Research in Community and Public Health Nursing (지역사회간호학회지)

Korean Academy of Community Health Nursing (한국지역사회간호학회)
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Ecological Factors and Strategies for Childhood Obesity Prevention Targeting Vulnerable Children: Using Community-Based Participatory Research

취약계층 아동집단의 비만예방을 위한 생태학적 요인과 해결전략 탐색: 지역사회 기반 참여연구 기반으로

  • Received : 2019.12.19
  • Accepted : 2020.07.23
  • Published : 2020.09.30
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Abstract

Purpose: This study aimed to explore ecological factors and strategies for childhood obesity prevention targeting vulnerable children using a community-based participatory research (CBPR) methodology. Methods: The CBPR was conducted by following basic process steps. Participants were 12 community stakeholders such as community child center directors (n=4), vulnerable children's mothers (n=3), community health center officials (n=2), and lay health advisors (n=4); they were purposively sampled from K municipal county in Seoul, South Korea. The qualitative content analysis was performed to explore main themes of the ecological factors and strategies by using data obtained from 5 times of focus group interview. Results: Twelve ecological factors associated with childhood obesity prevention were identified: Intrapersonal factors including emotional overeating; interpersonal factors including permissive parenting style of children's eating behaviors; organizational factors including social workers' less educational opportunities; and community/policy factors including less government financial support. Four ecological strategies for childhood obesity prevention were addressed: Developing obesity prevention programs targeting vulnerable children' lifestyles; promoting parents' active participation in education; building healthy meal service environments through empowering social workers; and building supportive community environment and securing community resources for child obesity prevention. Conclusion: Our findings may be informative in terms of providing a comprehensive understanding of multi-level ecological barriers against vulnerable children' obesity prevention and, moreover, guiding multi-level strategies for preventing childhood obesity targeting children enrolled in community child centers.

