Exploring Mothers' Perspectives About Why Grandparents in Appalachia Give Their Grandchildren Cariogenic Foods and Beverages: A Qualitative Study

Background Dental caries is the most common chronic childhood disease. Past studies revealed that grandparents provide their grandchildren with cariogenic foods and beverages (eg, those with free sugars and/or modified starches). Qualitative research can help identify what drives this phenomenon. Objective Our aim was to examine mothers' explanations for why grandparents in north central and central Appalachia give their grandchildren cariogenic foods and beverages. Design A qualitative study on children's oral health in Pennsylvania and West Virginia from 2018 through 2020 was performed. In-person, semi-structured interviews were conducted. Qualitative data from interviews were recorded, transcribed, and then coded using NVivo. Data analysis for this study was performed using thematic analysis with iterative theme development. Participants/setting The participants were 126 mothers of children aged 3-5 years from West Virginia (n = 66) and Pittsburgh, PA (n = 60). Main outcome measures Mothers' perspectives about why grandparents give their grandchildren cariogenic foods and beverages were analyzed. Results In the study sample, 85% of mothers (n = 107/126) named at least 1 of their children's grandparents as a member of their social network responsible for their children's oral health. From these interviews, 85% of mothers (n = 91/107) discussed that grandparents gave their grandchildren cariogenic foods and beverages. The mothers described the following 4 themes to explain why grandparents gave their grandchildren cariogenic foods and beverages: privilege of the grandparent role; responsibilities of the grandparent role; symbol of care and affection; and limited consideration or understanding of the detrimental impact. Conclusions Grandparents play a role in giving their grandchildren cariogenic foods and beverages, which could potentially contribute to childhood caries. Research is needed to develop effective social interventions to help some grandparents understand the implications of a cariogenic diet on their grandchildren's oral health and/or decrease their provision of cariogenic foods and beverages.

Automated summary

This study investigated why grandparents in north central and central Appalachia give their grandchildren cariogenic foods and beverages. The findings revealed that grandparents perceive their role as a privilege, responsibility, symbol of care and affection, and have limited consideration of the detrimental impact, which motivates them to provide their grandchildren with such foods and beverages.