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Objective: To ascertain paraprofessionals’ perceptions regarding a self-directed computer-supported nutrition educational intervention to disadvantaged mothers of infants. Design: Qualitative focus group study. Setting: Three county extension programs in a Midwestern state, which serve disadvantaged families. Method: Sixteen paraprofessional nutrition educators, affiliated with Extended Food and Nutrition Programs (EFNEP), took part in three focus groups led by a facilitator following a semi-structured questioning route. Results: Three themes emerged: (1) paraprofessionals’ perceptions of personal connections with learners; (2) paraprofessionals’ perceptions of lesson plans; and (3) paraprofessionals’ perceptions of self-directed lessons. Conclusions: Data provided exemplars of paraprofessional teaching strategies used with the disadvantaged populations they service, a recommendation to develop a blended curriculum, and insight regarding technology. A preventive nutrition education program, focusing on the reduction of childhood obesity though informed infant feeding practices, can be delivered using a combination of direct contact paraprofessional education and self-directed computer-supported lessons.

Objective: To ascertain infant feeding practices and to explore the feasibility of an in-home feeding intervention with Native American Indian (NAI) mothers in six Native American communities in the United States (US). Design: Qualitative focus group study. Setting: Six Native American communities in the Midwest region of the United States. Method: Fourteen NAI health paraprofessionals and 42 NAI mothers took part in 12 focus groups that were conducted by a facilitator, according to a semi-structured topic guide. Focus group data were supplemented with demographic data. Results: For the NAI health paraprofessionals, four major themes emerged: (1) maternal feeding practices for their infants; (2) special considerations when working with the NAI population; (3) sources of advice for NAI mothers; and (4) tailoring a feeding intervention to NAI mothers of infants. For the NAI mothers, four major themes emerged: (1) maternal feeding practices for their infants; (2) expectations about an in-home intervention and how to make it work; (3) useful information regarding infant feeding; and (4) importance of family. Conclusion: Data provided examples of NAI mothers’ feeding practices, suggesting that development of an effective intervention to assist NAI mothers transition their infants to solid foods can help promote healthy infant growth during their first year of life. Health paraprofessionals need to incorporate nutrition messages that are culturally-congruent for NAI mothers. Inclusion of NAI family members may enhance successful changes in infant feeding practices.

Objective To ascertain maternal expectations and experiences with mealtimes and feeding of toddlers among low-income African American mothers in two mid- to large-size cities in the United States. Design Qualitative focus group study. Setting Two Early Head Start programme sites in a Midwestern state which serve low income families. Method Twenty-seven low-income African American mothers took part in two focus groups which were conducted by a facilitator, according to a semi-structured topic guide. Focus group data were supplemented with demographic family data. Results Four major themes emerged: (1) maternal perceptions of healthy toddlers, (2) maternal food choices for toddlers, (3) maternal expectations about toddler autonomy and self-regulation of feeding, and (4) mealtime context and interaction. Conclusions and implications Data provided examples of maternal expectations and experiences, suggesting the development of healthy feeding patterns among some toddlers and provided evidence of less healthy feeding patterns in others. Evidence of less healthy feeding patterns included limiting toddler autonomy and food regulation, and misinterpretation of normative toddler behaviours. Because parenting practices and perceptions have been reported to contribute to social and environmental influences of obesity, this research could aid development of culturally sensitive nutrition education interventions.