A Mixed Methods Study on How Urban Slum Food Environments Influence Caregivers' Feeding Practices for Children Under Five Years in Pune, India

Condition(s) studied

Study summary

The goal of this observational study is to examine how urban slum food environments influence caregivers' feeding practices for children under five years of age in Pune. The main questions it aims to answer are:

* What are the characteristics of the food environment in selected slums of Pune using the 5 A's framework: availability, accessibility, affordability, acceptability, and accommodation?
* What are caregivers' perceptions of food safety, food prestige, and convenience as additional drivers of food choice within the slum context?
* Are caregivers' aware, and have understanding about the use of packaged food labels, especially in relation to identifying foods for young children?
* How do the local food environment and food choice (FEFC) drivers interact to influence caregivers' feeding practices, with a particular focus on the consumption of unhealthy foods and sugar-sweetened beverages among children under five years of age? Participants will be interviewed using digital forms to assess their food environment and food choice drivers. Anthropometric measurements of all children under five years of age in the household will be taken.

Eligibility

Primary outcome measure(s)

• Percentage food items in each of the 28 food groups available in each of the 4 study locations — An average of 1 year
  Food Availability in each study location will be assessed as the percentage food items available for purchase in each of the 28 food groups. The Food Outlet Census (https://sites.rutgers.edu/food-environment-toolbox/community-food-environment-mapping-food-outlet-census/) tool is being used to collect data on the foods available but the tool does not have any specific scoring criteria.
• Percentage of families in each study location who can afford to buy a healthy diet — An average of 1 Year
  Food Affordability of families will be assessed as the percentage of families who can afford a healthy diet. For this purpose then investigators will calculate Cost of a Healthy Diet (CoHD) using the tool available from Tufts University: https://sites.tufts.edu/foodpricesfornutrition/tools/. Per capita income of each household will also be calculated. These two parameters will help the investigators calculate the percentage of families in each location who can afford a healthy diet.
• Percentage of food items considered convenient by households in each location — An average of 1 year
  Convenience will be assessed as percentage of food items in each of the 28 food groups which participants consider convenient because their ease of storage, low perishability, ease of preparation.
• Gender and Family Role of the primary food-related decision maker — An average of 1 year
  The gender and family role of primary food-related decision maker will be assessed as percentages and illustrated using pie-charts
• Percentage of participants concerned with food safety — An average of 1 year
  Percentage of participants worried of safety of food due to poor hygiene or use of pesticides will be asessed
• Percentage of households with label awareness — An average of 1 year
  The percentage of households who were aware of food labeling (read labels, knew where the label was located) will be assessed
• Correlation of food environment characteristics with infant and young child feeding practices — An average of 1 year
  The correlation of different food environment characteristics such as accessibility, availability, affordability, with infant and young child feeding indicators such as ultra-processed food consumption, zero fruit and vegetable consumption

Trial sites (1)