Childhood Obesity Perceptions Among African American Caregivers in a Rural Georgia Community: A Mixed Methods Approach

Abstract

Given the pivotal role of African American caregiver's perceptions of childhood obesity in rural areas, the inclusion of caregiver's perceptions could potentially reduce childhood obesity rates. The objective of the current study was to explore childhood obesity perceptions among African Americans in a rural Georgia community. This concurrent mixed methods study utilized two theoretical frameworks: Social Cognitive Theory and Social Ecological Model. Using a convenience sample, caregivers ages 22-65 years completed a paper-based survey (n = 135) and a face-to-face interview (n = 12) to explore perceptions of obesity risk factors, health complications, weight status, built environment features, and obesity prevention approaches. Descriptive statistics were generated and a six-step process was used for qualitative analysis. Participants commonly cited behavioral risk factors; yet, social aspects and appearance of the community were not considered contributing factors. Chronic diseases were reported as obesity health complications. Caregivers had a distorted view of their child's weight status. In addition, analysis revealed that caregivers assessed child's weight and height measurements by the child's appearance or a recent doctor visit. Environmental barriers reported by caregivers included safety concerns and insufficient physical activity venues and programs. Also, caregivers conveyed parents are an imperative component of preventing obesity. Although this study found caregivers were aware of obesity risk factors, health complications, built environment features, and prevention approaches their obesity perceptions were not incorporated into school or community prevention efforts. Findings suggest that children residing in rural areas are in need of tailored efforts that address caregiver perceptions of obesity.

Can Age-Friendly Planning Promote Equity in Community Health Across the Rural-Urban Divide in the US?

“…Counties with more African American population rank lower on health across all county types. This was expected, as communities with more African American population have lower health outcomes [37] and lower life expectancy [54]. However, model results show two surprises: counties with more Hispanics have higher community health across all county types, and counties with more White poverty have lower health.…”

“…For example, a meta-analysis [36] reported an association between planning, transportation, and physical environment (such as parks and trails), on adults' and children's physical activity. In US nonmetropolitan communities, more outdoor recreation facilities are related to a lower prevalence of obesity among both children [37], and adults [38]. Even a state level variable, such as suburban sprawl, has been associated with the rise in obesity in the US since the 1990s [39].…”

“…Urban studies focus on the inadequacy of park space in low income and minority neighborhoods in the US [45,46]. Rural communities also face problems with the accessibility and safety of public parks [37]. For rural communities, transportation is often highlighted as the biggest challenge [47].…”

Qualitative perspectives from African American youth and caregivers for developing the Families Improving Together (FIT) for Weight Loss intervention.

“…Caregivers in one study believed that parents played the most important role in contributing to child weight status (Alexander, Alfonso, & Hansen, 2015). Previous quantitative and qualitative research has also found that AA youth preferred tangible or instrumental support from parents to improve lifestyle behaviors (Siceloff, Wilson, & Van Horn, 2014; Wright, Wilson, Griffin, & Evans, 2010).…”

Parents’ Perception of Child Weight Status, Risk Factors and Health Concern of Childhood Obesity: A Systematic Review

“…Six studies examined parents' perception regarding the risk factors of childhood obesity, parents perceived that genetic factors, less vegetable-consumption, low physical activity as key risk factors of childhood obesity 15 . Further, three studies revealed that parents perceived environmental factors such as poorly built environmental conditions, unsafe, dangerous environments, environmental barriers, and poorly maintained sidewalks had increased odds of being obese 41,39,49 . Other studies showed that parents perceived that low physical activity and additional hours of watching television as risk factors of childhood obesity 40 .…”