson et al., 2008; Malhotra et al., 2013; Quick et al., 2011; Trofholz et al., 2018), with variation in what bonding and connection looks like. For example, some families sat together and ate together at the same time, and others ate together but sat in different places where they were most comfortable and that space and physical resources allowed. We found that very few parents talked about the negative impact of family meals, yet most discussed positive childhood memories they had as motivation for continuing this ritual. This suggests that although no one “complained” of the challenges of running a home and raising children; there was an underlying tone that the families would appreciate simplified routines and more practical supports to help accomplish daily household and family-management tasks, especially for single-parent homes.

In our study, we found that mothers enjoyed talking about meal preparation and decision-making in creating family meals and provided a detailed account of how they planned food shopping and the rationale for their choices. To balance nutrition and budgets, parents’ integrated convenience, savings, and family-member food preferences along with their shopping and food preparation, demonstrating a high level of thought, organization, and prioritization of feeding and eating routines. In alignment with prior related work (Fulkerson et al., 2011; Malhotra et al., 2013), parents in our study also discussed the length of time it took for the mealtime process (about 2 hours), however none of the parents in our study expressed this was problematic, rather a worthwhile use of their time to nurture and connect with their children. However, explanations of how and why parents made certain decisions regarding feeding and eating environments were also situated within the context of access to resources in the community and social environments.

Throughout each major theme, parents’ discussion of how they balance nutrition and budgets was largely in the context of how they navigate their surrounding community and social environments. This included discussion of how transportation, proximity to grocery stores, childcare, and socioeconomic status, namely the use of benefit programs, indirectly or directly impacted nutritional environments in terms of time and resources available for tasks related to feeding and eating. Three quarters of our sample were employed full or part time and about half were receiving WIC or SNAP, all of which may help promote food security, meal planning, and facilitate food shopping. Many were working multiple jobs and their schedules varied from week to week. Because WIC and SNAP benefits are usually disseminated once per month, meal planning and food procurement can be highly variable throughout the month. As a result, families with limited and varying incomes may not always get to plan how to spend their money in advance or be able to do so consistently from week to week. Meal planning could also be challenging for those on a limited income because budgets can shift dramatically when small unexpected expenses arise (e.g., perscription co-pays, changes in food prices, need for clothing/shoes). As a result, parents may have to make more frequent adjustments to their spending habits, further limiting the ability to plan ahead for meals. However, strategies that facilitate meal planning and are mapped on to the resources available with programs like SNAP and WIC, incuding online nutrition education programs for WIC/SNAP recipients (Tripicchio & Anderson, 2023) show promise for addressing food insecurity and warrant further investigation. It is also important to recognize the role of policy as part of the broader macro system influencing food and meal planning (Davison & Birch, 2001).

Several parents shared other broader social factors of the macrosystem related to transportation barriers and sharing food shopping with family/friends. They also discussed how childcare challenges were important for supporting household tasks like managing the nutritional environment at home. However, parents without these resources may have less time to plan and prepare meals. For example, time available for food preparation is greatly reduced when the parents work longer or have non-standard hours and when more time is spent on transportation to food stores. As a result, families with such barriers must balance tradeoffs between time spent at work, in leisure, and managing nutritional environments (Davison & Birch, 2001).

