3.1.1. Subtheme 1: Know.

This subtheme is defined as the mother’s education, information, and experience on nutrition, and the role of different groups and types of food on health. Across all four focus groups, mothers shared being intentional about limiting or encouraging certain foods. They wanted to limit sugar intake because the child is still developing, candy can cause tooth decay, junk food is not good for the body, and processed food is not as healthy as homecooked meals. As stated here,

“For me, I avoid [inaudible] and things like candy sweets they’re not available in our house like you don’t buy them just to stay there, to avoid the too much sugars and maybe the spoiling of teeth.”–R24

On the other hand, participants shared that eating nutritious foods such as fruits and vegetables, plants, and animal products, was necessary for the child’s development. A balanced diet included all food groups, food gave you vitamins, and fruits helped relieve constipation. As shared by this mother,

“I have um worked on him consuming more fruits than before. He used to be really constipated and I had to do something about it.”–R23

3.1.2. Subtheme 2: Want to Know.

This subtheme is defined as additional information the mothers would like to receive on nutrition. In three of the focus groups, participants wanted to know which foods boost appetite, keep kids healthy, when to eat certain foods (e.g., time of day), recommended amounts of various macro- and micro-nutrients (e.g., protein, veggies, calcium), how to encourage the child to eat at various stages in childhood, correct serving sizes, and what is truly inside the food served at restaurants. For example, two mothers said,

“In my case, I would like to know the foods that my kid should eat in order to stay healthy and grow more healthier and the times to eat …”–R5

“It is how to get rid of that snack yeah, it’s costly.”–R4

3.5.1. Subtheme 1: Adopting the US lifestyle (opportunities and challenges).

This subtheme definition focuses on perceptions around adopting a US lifestyle, such that, since moving to the US, negative things mothers said about access to, eating and preparing food, and weight, changes in her diet, positive lifestyle changes, and how differently the child would eat if he/she lived in the mother’s native country. Overall, across all four focus groups, mothers made four main observations about food in the US, (1) there is an abundance of food (e.g., more snacks and larger portions ), less structured eating, and more fried foods; (2) the food quality, flavor, taste, and nutritional content are different compared to their native foods; (3) food is not as organic or as fresh in comparison to food in their native country; and (4) food is more expensive. For example, these mothers said,

“Well, definitely is the whole lot more food in this country that isn’t necessarily, you know as organic and fresh as back home. and, obviously, the more organic produce is more expensive here than back home and then definitely a lot more snacks are available here than back home, so I think my. well back home, I probably was eating more of the like heavy Nigerian food, you know, beans and rice and fufu and bigger servings”–R2

“In South Africa you can get varieties of food, homemade yes. But when you come to Atlanta and you have to buy a lot of stuff it’s quite expensive, you know. Yeah, you may look for the same type of food, but you may not get it, so you have to take another option and it becomes expensive.”–R5

On the other hand, some mothers have experienced positive lifestyle changes in their nutrition. Some have developed better eating habits, become more aware of alternatives to their native foods, learned about portion sizes, diversified their diet, and eat more salads and fruits. Although many mothers shared that the cost of organic produce in the US is prohibitive, one found eating organic food easy. As this mother put it,

“Um so for me growing up just like most people from Nigeria said we would have three meals my mom made sure of that uh that has changed definitely since relocating for me I rarely eat breakfast I just don’t get hungry now because I don’t want to… Diet has changed. Growing up I don’t remember eating salads. Now I’m a salad kind of girl so I would have like a salad around noon for lunch I definitely love Seafood not much of a meat eater, but I would eat fish all day if you let me and I didn’t eat that growing up like we always had like beef and stuff like that chicken. And now I’m not really much of a beef or chicken kind of girl, but I’ll take fish any day. I love fruit so I would eat fruit I try to snack on healthy stuff even though I have three kids.”–R30

In participants’ native countries, food was varied, natural, and homegrown, most meals were homecooked, some mothers shared eating heavier meals (e.g., big meal for lunch, smaller meal for dinner), on a structured eating schedule (e.g., cooked and ate 3 meals per day), and at the table. Also, some shared that chips or candy were absent in the home, eating out was on occasion, and snacking was limited. As stated here,

"…When I just got here [the US] was different because I was home [native country] all the time, so it was kind of structured back then. I woke up in the morning, I’ll get my normal breakfast, eat my lunch, eat my dinner, three straight meals a day. But then when I got into the system when I started getting busy it got so different."–R7

