Perceptions of child weight and health among Hispanic mothers in Arkansas: formative research for the La CASA trial

Hispanic children in Arkansas experience disproportionately high rates of obesity, highlighting an urgent need for effective and culturally relevant prevention strategies. Cultural values can shape families’ perceptions of child weight and health and their feeding practices. However, most research has focused on urban or more established Hispanic communities, leaving a gap in understanding these perspectives in rural Southern settings. This study explored perceptions of child weight and health among Hispanic mothers recruited through faith-based organizations in Arkansas to inform the development of the La CASA Trial, a culturally tailored, faith-based childhood obesity prevention intervention. A qualitative exploratory design was employed. Thirty Hispanic mothers of children aged 5–16 years were recruited through faith-based organizations across Arkansas. Semi-structured interviews were conducted in Spanish, transcribed, and translated into English. Data were analyzed for themes using MAXQDA-24. Seven themes were identified. Participants commonly viewed “chubbier” children as healthy, reflecting cultural values that link body size with good care. At the same time, some recognized that excess weight can lead to health problems as children grow older. Food was described as an expression of love and tradition, with participants’ accounts linking these values to larger portion sizes. Participants reported barriers to healthy eating, including limited time, work demands, and lack of nutrition knowledge. They also described a strong sense of responsibility for feeding their children, while navigating family and cultural expectations. Participants expressed interest in culturally relevant nutrition education delivered through trusted community settings, such as churches. Participants’ accounts highlighted how cultural values and caregiving practices shaped their understanding of child weight and health. Their perspectives suggest that obesity prevention strategies that respect these cultural values, incorporate hands-on nutrition education, and are delivered through trusted community settings such as churches may be perceived as acceptable and culturally relevant, with potential to encourage engagement. These findings will inform the design of the La CASA Trial.