In relation to the broader physical and economic environments of the exosystem, it is well known that the food environment plays an important role in diet and nutrition-related health disparities in low-income communities. For example, food swamps are more likely to be associated with health outcomes than food deserts (Hager et al., 2017). This means that higher costs of nutrient-dense foods and convenience and lower costs of calorie-dense foods are disproportionately represented in low-income communities. Additional strategic planning and resources are needed to maintain healthy decisions when challenged by the physical environment. Families clearly understood the components of a healthy meal and the impact of diet on their children’s short and long-term health. However, they noted that price was the biggest barrier to eating healthier foods (Krukowski et al., 2012), which challenges the stigma that families with low incomes do not have the knowledge or skills to maintain a healthy diet. Further, participants did not openly discuss being on public benefits, how these benefits impacted their food shopping, or not having enough in benefits or money to get what their family needed. This is likely due to stigmas and cultural beliefs (part of the macrosystem) associated with parenting under poverty and assumptions made about parents not being able to provide when they can. Rather, parents described the impact of inflation on their food budget and logistical barriers (e.g., transportation, childcare) to procuring food, in addition to the benefits of finding good sales on food that helps aid them in acquiring what their family needs. Health-promoting environments with more accessible, affordable healthy options for families could support parents in procuring foods that meet their nutrition and budgetary needs and constraints.

Implications

Evidence shows that families with lower socioeconomic status (SES) have less optimal nutritional environments than their higher SES counterparts (Schuler, Bauer, et al., 2020; Schuler, Daundasekara, et al., 2020), justifying the importance of studying multi-level contextual determinants of healthy and sustainable food choices in parents with a lower SES (Vos et al., 2022). Our findings aligned with prior work demonstrating that flexibility and convenience with a variety of healthy options is ideal for busy parents with young children (Berge et al., 2018). Importantly, this work highlights additional community and macro-level targets to improve nutritional environments among all families with young children, regardless of socioeconomic status, race, or ethnicity if they are combined with priorities for building community capacity and improving social policies that increase convenience and cost savings. At the family-level, incentivizing feeding and eating practices as a cost and time-efficient way to facilitate both nurturing and nutrition appears to be universally desired by parents (Trofholz et al., 2018; Vos et al., 2022). In addition to family time, interventions could improve child nutrition by increasing quick and healthy snack options that aim to increase the nutritional quality of snacks and foods eaten on the go or between meals. Opportunities to connect with other parents and peers, share meal prep and menu plans, and cost-savings tips for families with young children could help promote healthier, routine feeding and eating environments.

Community-level findings suggest improving social and financial capital are important to promote healthy nutritional environments. Improving the nutrition and physical health-related resources in community agencies and healthcare settings could be one way to increase family access to health-promoting resources. For example, community agencies that facilitate access to WIC and WIC clinics could be ideal to facilitate shared ideas for improving family nutrition environments through tools for menu planning and cooking satisfying, convenient, nutritious, low-cost meals and snacks. Community venues and events that provide shared spaces for parents and peers to interact in supportive, non-judgmental ways could improve social networks and access to practical supports that promote healthy environments (e.g., shared transportation to food store, shared childcare/supervision). Interventions that boost social support and connect those with transportation to those without it could help increase access to affordable and quality foods on a regular basis. This may help to improve nutritional quality and the quality of family connections, as well practical supports not directly related to the mealtime environment, such as resources that help families simplify their routine or free up their own personal resources to invest in feeding and eating routines. Examples of such practical supports include childcare and safe places to play with reliable and trustworthy child supervision and transportation sharing. Studies that evaluate the effectiveness of community partnerships that can provide safe and reliable childcare on as-needed and temporary basis to support food procurement and meal planning need further exploration.

Study results also provide several macro-level implications. Policy initiatives are needed to address the rising costs of food. This could be accomplished in part by increasing WIC and SNAP benefits for recipients to meet higher food costs. Reducing or subsidizing convenience fees for online food shopping and home-delivery could also facilitate food and nutrition security for time- and money-constrained families with young children. Due to the impacts of transportation barriers on family food environments and access, future research should examine methods of reducing transportation barriers through such macro-level policies and programs. Social policies that subsidize commonly used ride-share programs (e.g., Uber, Lyft) or that incentivize ride-share programs to lower transportation costs for income-eligible families (e.g., tax incentives/breaks) could provide another layer of support for food security.