"…All right, so literally my diet hasn’t changed too as well. I still eat most of my African food and which I also allow my kids to eat too except that I have had this opportunity to have variety of fruits here in America. So that has really, I incorporated that into my diet. I eat variety of fruits now which we don’t really too much have access to in Africa.”–R26

Mothers did not hesitate to share the differences in their children if they lived in their native country. For example, their dietary habits would include fewer snacks, less juice, no cereal, and rich in natural foods and not canned or processed foods. As stated here,

“So, they definitely would not be having as many snacks as they do now, like you know in school, they give them morning snack, afternoon snack and then, when we pick them up from school, we also give them a snack so they probably will not be eating as many snacks.”–R2

“If she was born back home, I would feed her with traditional porridge from millet compared to now …again snacks would not be their favorite meals”–R1

“If she was born in my native country, I would feed her with Kenyan foods all through. I don’t think I would introduce snacks.”–R6

“So, I I think that they would there would be a lot less juice they would not consume cereal at all which they do now because it’s not as easily accessible back home and it’s very expensive…”–R19

3.5.2. Subtheme 2: Nutrition Change.

This subtheme is defined as the reasons for change in diet in the US (accessibility, cost, availability, schedule). In two of the four focus groups, work schedule, cost of foods, access to fruits, access to native foods, cost of organic food, and lack of a support system are some of the reasons mothers gave for the change in their dietary habits in the US. The pace of life in the US is very different compared to that of their native country; it is much faster and more stressful. In their native country, they had help from family members, so they didn’t feel the stress of raising a family. These are some of the factors responsible for the change in their new lifestyle such as the number of meals which has decreased from three square meals a day to two and one for others, skipping breakfast, cooking less, and cooking weekly instead of daily. As these mothers said,

"So, the eating habit back home was very wonderful. I wish I could adopt that here. and then I don’t know but I’m trying. Some days it works, some days it doesn’t. I know here everything is junk junk junk. Here, the organic is very expensive so we can’t even afford it so we have to go with whatever we can afford yeah."–R7

"… And um I’ve really been drained by the system um eating much of um chips and chicken and cereals and the rest yeah that’s my experience."–R10

3.5.3. Subtheme 3: Child’s Diet: Common Foods.

This subtheme focuses on reports of what the child eats for breakfast, lunch, dinner, and snacks in the US. Across all focus groups, most children’s diets consisted of a mixture of African foods and American foods. For breakfast children eat a wide variety of foods, including oatmeal with fruits, eggs, sausage, bacon, bread and tuna, tea, or peanut butter, meat pie, pastries, samosas, pasta and chicken, and chicken nuggets. During lunch at home, they also ate a mixed diet. Children ate mashed potatoes, mac and cheese, chicken nuggets, pasta, salmon, steak, veggies, ugali, and plantains. The dinner menu was similar to the lunch menu. As for drinks, water was the most common. Children also ate a variety of fruits such as oranges, apples, mangoes, and strawberries. Snacks were very popular in most children’s diets, and they varied widely. Children ate fruits, chocolates, cookies, vegetables, yogurt, chips, and popcorn. For example, three mothers said,

“My kids, they love to eat fufu and okra soup a lot yeah, they love to eat that a lot. They like to eat jollof rice too, vegetables, fish you know stuff like that, mostly like Nigerian meals. They eat other pizzas stuff like that but those are an occasional basis. They like to eat um yam and sauce with vegetables most of their food comes with vegetables spinach or kale you know and some other Nigerian vegetables, like we call it ugwu. It is pumpkin leaves, yeah. So, most times I try to put vegetables in all their food. The okra soup is made with a lot of vegetables too.”–R14

“In the mornings, they eat either bread and peanut butter and some water and a fruit or they eat oatmeal or cheerios and almond milk with the go go’s squeeze, those green apple sauce juice packs.”–R2

“…and yes, for breakfast mostly it’s usually the egg omelets and sausages and milk.”–R21

In all four focus groups, while most families ate African foods regularly, for a couple of mothers, their native foods were not as frequent, once a week or when visiting grandparents. As stated here,

“I think for my household, we are actually different. I don’t do a lot of our traditional food, not as often so my son, he knows it and now I still eat it like if we go to my parents and stuff. But I don’t; cook it at home often. I cook lots of the American style food. So, it’s completely different to what I grew up from what he’s eating now.”–R3

Eating out was not a common practice in many households. Among mothers who talked about eating out, they did so once or twice a week and usually on the weekend. Another food type parents deferred to the weekend was desserts. As this mother put it,

“You know we eat the same thing African food yeah and restaurant once in a blue moon. I don’t like eating out so I’m so picky, I mean everything is homemade. Most of it. once in a blue moon is if you have to eat in the restaurant, it got to be seafood like … Yeah, I really watch their diet.”–R8

