Introduction

Parents have the largest influence on their children’s food and physical activity behaviours during infancy and early childhood [1, 2]. Children’s learning about food and physical activity is substantial during this time through their observation and imitation of significant others. The influence of parents at this time is considered central [1–5]. The majority of “family” research, however, concentrates on maternal influences or combines the data of both parents, [6–8] precluding an understanding of the independent effects of fathers on young children’s health behaviours. This is likely the result of traditional views of parental roles where mothers have been considered family caretakers and fathers the family breadwinner [9]. The last few decades have witnessed a change in the societal roles of parents, demonstrated by the increasing number of mothers with young children in the workforce [10, 11] resulting in a likely increase in fathers’ participation in family caretaking duties. For example, in a recent study involving over 400 Australian fathers, it was observed that over 50% of fathers reported taking responsibility for some of their young children’s meals [12]. Additionally, much of the literature concentrates on school-aged children, by which time a broad range of other non-family influences may be more important in determining the health behaviours of children [13].

The evidence of the influence of fathers on young children’s health behaviours has been increasing. For example, Wake and colleagues, in their analysis of nationally representative Longitudinal Study of Australian Children data, observed that it was the parenting behaviours and styles of fathers (and not mothers) that were associated with the body mass index (BMI) of their young children [14]. Further, Vollmer and colleagues’ cross-sectional investigation of 150 fathers and their pre-school children observed positive associations between fathers and their children’s vigorous physical activity [15]. Additionally, a recent Australian study of dietary intakes of over 300 fathers and their 20 month-old children, observed positive associations between fathers’ and children’s intake of fruit and sweet snacks independent of mothers dietary intake [16]. Collectively, these studies suggest that fathers’ behaviours may be important influences for their young children’s dietary and physical activity behaviours and subsequent health outcomes. Despite these findings, there is only limited qualitative research on this topic that includes fathers [17]. Qualitative studies are likely to provide an in-depth understanding of the paternal role in the context of young children’s eating and physical activity behaviours and complement the existing evidence from quantitative research by providing preliminary insights into this area and contribute to hypothesis development for future studies.

A recent example of qualitative work investigating young children’s lifestyle behaviours that included fathers is that by Khandpur and colleagues. That study investigated food parenting practices employed by fathers to shape their young children’s dietary behaviours. Twenty food parenting practices were identified, with the most common food parenting practices used including having food rules, letting children dictate food preferences, making healthy foods available, feeding on a schedule, incentivising food consumption and pressuring children to eat.[18]. Additionally, Vollmer and colleagues, in their investigation of fathers’ perceptions about their role and feeding practices, observed that it was fathers’ positive perception of their role at mealtimes (and not their appraisal of maternal perceptions of their role at mealtimes) that was associated with lower use of controlling feeding practices such as pressure to eat or food restriction in their preschool children [19]. While these studies add to the limited literature regarding paternal views about the health behaviours of their young children, they investigated only food parenting practices. Further, they did not consider other potentially important influences on young children’s diets such as fathers’ dietary intakes, nor did they consider fathers’ influence on their young children’s physical activity behaviours. Given this topic is essentially unexplored, providing an understanding of fathers’ views and beliefs about the dietary and physical activity behaviours of their young children will enhance our understanding of the paternal role in this context.

Accordingly, the aims of this qualitative study were to assess fathers’ beliefs and perceived roles in the eating and physical activity behaviours of their young children. This study also aimed to examine fathers’ views regarding the type of support they require to best promote healthy eating and physical activity behaviours in their young children.

Methods

Results

Twenty-three fathers responded to the recruitment flyer with a total of 20 fathers interviewed (three did not schedule a time for an interview, despite repeated contact attempts). Participant characteristics are presented in Table 1. The mean age of fathers was 40 years with the majority (16/20) aged between 32 and 42 years. All fathers were married or living in a de facto relationship, although one father was separated from the biological mother of his child and had shared custody. Nine fathers were university educated, seven held a trade qualification and four attended high school only. Almost all fathers (18/20) were the primary caregiver for their children for some time during a typical week with 10 fathers engaging in primary care for more than 10 hours in a typical week. The emergence of new themes slowed after 14 interviews. Data continued to be collected until no new themes emerged and data saturation was considered to have occurred [24].

