Abstract
BACKGROUND: Mindful eating strategies have shown promise in addressing obesity and food insecurity among children. However, limited research has examined the acceptability of mindful eating programs among low-socioeconomic families in rural areas. This study evaluated caregivers' and teachers' acceptability and satisfaction with a 14-week, school-based mindful eating program for preschoolers to inform future implementation. The program effectively improved home eating environment, household food insecurity, and child body mass index. METHODS: A convergent parallel mixed methods study design was used to evaluate the 14-week mindful eating intervention among 200 preschoolers from 26 Head Start classrooms in rural Michigan, United States. After intervention completion, acceptability and satisfaction data were collected and assessed from 192 caregivers and 23 classroom teachers via (1) quantitative online survey data analyzed using descriptive statistics, and (2) qualitative data from individual interviews completed with a subset of parents and teachers that were analyzed with thematic analysis. RESULTS: Both quantitative and qualitative data showed high acceptability and satisfaction. Caregivers (survey: 88.9%, interview: 94.1%) and teachers (survey: 87.0%, interview: 100%) were satisfied with the program. Teachers (survey: 82.6%, interview: 87.5%) agreed the program improved children's eating behaviors. Most surveyed caregivers (81.1%) agreed the completion of child letters sent home after the program session helped caregiver-child communication. Several barriers and suggestions for implementation were also identified by interviewed teachers and caregivers, including the limited availability of specific fruits and vegetables in local areas, concerns about preschoolers' comprehension of curriculum, and recommendations on improving recruitment strategies. CONCLUSIONS: This study highlighted the high acceptability and satisfaction of a mindful eating program among caregivers and classroom teachers. The findings offered implications for future interventions to integrate mindful eating programs into early childcare organizations to help address child obesity and food insecurity. Future research exploring nutrition-related policies to sustain implementation of mindful eating programs is needed. CLINICAL TRIAL REGISTRATION: The clinical trial was registered at ClinicalTrials.gov (NCT05780008) on 27 February 2023.