3.5.4. Subtheme 4: Child’s Diet: School Lunch food.

This is defined as whether the child eats school lunch or takes a packed lunch, the reasons the mother gives for the child eating school lunch or packed lunch, the mother’s feelings/thoughts/opinions about school lunch, and where the mother thinks the child eats better, at school or home. When it came to school lunch, children ate the school lunch or a packed lunch. Overall, across all four focus groups, mothers did not know how well their children ate at school. In three focus groups, mothers felt that their children ate better (i.e., the nutrition of the food) at home than at school, but one mother felt that her child ate better at school because of the discipline and structure. Mothers who packed lunch did so for various reasons, such as the school lunch did not match their standards at home, it was not as nutritious, it cost too much (e.g., $10), no school lunch was offered, the food was unfamiliar to the child, and the child was not going to eat what was on the menu for the day. Usually, mothers packed food that the child would normally eat at home or sandwiches. For example, two mothers said,

“The best is to pack her lunch, because I don’t really know what the school will feed her with, like I don’t trust the feeding in school to be the same with my feeding standards at home.”–R9

“Yeah, my son is at school. I take him to daycare. So, I think that he eats better at school than at home because there are disciplines not like at home, where I have to force him to eat.”–R1

There was some positive feedback on school lunch. A few mothers believed that the quality of the school lunch had improved in recent years and acknowledged how hard it can be to try to cook and feed school children. Because of school lunch, some children started eating more vegetables. One mother shared that her daughter started asking for spinach at home after being introduced to it at school. For another, her children only take fruits as snacks to school because they are pushing for less processed food. As this mother said,

“Never prior to starting school he would not eat broccoli but now he eats broccoli because he was eating it at school …so because of that but I think it’s introduced them to veggies. I think they’ve done better my oldest would eat broccoli now and he never ate it as a kid for me before he started school.”–R30

4.1.1. Knowledge and beliefs.

Overall, Black immigrant mothers in this sample shared congruent knowledge, attitudes, and beliefs on nutrition, which in turn was found to directly influence their food parenting practices. Mothers confidently shared which foods the child should eat and why. This finding corroborates what Cook [23] found, that Black immigrant mothers in the UK were knowledgeable of what constitutes a healthy diet: lots of fruits and vegetables, whole, natural, and fresh foods. Participants were also educated on, capable of, and confident in preparing healthy meals for their children. Additionally, mothers in this study frequently reported rules about snacking, (i.e., the number, the type, and the timing of snacks). Also, they intentionally kept some foods out of their child’s reach, and ensured the child did not eat too many sweets or their favorite unhealthy foods.

On the other hand, focus group participants also shared what additional information they would like to receive on nutrition, notably foods that can boost appetite in a child that does not like to eat minimally processed food, foods that help the child to grow and remain healthy, and how much to consume from each food group. Most mothers were clear on what foods they considered healthy and unhealthy. A prevailing belief among mothers was that fresh food is not easily accessible in the US, and it is expensive. Many perceived their native foods to be healthier and less processed. These results match those observed in an earlier study by Jakub [24] and a scoping review [25], where some Black African immigrants considered their native foods, including those with high-fat content, healthier compared to American foods because African cuisine is primarily minimally processed, unlike American cuisine.

Although mothers displayed confidence in their knowledge and beliefs on healthy and nutritious foods for their children, they also wanted to obtain more information on this topic. In sum, there are three main points. Mothers seem to be doing the best they know how at this point and with the information they have. Second, they are concerned whether the offered food is indeed the best for their child. Finally, mothers want more information to confirm that what they are doing is indeed the best approach for feeding the child. As previously mentioned, SCT has been used to help explain human health behavior [16, 26]. Focus group discussions confirmed the relationship between the personal and behavioral factors in this group of Black immigrant mothers. Specifically, a mother’s nutritional knowledge (personal factors) directly influences her food parenting practices (behavioral factors) and her child’s dietary habits.

4.1.2. Attitudes.

Parent’s childhood experiences influence how they feed their children [27]. A mother’s perception about food influences how she feeds her children, and these perceptions have been influenced by how her parents fed her as a child. In this investigation, Black immigrant mothers reported being more likely to prepare homecooked meals if their mothers did so and also to give their children foods they ate and/or enjoyed as children. Additionally, for many mothers, snacking is not a part of their native culture, and they want to limit the amount and type of snacks their children eat. Further exploration of the nuances of maternal attitudes and the impacts of these attitudes on feeding practices would add to the body of research in this topic.