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Table 1. Participant characteristics.

https://doi.org/10.1371/journal.pone.0179210.t001

Thematic analysis of the transcripts revealed eight broad themes about fathers’ beliefs, perceptions and attitudes towards the dietary and physical activity behaviours of their young children: (i) shared responsibility and consultation; (ii) family meal environment; (iii) parental role modelling; (iv) parental concerns around food; (v) food rewards; (vi) child health education; (vii) limiting screen time; and (viii) parental knowledge. A summary of themes, sub-themes and sample verbatim quotes are presented in Table 2. Analysis of themes according to paternal education/employment revealed no substantial differences in the views of fathers.

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Table 2. Summary of themes, sub-themes and sample verbatim quotes.

https://doi.org/10.1371/journal.pone.0179210.t002

Discussion

This study contributes to the limited work examining fathers’ beliefs and perceived roles in the eating and physical activity behaviours of their young children. Additionally, it provides an understanding of paternal views regarding the type of support fathers require to best promote these behaviours. The findings suggest that fathers believe healthy eating and physical activity behaviours are important for their young children; that fathers believe they can promote and support these behaviours in a number of ways; and that their role in such promotion and support is an important one. The results presented here build on existing qualitative work in this area by expanding our understanding of fathers’ perceptions regarding young children’s eating, as well as contributing unique perspectives on the paternal role in their young children’s physical activity behaviours. It is of interest to note that of the eight themes identified, three related to both diet and activity, four related to diet only and one related to physical activity only.

Fathers acknowledged their shared responsibility with mothers in the context of the dietary and physical activity behaviours of their young children. There has been limited work investigating fathers’ perceptions about young children’s dietary behaviours, with the focus generally on paternal feeding practices, (such as pressure to eat and food restriction), in relation to child weight status [12, 19, 25]. However, emerging research has begun to capture the views of fathers on their roles and responsibilities regarding family meals. For example, Mallan and colleagues identified that perceived responsibility for child feeding, along with a more involved attitude toward their role as a father, were positively related to how often fathers ate meals with their children [26]. Fathers in our study described family meals as an important opportunity to develop family social fabric and developmentally appropriate mealtime rules. This is supported by early work by Horodynski and colleagues, who, in their qualitative study of African-American fathers of toddlers, described mealtime patterns of behaviour, such as the establishment of family customs and the development of routines or rules that govern these customs [27]. There is also limited data reporting fathers’ perceptions about their role in young children’s physical activity behaviours. Whilst fathers’ physical activity has been reported as a probable positive correlate of children’s physical activity, [28] as has parental support for physical activity, [29] to our knowledge, fathers’ perceptions about their roles in young children’s physical activity behaviours have not been studied previously. Ferreira and colleagues, in their review of environmental correlates of physical activity, noted that fathers’ physical activity (and not mothers’) was a consistent positive correlate of physical activity in children [28]. Additionally, Cleland and colleagues, in their longitudinal study of the family physical activity environment observed that paternal direct support was positively associated with weekend MVPA in older boys [29]. However, the observations of the Cleland study and the Ferreira review were in children older than five years of age. Our study contributes to the understanding of fathers’ roles in children’s physical activity behaviour through investigation of paternal beliefs that specifically relate to the younger child. Such investigation has provided unique perspectives not previously examined in fathers of children in this age group. In this study, fathers believed they were responsible for role modelling healthy eating behaviours with importance placed on role modelling at the evening meal. This is somewhat supported by work by Campbell and colleagues, who, in their qualitative study exploring Australian parents’ views of children’s food choices, noted that the majority of parents (mothers) in that study believed parental modelling at meals times to be important [30]. However, unlike role modelling desired eating behaviours at specific times, fathers felt opportunities to role model physical activity behaviours were less restrictive with importance placed on enjoyment and participation. Fathers also believed being physically active, (and consequently role modelling physical activity), in these different contexts, to be beneficial to the development of their children’s physical activity behaviours. This notion is supported by a review of correlates of preschool children’s physical activity by Hinkley and colleagues which reported that children with active parents tended to be more active [31].

