The Food-Related Moral Experiences of Children (Aged 6–12) With Swallowing Difficulties: A Participatory Hermeneutic Ethnography Study Protocol

Background: Food is a vital need for every individual, acting as sustenance and cultural expression. Adequate nutrition is a right for every child, influencing their self-perception and worldview. Children aged 6–12 with swallowing difficulties face unique food experiences influenced by relational and environmental factors. Understanding these experiences and factors that could shape these experiences is essential. Sameroff's transactional model highlights the dynamic interplay between children and their surroundings, especially families and caregivers, shaping children's food-related experiences. This study explores the food-related moral experiences of children with swallowing difficulties and how interactions with families/caregivers influence these experiences. Methods: This study employs participatory hermeneutic ethnography to explore the meaningful aspects of children's lives, including local norms and institutional practices. The research will focus on children aged 6 to 12 with swallowing difficulties, involving 10 to 15 participants from homes and schools. The participatory approach emphasizes children and families' active involvement, concentrating on food-related moral experiences. The analysis, guided by a Childhood Ethics framework, will consider family influences and healthcare contexts. Multiple methods, such as participant observation and interviews, will be used simultaneously in data collection, with ongoing involvement of children and families in the research process. Conclusion: This study will enhance understanding of the food-related moral experiences of children with swallowing difficulties and inform targeted interventions to improve mealtime experiences. Key Messages: Food experiences in children with swallowing difficulties carry moral meaning (e.g., dignity, inclusion and autonomy). This study centres children's voices using participatory hermeneutic ethnography. Results will inform mealtime practices that support both nutrition and emotional well-being. Children and families should be active partners in care, research and policy. Findings can guide child-specific care strategies, training and policy changes.