4.1.3. Modeling.

Modeling was another theme that emerged during focus group data analysis. When we asked mothers about their diet from their child perspective, they listed African foods, American foods, foods from other nationalities, sweets, and fruits. They also shared which foods they avoid or eat away from their children, such as processed, packaged, and junk foods. These findings are similar to those from previous studies in immigrant populations who valued fresh, natural, minimally processed, and native foods, and homecooked meals over canned, processed, and fast foods [25, 28, 29]. Many mothers reported being conscious of eating more healthily in front of their children. Interestingly, mothers made a distinction between the foods they eat in front and away from their children. Perhaps, children are aware of all the types of foods their mothers eat, and their dietary behavior is influenced beyond the modeling mothers strive to parent overtly.

Participants’ comments on attitudes and modeling match findings from a systematic review [30] that revealed that adolescents’ belief in healthy eating increased when they saw family members eating healthy food. Youths were more motivated to make healthy or unhealthy choices by observing parents or siblings’ food choices. Birch [31] also reported that children’s dietary behavior is influenced by observing that of their parents. In short, a mother’s eating style can explain her child’s eating style [32].

4.1.4. Acculturation.

A major theme across all focus group interviews was acculturation. This is unsurprising, because studies on immigrant population have previously reported on the key role acculturation plays on eating, nutrition, and weight in both positive and negative ways [5, 17, 33, 34]. The mother’s reported knowledge and attitudes, the foods she eats, feeds her children, and the why, were all heavily influenced by the culture of her native country. Most participants shared that eating healthy is important. Mothers believe that fresh food is not easily accessible in the US, eating healthy in the US is difficult, and think that certain foods should be avoided. They also shared that the quality, flavor, taste, and nutritional content of food in the US is not the same, unsatisfactory, compared to the food in their native country. Also, food costs more, and eating organic is not as feasible. Consequently, their eating has changed since migrating to the US. A possible solution to overcome food costs, is to purchase healthy food on sale, eat foods based on their harvest season (e.g., fall foods in the fall, winter foods in the winter), plan the food menu for the week in advance, shop at different grocery stores, and utilize online resources to learn how to save money on purchasing nutritious foods.

For some mothers, their eating has improved since migration in the following ways: becoming aware of portion sizes and eating more fruits and salads. As mentioned earlier, their diets now have some American elements, such as snacking, international cuisines, and eating out. These findings further support the idea of bi-dimensional acculturation, where Black immigrant mothers maintain parts of their native culture and adopt parts of the American culture, experienced by African immigrants women in high-income countries who consumed both their native foods and non-native foods, but preferred their native foods, added salt and other spices to the local food to make it tastier [34].

There are multiple reasons for the change in the diet of Black immigrant mothers since migrating to the US, the cost of food, availability of native foods, excess availability of fast foods, schedules, no to minimal support system, and stress levels. These findings support previous research who reported that African immigrant women adopted American dietary habits more easily because of busier schedules, less time to cook their native foods, and easy access to unhealthy foods [29, 34]. Alsubhi [5] and Berggreen-Clausen [25] also found that because of work schedules, immigrant mothers had less time to cook for their children, and the cost of healthy food was a barrier to eating healthy.

The children of the women in this study were noted by their mothers to eat a mixed diet of African and American foods. In some homes, the diet is primarily African, in others it is largely American. This finding matches a study [35] where the diet of African immigrant children in the US was significantly influenced by their parents’ native culture. Overall, their diet consists of whole foods, homemade foods, fruits, processed foods, and snacks. This is consistent with another study [29] of Black immigrant children who reported eating a mixed diet, and positive diet (i.e., fruits, vegetables, milk) changes since migrating to Canada. A popular drink among children is water, which is the preferred beverage according to the United States Department of Agriculture dietary guidelines [36].

Furthermore, for children enrolled in school, mothers reported that they either eat at school or bring a packed lunch. Mothers are uncertain what the child eats at school, or how much they eat. Many mothers say their children eat more nutritious and better-quality food at home compared to school. Moreover, some reported the positive influence school lunch had on their children, such as eating more vegetables.

The results of this study support the utility of the SCT model in food parenting practices research. In particular, a mother’s personal factors (knowledge, attitudes, and beliefs) have a reciprocal relationship with her environment (acculturation) and directly influences her behavior (food parenting practices). More research is needed to explore the relationship between mothers’ specific food parenting practices, the child’s dietary behavior and weight. Further research might investigate what other elements in a mother’s environment influence specific food parenting practices such as social determinants of health, and child’s age and sex.