While fathers were aware of their role in influencing their children’s diet and physical activity, largely through shared responsibility and modelling, they felt there was a lack of information to guide them. Fathers, in the present study, expressed a desire to be better informed about their children’s diet and physical activity needs through access to reliable information. This is in contrast to recent qualitative work by Tanner and colleagues, where mothers described fathers as disinterested in healthy food provision in comparison to mothers [9]. However, as was the case with some fathers in our study, mothers in the Tanner study also described fathers as being unskilled to provide healthy food options.[9] Lamb postulated that fathers’ engagement with their children is determined by four factors, one of which is adequate parenting skills and that possession of these skills results in a higher likelihood of engagement with their children [32]. Yet the fathers in our study, despite identifying a lack of knowledge and skills at times, were already discussing these needs with their partners. This is supported by recent work by Khandpur and colleagues who described the majority of fathers in their qualitative study as sharing parental responsibility for child feeding with their partners, as well as engaging in discourse to resolve any differences that may arise [33]. That these similarities and differences exist in the current literature on fathers’ involvement and perceptions with respect to their young children’s dietary and physical activity needs is not surprising and indicates that significant further study is warranted.

A number of themes were identified relating to parental food concerns. For example, fathers described their belief that foods that are purported to be more convenient were often highly processed, high in energy and low in nutritional benefit. This finding is of interest given that previous studies have reported parental misconceptions regarding the quality of children’s diets. For example, Kourlaba and colleagues, in their large study of Greek mothers and their children below five years of age, observed that over 80% of mothers overestimated the quality of their child’s diet [34]. The fathers in our study, whilst making no comment on the quality of their children’s diets, clearly felt that the convenience and snack foods entering their children’s diets were of poorer nutritional quality than desired.

Fathers were concerned about food marketing towards children, specifically the efforts of such marketing to undermine parental responsibility for food choices through child requests for particular foods. This belief is aligned with recent research that suggests the marketing and advertising of food products to children, via multiple media platforms, are for foods that are of poor nutritional quality [35–37] and influence children’s food preferences and subsequent requests for such foods [38]. That fathers raise these points, and attempt to provide context to their children about these foods, suggests they are not only active participants in the care and feeding of their young children, but also concerned about the impacts of broader social environments on the dietary behaviours of their children.

The use of food as a reward to encourage consumption of another food was commonplace. The use of food as a reward has been well documented previously [30, 39] and so it is not surprising that all but one father indicated using this strategy. Approximately half the fathers expressed concern that using this approach could result in their children liking the reward food more, and the rewarded food less. Early work investigating this notion has produced mixed results, indicating the positive effect that might be expected (increased consumption of the rewarded food) when offering a reward wasn’t observed, although supporting fathers’ concerns, liking for the reward food did increase [40, 41]. Of importance is that the use of food as a reward has been shown to have associations with obesity-promoting eating behaviours in young children [42–44] and increased BMI z-scores in primary school aged children [45]. The fathers in this study, whilst not directly linking the use of food as a reward to their children’s weight status, were concerned regarding the possible development of obesity-promoting eating behaviours such as increased exposure and preference for a reward food. Such concern furthers the previously discussed notion of fathers seeking additional guidance to be better informed about their children’s diet and physical activity needs through access to reliable information.

