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Transformations in eating practices are reflected in the multiplicity of competing food-related discourses. These discourses contribute to different food categorizations among individuals. Scientists have long argued that food categorizations may help understanding cultural systems of health beliefs. However, not enough work has been conducted to improve the understanding of the dimensions of food categorizations and their interface with food choices, tastes, and culturally defined food systems. This study aims at describing and interpreting how low-income women living in three urban settings in Santos, Brazil, classify and give meaning to foods. We used the pile sorting method to investigate categorizations created by 90 women, following 6 steps: (1) creating units of analysis, (2) sorting the units of analysis into piles, (3) running multidimensional scaling analysis, (4) running cluster analyses on the multidimensional scaling coordinates, (5) labelling the clusters, and (6) analyzing consensus among the participants. The final solution to food categorizations comprised six clusters, namely: home meals, convenience foods, special meals, fish, breads and cereals, and hot dogs. Additionally, we observed four rationales for food categorization: frequency of consumption, degree of healthfulness, personal taste, and meals in which the food was usually part of. These categories highlight the importance of considering personal taste and the type of meal that the food is culturally consumed in, to propose meaningful interventions and appropriate education tools, towards promoting healthy eating practices, especially among vulnerable populations.

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RESUMO

BACKGROUND: The cognitive processes involved in individuals' perceptions and prioritization of information, and how these change with experience or exposure to interventions, are rarely examined in the evaluation of nutrition interventions. Exclusive breastfeeding counseling is a common infant and young-child feeding intervention and is used to promote HIV-free survival in the prevention of mother-to-child transmission programs. However, it is often designed without adequate attention to the changes in mothers' perceptions over the course of their early breastfeeding experiences. OBJECTIVE: The aim of this study was to identify HIV-infected breastfeeding mothers' cognitive structure (their organization of messages and ideas) of infant feeding messages and to characterize whether their cognitive organization of infant feeding messages changed from pregnancy through the first 5 mo postpartum. METHODS: With the use of semistructured interviews and the cognitive mapping technique of pile sorting, we interviewed 30 HIV-infected breastfeeding mothers in Port-au-Prince, Haiti. We asked them to sort and rate 18 infant feeding messages 3 times (during pregnancy, 0- to 1-mo postpartum, and 3- to 5-mo postpartum). We analyzed their responses by using multidimensional scaling, property fitting, and partition analyses. RESULTS: At all 3 visits, we found consistency in women's cognitive mapping of messages. For example, mothers consistently differentiated messages pertinent for exclusive breastfeeding compared with those that pertained to other practices. However, subtle variations in mothers' cognition over time were also evident, particularly at 0- to 1-mo postpartum, when message proximity was tightly clustered compared with the earlier and later periods. CONCLUSIONS: We conclude that mothers share a common cognitive organization of infant feeding messages and that this organization changes over time. Attention to variations in cognition can support context-sensitive, patient-centered counseling by practitioners and improve the effectiveness of nutrition interventions. Pile sorting is an efficient, systematic technique to examine cognitive processes related to health and nutrition.

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Childhood poisoning is a leading public health concern in our society. The death rate from unintentional poisonings among children has increased by 80% from 2000 to 2009. Immigrant children are also at-risk. A qualitative study, consisting of a pile sort, was conducted among immigrant Mexican mothers to determine their safety perceptions of commonly used medicines, herbs, and cleaners. Participants (N = 35) were selected for semi-structured interviews from a pediatric primary care clinic in the Dallas/Fort Worth Metroplex. Some mothers over-estimated their children's ability to discern the dangers of substances, relied heavily on sensory skills of children, and perceived a medicine as safe after successful use in the past. Other mothers were more cognizant of allergic reactions, ingestion, and the need to store substances carefully. Brief interventions that incorporate culturally-appropriate safety messages are needed to assist Mexican mothers in creating a safe home environment.

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