Table 2.

Summary of Breakfast Findings and Concerns for Child Obesity

Domain	Themes and sub-themes
Current breakfast practices	• Participants' children typically eat a range of breakfast foods, including both American and culturally traditional foods • Most families did not eat breakfast together during weekdays • Some participants' children ate breakfast at school on occasion
Benefits of eating breakfast	Good for school performance • Helps children wake up • Helps children concentrate in school; good as "brain fuel" Culturally-relevant • Part of the culture to eat breakfast (Spanish, Vietnamese)
Barriers to eating breakfast in general	Lack of time • Families too busy in the morning and children wake up late Children not hungry • Ate dinner late • Not active in the morning Children unaware of the importance of breakfast • Parents not teaching/reminding children
Barriers to eating school breakfast	Food content • Not enough hot dishes, especially culturally-appropriate hot foods • Pork products served (not eaten by Somali families) • Lack of variety Food quality • Food too processed and some food expired • Need more fruits and vegetables Lack of adequate time to eat • Buses arrive late and children will not get breakfast at all Concern not adequately supervised • Children play instead of going to cafeteria • No assurance children will be monitored to eat food served
Approaches to improve school breakfast program	Food content/quality • Offer more culturally-specific foods, especially hot main dishes • Survey parents about what they want • Offer taste tests to children Supervision • Reminders to children to eat breakfast from school staff/bus drivers Adequate time to eat • Ensure bus arrival time appropriate & children get breakfast if late
Concerns for childhood overweight	Lifestyle in the U.S. worse for physical activity • More sedentary activities–TV, video games • Parents too busy to supervise children in physical activities • Children living in U.S. less independent, and less fit (Vietnamese) Concern expressed more about other children, not their own