Keywords

References

  1. World Health Organization. Report of the commission on ending childhood obesity [Internet]. Geneva: World Health Organization. 2016 [cited 2019 April 23]. Available from: https://apps.who.int/iris/bitstream/handle/10665/204176/9789241510066_eng.pdf?sequence=1
  2. Abarca-Gomez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in bodymass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. The Lancet. 2017;390(10113):2627-2642. https://doi.org/10.1016/S0140-6736(17)32129-3
  3. Kim HR, Cho JH, Kim SW, Kang YH. A report: development of policies on childhood obesity prevention in South Korea. Policy Report. Sejong: Korea Institute for Health and Social Affairs; 2014. Report No.: 2014-46.
  4. Jung Y, Ko S, Lim H. The socioeconomic cost of adolescent obesity. Health Social Welfare Review. 2010;30(1):195-219. https://doi.org/10.15709/hswr.2010.30.1.195
  5. Singh GK, Siahpush M, Kogan MD. Rising social inequalities in US childhood obesity, 2003-2007. Annals of Epidemiology. 2010;20(1):40-52. https://doi.org/10.1016/j.annepidem.2009.09.008
  6. Choo J. An obesity prevention framework for vulnerable children based on a methodology of community-based participatory research: Using a strategy of training community lay health advisors [Internet]. Seoul: Korea Health Promotion Institute. 2013 [cited 2018 December 20]. Available from: http://www.ndsl.kr/ndsl/search/detail/report/reportSearchResultDetail.do?cn=TRKO201500007074
  7. Noh JW, Kim Ye, Oh IH, Kwon YD. Influences of socioeconomic factors on childhood and adolescent overweight by gender in Korea: Cross-sectional analysis of nationally representative sample. BioMed Central Public Health. 2014;14(1): 324. https://doi.org/10.1186/1471-2458-14-324
  8. Birch LL, Anzman SL. Learning to eat in an obesogenic environment: A developmental systems perspective on childhood obesity. Child Development Perspectives. 2010;4(2):138-143. https://doi.org/10.1111/j.1750-8606.2010.00132.x
  9. Kim HR. Multi-sectoral coordination strategy for policies and programs on nutrition service and obesity prevention. Korean Journal of Health Education and Promotion. 2013;30(4):57-67. https://doi.org/10.14367/kjhep.2013.30.4.057
  10. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Education Quarterly. 1988;15(4):351-377. https://doi.org/10.1177/109019818801500401
  11. OECD. Health at a Glance 2013 [Internet]. Seoul: OECD Publishing. 2014 [cited 2019 May 1]. Available from: http://www.oecd.org/health/health-systems/health-at-aglance-2013-9789264215221-ko.htm
  12. Jung M, Jung Y, Jang S, Cho BH. The methodology of community-based participatory research. Korean Journal of Health Education and Promotion. 2008;25(1):83-104.
  13. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health. 1998; 19(1):173-202. https://doi.org/10.1146/annurev.publhealth.19.1.173
  14. Yoo SH. Using community-based participatory research (CBPR) for health promotion. Korean Journal of Health Education and Promotion. 2009;26(1):141-158.
  15. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24(2):105-112. https://doi.org/10.1016/j.nedt.2003.10.001
  16. Amico KL, Wieland ML, Weis JA, Sullivan SM, Nigon JA, Sia IG. Capacity building through focus group training in community-based participatory research. Education for Health (Abingdon). 2011;24(3):638.
  17. Morse JM, Field PA. Qualitative research method for health professionals. 2nd ed. Thousand Oaks: SAGE Publication; 1995. 254 p.
  18. Park S, Choo J, Chang SO. Healthy eating for obese children from socioeconomically disadvantaged families: Its ecological factors and strategies. Journal of Transcultural Nursing. 2019; 30(3):268-279. https://doi.org/10.1177/1043659618795037
  19. Wardle J, Guthrie C, Sanderson S, Birch L, Plomin R. Food and activity preferences in children of lean and obese parents. International Journal of Obesity. 2001;25(7):971-977. https://doi.org/10.1038/sj.ijo.0801661
  20. Cho KM. An analysis survey on physical development and health status of elementary children in poverty in Incheon area. Korean Parent-Child Health Journal. 2009;12(2):147-159.
  21. Liu Y, Chen H, Liang L, Wang Y. Parent-child resemblance in weight status and its correlates in the United States. PLoS One. 2013;8(6):e65361. https://doi.org/10.1371/journal.pone.0065361
  22. Demir D, Bektas M. The effect of childrens' eating behaviors and parental feeding style on childhood obesity. Eating Behaviors. 2017;26:137-142. https://doi.org/10.1016/j.eatbeh.2017.03.004
  23. Kim J, Kim G. An analysis on determinants of self-care days among school-aged children. Korean Journal of Human Ecology. 2013;22(1):1-15. https://doi.org/10.5934/KJHE.2013.22.1.1
  24. Meyer SC. Maternal employment and childhood overweight in Germany. Eonomics & Human Biology. 2016;23:84-102. https://doi.org/10.1016/j.ehb.2016.05.003
  25. Li M, Xue H, Jia P, Zhao Y, Wang Z, Xu F, et al. Pocket money, eating behaviors, and weight status among Chinese children: The childhood obesity study in China mega-cities. Preventive Medicine. 2017;100:208-215. https://doi.org/10.1016/j.ypmed.2017.04.031
  26. Lee JY, Park J, Kim HS, Kim WS, Hwang G. Barriers to promoting physical activity among overweight and obese children from low-income families using community child care centers. Korean Society of Public Health Nursing. 2017;31(2):327-340. https://doi.org/10.5932/JKPHN.2017.31.2.327
  27. Larson N, Ward DS, Neelon SB, Story M. What role can childcare settings play in obesity prevention? A review of the evidence and call for research efforts. Journal of the American Dietetic Association. 2011;111(9):1343-1362. https://doi.org/10.1016/j.jada.2011.06.007
  28. Gosliner WA, James P, Yancey AK, Ritchie L, Studer N, Crawford PB. Impact of a worksite wellness program on the nutrition and physical activity environment of child care centers. American Journal of Health Promotion. 2010;24(3):186-189. https://doi.org/10.4278/ajhp.08022719
  29. Noh E, Eun S. The policy support plans of obesity prevention and management for childhood and adolescent [Internet]. Seoul: The Seoul Institute. 2013 [cited 2019 June 15]. Available from: https://www.si.re.kr/node/46237
  30. Langille JL, Rodgers WM. Exploring the influence of a social ecological model on school-based physical activity. Health Education and Behavior. 2010;37(6):879-894. https://doi.org/10.1177/1090198110367877

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