Strengths and Limitations

Strengths of our study center on our recruitment strategies and focus on families experiencing food insecurity in urban areas. We were able to recruit participants from a variety of community-based organizations; this allowed for greater diversity of information. Even with this diversity, our results were relatively consistent with families offering positive strategies for managing tight budgets and young, picky eaters. Reaching an under-represented group of parents in terms of poverty level, gender, race and ethnicity is a major strength of the present study. However, differences in cost considerations and decision making between men and women (Dorman, 2021) suggest additional research among all adult family members on this topic may be warranted. For example, mothers tend to spend more time caring for children’s physical needs compared to fathers, including food shopping and meal preparation (Flagg et al., 2019; Storz et al., 2022; Taillie, 2018; Virudachalam et al., 2014), there may be sex differences when making decisions regarding the home food environment (e.g., grocery shopping, meal preparation, cooking; Crane et al., 2019; Flagg et al., 2019; Mortimer, 2013; Storz et al., 2022; Taillie, 2018; Virudachalam et al., 2014). Further, although almost half of the sample reported having at least some college education, many did not complete a bachelor’s degree. Several parents described their goals for higher education and attaining a higher wage job but were limited in their ability to complete these programs due to constraints on time, financial support, and social support.

Relying on self-report and conducting interviews virtually could shape the type of information shared, leading to response bias. However, existing research shows that recruitment and findings are similar between in-person and virtual methods (Eigege et al., 2022; Marshall et al., 2023). Some participants may feel more comfortable with virtual interviews as they don’t need to let a researcher they do not know well into their home and transportation, childcare, and time barriers are minimized.

Further, we did not note any differences across Black/African American and Hispanic parents. This could indicate that there are some universal strategies that are relevant for all parents with economic constraints, regardless of race or ethnicity. However, if parents and caregivers from other racial and ethnic backgrounds were asked the same questions, the cultural implications would be clearer and could determine what universal and culturally specific factors are required for healthy development in early childhood. A re-analysis of the data and specific examination of diverse racial and ethnic groups (McFarren et al., 2020) could help elucidate subgroup differences.

Additionally, many participants in our study were familiar with academic research methods, therefore there could be response bias where participants were offering socially desirable responses. Last, although we were able to interview 21 participants, we are aware our findings are not generalizable to other low-income parents, especially among non-traditional parents such as fathers and grandparents, or households outside of an urban environment. The rates of poverty in rural areas coupled with transportation and food access remain distinct and important areas of inquiry.

Conclusion

Parents experiencing low-income in urban environments value teaching and promoting healthy decision-making through their feeding and eating routines, and having a regular, structured time to connect and bond. Most families developed low-cost, time-efficient strategies to facilitate nurturing and nutrition. Strategies to reduce child food waste, increase the nutritional quality of snacks, and developing and sharing menu plans that prioritize cost effective, quick, and convenient could support home nutrition environments for families with food insecurity and economic constraints. Importantly, this study identified other multi-level factors influencing parent feeding and the home food environment. At the community level, building social and community capacity could help support health-promoting environments, including connections to practical supports that include trustworthy childcare, peer support, and strategies for improving nutrition and food procurement, meal planning, and feeding and eating environments. Finally, broader impacts on food and nutritional environments could be accomplished with policies and programs that provide targeted supports for families with young children and economic constraints. Overall, findings confirm the important need for multi-level strategies that incorporate macro, community, and family-level supports to create more protective and equitable nutritional environments for families with young children and limited economic resources.

Table 2.

Sample Demographics (N = 21)

	N or M	%/SD	Min-Max
Gender (female)	19	90%
Primary Caregiver (PCG) age	33.2	32.5	22-75
PCG Race/Ethnicity
Black/African American	11	52.4%
Hispanic	8	38.1%
PCG Hispanic or Latino descent	7	33.3%
Child age (months)	29.7	12.1	11-52
Government Program Participation
WIC	14	66.6%
SNAP	13	61.9%
Both WIC & SNAP	11	52.4%
TANF	3	14.3%
Housing assistance	2	9.5%