Caregiver perceptions of the food marketing environment of African-American 3-11-year-olds: a qualitative study.

OBJECTIVE
To assess caregivers' perceptions of the extent to which the food marketing environment influences food consumption among African-American children (aged 3-11 years) in order to generate potential strategies to make the marketing environment more favourable to healthier eating.

DESIGN
Individual semi-structured interviews with caregivers were conducted by trained community leaders to ascertain their awareness of and perceptions about food marketing environments contributing to African-American children's food consumption.

SETTING
Six predominantly African-American communities in metro Birmingham, Alabama, USA with high proportions of school-age children and lower-income residents.

SUBJECTS
Caregivers (n 25) were predominantly female (93 %) and either parents/guardians (64 %) or grandparents (28 %) of African-American children aged 3?11 years. Caregiver mean age was 43 years and 46 % had lived in their current residence for over 10 years.

RESULTS
Caregivers reported all aspects of the food marketing matrix as supporting unhealthy eating among African-American youth. Child preference for foods higher in fat and sugar, lower pricing of less healthy foods, limited access to healthier food retailers and targeted advertisements were particularly influential on the food selection, acquisition and consumption of children. Company loyalty, corporate sponsorship of local events and conflicts over parental v. food company responsibility contributed to less consensus about the overall impact (positive or negative) of food companies in African-American communities.

CONCLUSIONS
While caregivers perceived aspects of their food marketing environments as primarily contributing to unhealthy eating among African-American children, framing the demand for changes in the food marketing environments of African-American youth may be particularly challenging.