Fathers’ described limitations they imposed on screen time use such as time of day and duration. Whilst there appears to be a lack of established correlates of preschool children’s sedentary behaviours, [46] fathers’ beliefs regarding limiting screen time use appear to be supported by work of Spurrier and colleagues who observed associations between fewer rules about electronic entertainment and higher indoor sedentary time in their study of 280 preschool children’s home environments [42]. Where limitations on screen-based activities did occur in the context of dietary behaviours, this was generally related to the evening meal. Whilst the intention of these actions may be in the context of family customs, they may also provide benefit with respect to dietary intake. For example, Lloyd and colleagues, in their study of maternal and paternal parenting practices in 70 Australian families, observed that screen time use was inversely associated with children’s energy intake from core foods [47]. Thus, fathers’ actions of limiting screen time during family meals may contribute to both the family social fabric as well as healthier dietary intakes for their young children.

It is of interest, that despite including fathers from different SEP categories, analysis of themes according to paternal education/employment revealed no substantial differences in the views of fathers. Previous work undertaken in fathers of young children has indicated that paternal education moderates the relationships between father and child intakes for savoury snacks and take-away foods [48]. However, work investigating the relationship between parental education and children’s physical activity has shown equivocal results. For example, work by Burgi and colleagues, in their investigation of associations between parental education, parental work status and children’s physical activity, observed no differences in child physical activity irrespective of paternal or maternal education or paternal work status [49]. This is supported by work from Kelly and colleagues who, in their investigation of the effect of SEP on the objectively measured physical activity of four to five-year-old children, observed no relationship between low SEP and lower physical activity behaviours[50]. Contrasting these observations is work by Yang and colleagues, who, in their longitudinal investigation of SEP as a predictor of children’s physical activity, observed that nine year-old boys whose fathers were more highly educated participated in more sport than children of lesser educated fathers [51].Although this study contributes to the literature by examining fathers’ perceptions about the diets and physical activity behaviours of their young children, it is not without limitations. Despite including fathers from a range of SEP, the sample may not be representative of all fathers. It is of interest, however, that the themes identified did not differ according to paternal SEP. That fathers were recruited from childcare centres and kindergartens may limit generalisability in that these fathers may be routinely involved in child rearing duties; those who chose to participate may possibly be more interested in nutrition or physical activity and thus only represent a subgroup of fathers. Accordingly, these results may only be generalizable to fathers who have higher levels of involvement in their children’s mealtimes and play. This study only captured fathers’ perspectives and it is possible that mothers’ perspectives with respect to the identified themes may be different. However, the qualitative nature of these data enriches the authentic understanding of fathers’ perspectives in the child food and activity context and contributes to the knowledge base informing the development of evidence-based child health interventions. Such interventions could investigate family dynamics in the context of individual parenting with respect to young children’s eating and physical activity behaviours. Additionally, coupled with previous findings regarding dietary associations between fathers and their young children’s dietary behaviours [16], the contribution of this study to the understanding of fathers’ perspectives on their young children’s eating and physical activity behaviours, may also improve the ability to engage both parents in the delivery of such family-focused interventions.

Conclusion

This exploratory study presents the views of a socio-economically diverse group of fathers regarding their perceived roles in the dietary and physical activity behaviours of their young children. Additionally, it provides insights into the underlying perceptions that generate these views. This study reveals that fathers view themselves as active participants in their young children’s dietary and physical activity behaviours. The findings suggest that fathers’ believe healthy eating behaviours and being physically active are important for their young children and that these behaviours can be promoted in a number of ways. Future, family focussed investigations, would benefit from including fathers to allow a thorough understanding of their beliefs and influences regarding children’s health behaviours. This, in turn, would improve the ability to deliver effective family-focused child health interventions.

Supporting information

Acknowledgments

We acknowledge the support of the Department of Education & Training Victoria, the North-Western Department of Education and Early Childhood Development region of Melbourne and childcare/kindergarten centre directors for access to fathers through their centres. We are also grateful to the participating fathers for their involvement in this study.