2.1. Children’s actions.

2.1.1. Eating behavior. Mothers reported that many children preferred sugar-sweetened beverages, cake, and unhealthy snacks, and sometimes they liked to go out to eat pizza. Few children had consumed fruits and homemade juice as a snack. “He always eats cake for a snack. If there is no cake in his package, he is stubborn and says I don’t go to the preschool at all …” (mother of a 5-year-old boy). However, one mother said “every day, my son eats fruit, completely” (mother of a 5-year-old and 1 month boy). Some mothers stated that their children had a restriction on eating some kinds of food due to asthma or reflux. “He has asthma, and I ask the preschool principal not to give my son certain food” (mother of a 5-year-old boy).

2.1.2. Physical activity and sedentary behaviors. Most mothers mentioned that their children had a lot of physical activity and played with their bicycles or scooters and playground equipment in parks. “… Some children are very slow; however, my daughter is very active” (mother of a girl aged three years and eight months). Many mothers also stated that their children often performed sedentary behaviors, such as brain games and using the screen at home. “Every day she watches TV from 1:00 PM to 4:30 PM… And also she makes handicrafts, and she draws” (mother of a 5-year-old girl). A preschool principal said that if weather was good, children would play in the preschool yard under the teacher’s supervision. “Some days we will have a playing program in the yard if the weather circumstances are favorable and it is not polluted. Children go to the yard and run. There is some playground equipment …” (principal, code 12).

2.2 Actions of others.

Another category of behavioral factors included actions affecting the health of others: “the effect of the behavior of parents and peers; the effect of the behavior of principals and teachers in the preschool, and the influence of grandparents’ and neighbors’ behaviors.”

2.2.1. Actions of parents. More mothers admitted that they forced-feed their children, and even fathers endorsed and complained about it. “Her mother, yes, but I say whenever she is hungry, she comes and says it to us …” (father of a girl aged four years and two months). Although few mothers reported no use of coercion, or some of them reported using it before, it was not currently used after finding its disadvantageous. “Even I wanted to force-feed them, so that they would get nausea, they even vomited what they had eaten. I preferred not to give them anything forced” (mother of a girl aged 5 years and 6 months).

Parents also reported they were responsible for taking their children to the preschool by car or on foot. Families whose homes were close to preschools and housewives mothers usually took their children to the preschool on foot. “Myself. Because our route is close to the preschool I myself take him in the mornings, and I take him home at noon” (mother of a 4-year-old boy). Mothers said in cases where the father was in charge of taking the child to the preschool, or when the distance was long between home and the preschool, parents took their children by car. “We get in a taxi. From here to home we can’t walk because it is far away” (mother of a five years and one month boy). Some mothers reported that they took their children to the park, and also a few children’s fathers took them to the club or pool. “I take my daughter to the park once a week every summer” (mother of a four years and six months old girl). Some mothers explained that they gave children a cell phone or tablet to entertain them and to lessen their mischief, and also mothers could handle daily tasks. “… His father and I have a homebuilding program on our phones, and if he bothers us, we will give him our cell phone for ten minutes or a quarter” (mother of a 5-year-old boy). In addition, some parents reported doing sedentary activities, such as painting, crafts and playing with Lego bricks with their children, because they were living in apartments and had some limitations for noise and also mothers were not eager to play active games, such as wrestling and jumping. “He knows I’m not a person to play active games, he says mom, let’s play a brain game. He says I know you like sitting game, which game” (mother of a boy aged five years and six months).

2.2.2. Peers’ actions. Most mothers and principals reported that dietary behaviors of peers affected children; however, some mothers revealed that peers’ dietary behaviors did not affect their children’s behaviors. Peers affected most children when they did not like a kind of food and they did not eat it; thus, the child tried doing that behavior. “For example, if a child doesn’t have soup, she comes home and says I will not eat soup, but she doesn’t insist on it” (mother of a girl aged five years and 10 months). Another mother said “No, for example, my family’s children don’t influence my son at all” (mother of a 5-year-old boy). A positive effect of peers regarding dietary behaviors was to improve nutrition due to eating as a group of children in the preschool. “She is getting better now. Until she did not come to preschool, she didn’t eat food at all… But since she comes to the preschool she sees kids, and she gets better” (mother of a girl aged three years and seven months).

2.2.3. Actions of principals and teachers. Mothers and one of the principals mentioned the influences of teachers on children’s behavior, especially dietary behaviors. “My daughter said: I was reluctant to eat my snack (carrot) but aunt (her teacher) said to eat it, and I said to myself it was a pity, and I ate it” (mother of a girl aged five years and 11 months). The principals reported caring about the children’s health and nutrition and tried to use high-quality foods to prepare children’s meals. “We have chefs. Cooking is performed according to the approved food program here. I myself buy foodstuffs from a safe store… In addition, we don’t use bulk food because they are contaminated” (principal, code 12).

2.2.4. Actions of grandparents and neighbors. The interferences of grandparents in the feeding of children were mentioned by some parents. “When my maternity leave was over, and I went to work, my family pressured on me more, and they said, you were going to work, and Paria became foodless, look, the child became slim. They pressured me, and I pressured my daughter …” (mother of a girl aged three years and eight months). Also, mothers said that one of the reasons for restricting children from playing and doing physical activities is some limitations of living in an apartment. They said we have to play sedentary games with our children instead of running because our neighbors are bothered by the noise of children. “Thinking games, sitting activities… She plays running games to the extent that the apartment is allowed to play" (mother of a girl aged three years and seven months).

3.1. Physical environment.

3.1.1. Home. Spending time on screen-based behaviors, including television, a mobile phone, or a tablet, was common among children at home. A few mothers reported spending a lot of time watching TV with their children. “… If he stays awake 10 hours a day, he watches TV for six hours” (mother of a boy aged three years and six months). However, a few mothers also reported that children had a lot of activities at home. “At home, she goes over to the desk or table and she jumps on the furniture” (mother of a girl aged five years and 10 months). At home, children were reported eating some kinds of food, such as unhealthy snacks, “She eats unhealthy snacks completely at home …” (mother of a girl aged five years and six months).

3.1.2. Grandparent’s home. Some parents reported their children playing with their peers at grandparents’ homes, other children in their neighborhood, or with relatives’ children. “… There are a lot of playmates at my mom’s building, and she plays with them at the weekend” (father of a girl aged four years and two months).

3.1.3. Preschool. Children spend most of the days in a week and most of the hours in a day in the preschool and were eating breakfast, lunch, and snacks there. "Yeah, breakfast, snacks and lunch. After lunch, again, I prepare something for her; she says I am hungry” (mother of a girl aged five years and 11 months). Mothers and principals pointed out that children prefer eating their meals in a group and with cravings in the preschool. “Some of them don’t have meals well. … but because they are in a group, they are encouraged to eat. When they see all the children are eating a kind of food it will be an encouragement for them to eat” (principal, code 12). In the preschool, the principal stated that children were allowed to bring Pofila (Popcorn) as the only snack, and also they had fruit, nuts, packaged milk, and biscuits for the snack. “Snacks, they can bring Pofila only” (principal, code 12).

4.1. Predisposing factors.

Among the predisposing factors, according to data analysis, “the child’s attitude, parent’s and principals’ attitude, as well as parents’ knowledge and parents’ and principals’ beliefs” were explored.

4.1.1 Attitude. 4.1.1.1. Children’s attitude. The results showed that some children preferred playing and doing physical activities to using mobile phones or playing with dolls or watching TV, and also, most of them tended to have a playmate. “She does not like TV a lot, she likes playing. We play with a ball each other” (mother of a girl aged three years and eight months).

4.1.1.2. Parents’ and principals’ attitude. Most mothers were satisfied with their children’s diet and weight gain. They perceived that children were eating healthy food and fruits more than unhealthy snacks. “Now I feel she is eating healthy food more than junk food. She eats a meal in the preschool and then eats with me at home and with her father in the afternoon…” (mother of a girl aged five years and 10 months). Most mothers also reported that their children’s weight is normal, and according to their doctor, their weight gain is satisfactory. “His weight is often normal… the doctor is claiming he is on the growth line, above the growth line but not obesity, overall, his skeleton is huge” (mother of a boy aged five years and one month). Parents and principals felt that children were eating foods better at preschool than at home. "It seems she eats well here, but at home, her mother has to put food in her mouth" (father of a girl aged four years and two months). Many parents were satisfied with their children’s physical activity, and they said that their children were constantly jumping and their physical activity was at a high level. "Her physical activity is tremendously high. Every moment she comes home, she plays a lot until she goes to bed” (mother of a girl aged four years and nine months). Some mothers also complained about screen-based behaviors among their children. “He watches animations a lot. For example, when we go home from here, he watches animation until he sleeps" (mother of a boy aged five years and one month). Some mothers were inclined to have obese children, and they were not dissatisfied with their children’s weight gain and eating behaviors. "She is underweight and weak; she is slim …" (mother of a 5.5-year-old girl).

4.1.2. Knowledge. 4.1.2.1. Parents’ knowledge. Knowledge of the children’s nutritional preferences and making healthy food were reported by most mothers. "… I even make pizza, not sausage. I use chicken and pizza cheese" (mother of a girl aged five years and 10 months). “He ate mixed meat, but now he does not eat that …” (mother of a boy aged three years and six months).

4.1.3. Beliefs. 4.1.3.1. Parents’ beliefs. Some parents believed that their children’s weight would be normal. They believed that their children should stay fit and have a healthy weight. “I always say a child has to be healthy, not overweight…" (father of a 4-year-old girl).

4.1.3.2. Principals’ beliefs. Principals believed that a child ate food well with other children and without coercion. "If children don’t eat at home due to coercion, they will have very well in the preschool. The most reason is that they eat meals together" (principal, code 12).

4.2. Enabling factors.

According to the data analysis, "parents’, principals’, and teachers’ skills, rules and laws in the preschools, and also availability" were placed under the enabling factors.

4.2.1. Skills. 4.2.1.1. Parents’ and principals’ skills. Many parents reported performing healthy eating behaviors in front of their children. “There is some food that her mother and I do not like, but we do not show that in the appearance … “(father of a 4-year-old girl). Some parents have reduced their screen time. "He used the phone maybe 1 or 2 hours a day, but now we have not used it for one year” (mother of a 5-year-old boy). On the other hand, principals and one mother reported providing unhealthy snacks by mothers for their children. “… We had insisted on mothers to make natural juice. Some of them do it, and some of them don’t …” (principal, code 12). One of the skills of preschool principals and teachers was to pay attention to the health of preschool children “… cotlet (a mixture of meat, potatoes, and eggs), I don’t really agree that a child eats it because of frying" (principal, code 11).

4.2.2. Laws and rules. Preschool principals and some mothers stated that all children should consume preschool meals even very little. "… She/he says I don’t eat food this morning, I say it is okay, eat two spoons (a little). Because it is a rule to eat it" (principal, code 11). They also reported that there was a regular and similar diet plan in the preschool. “The Preschool has a diet plan … based on the plan I provide the snack, and they eat it with each other” (mother of a 4-year-old boy).

The principals mentioned that if the weather was favorable, they would play in the yard, and if the weather was rainy or snowy, they would play inside the preschool. “… If it is not snowy or rainy, they wear their clothes, and they play in the yard. If the weather is unfavorable…” (principal, code 11). Principals also stated that according to a law in the preschool, there was a weekly food plan prepared by them and approved and signed by a nutritionist. However, they also reported that there was no nutritionist at the preschools to approve food plan; thus, they searched for this approval through mothers who knew an independent nutritionist or asked a nutritionist in the Welfare Organization. "I write a weekly food plan and it is approved by a nutrition consultant. She has a seal" (principal, code 11). There are some rules regarding the supervision of the Welfare Organization in preschools. The principal said that sometimes the inspector is referred from the Welfare Organization to monitor the preschool, and also some meetings and workshops are held by the Welfare Organization for the principals; however, attending meetings and workshops was not obligatory. “The Welfare Organization Sometimes monitors the preschool… “(principal, code 12).

4.2.3. Availability. Most mothers reported that screen appliances were available to children at home, and some children had a television in their room. "… He has a TV in his room and lies down on his bed and watches an animated CD " (mother of a boy aged five years and one month).

4.3. Reinforcing factors.

According to the data analysis, “family support and effects, teachers’ encouragement and influences, and peers’ influences” were under the subcategory of feedback, encouragement, and influence of others and as reinforcing factors of weight management.

4.3.1. Feedback, encouragement, and influence of others. 4.3.1.1. Family support and effects. Most parents supported their children’s physical activity and reported their children playing with their grandparents, uncle, peers, and brothers. "Because she has an older brother and they run and play soccer a lot at home, and also we take them to the park most of the time" (mother of a 5.5-year-old girl). On the other hand, parents’ behaviors were encouraging to use screen by the children "… sometimes I said: play with my phone …” (father of a 4-year-old girl). Parents’ eating behaviors had an influence on the children’s dietary behaviors, as many children refused or accepted some foods like their parents. "If I say I don’t eat something, she does not eat that too” (mother of a girl aged three years and seven months).

4.3.1.2. Teachers’ encouragement and influences. In preschool, children’s behaviors could be influenced by their teachers, and some mothers reported affected children’s eating and physical activity behaviors by their teachers. “Teachers are also effective because my daughter constantly emphasizes what food items are useful and what food is not beneficial …” (mother of a 4.5 year-old girl).

4.3.1.3. Peers’ influences. Children were highly influenced by their peers regarding eating and physical activity behaviors as they followed their peers’ behaviors and tried to behave like them. “She said that one of my friends didn’t eat food, I wanted not to eat it too" (mother of a girl aged four years and nine months). Children were more encouraged to play and have physical activity when they had a playmate. "Because my mother’s next-door neighbor has a girl, she loves to go there and to play with her" (mother of a girl aged four years and nine months).

5.1. The effects of maternal mood status and quality of parental relationship on child‘s weight-related behaviors.

Some mothers reported affecting their children’s eating and physical activity behaviors by their mood status and quality of the relationship between parents. They also stated that their children do not eat enough food or eat less affected by these factors. “When I’m tired or upset, her behavior changes, her appetite will be less” (mother of a girl aged four years and six months). Another mother said that she got divorced, which affected her son’s eating: “his father and I live separately … he ate little food at first, and he could not focus on everything …” (mother a 5-year-old boy).