Potential facilitators of healthy eating included desire to avoid chronic disease, effort to limit junk food consumption and school support. Despite support for efforts to improve nutrition in the Delta, participants voiced a sense of inevitability related to children's consumption of unhealthy foods.
This study suggests that parents and teachers express concern related to eating habits of children, yet they experience barriers to healthy eating which contribute to a sense of disempowerment. Improving health in the Mississippi Delta requires comprehensive strategies that offer its citizens a sense of agency. Childhood obesity among U. Childhood obesity is not only associated with risk of adult obesity and metabolic syndrome Serdula et al. Current trends in addressing obesity via public health efforts have been increasingly focused on the roles of the environment, policies and systems in the obesity epidemic.
National health goals, objectives and initiatives emphasize an ecological approach to disease prevention and health promotion Boyle and Holben, While the obesity epidemic has been broad in its societal impact, minorities particularly Hispanics and African Americans experience a greater share of the burden Zhang and Rodriguez-Monguio, Efforts to address the epidemic must strive to understand the complex systems in which food decisions are made, and endeavor to include the voices of those most vulnerable when both formulating and evaluating solutions.
There is also a high concentration of African Americans in the Mississippi Delta, and this population group experiences greater risk for obesity compared with non-Hispanic whites Ogden et al. In , Census Bureau, Furthermore, the poverty rate in Mississippi exceeds the national average.
Work is underway to bring about environmental changes to impact child nutrition. Yet, parents are primary gatekeepers when it comes to early exposures and food Gibson et al. Additionally, schools can play a powerful role in influencing child nutrition by providing nutrition education and healthy school food environments Briefel et al.
In an era of increased emphasis on food environments, it is critical to listen to the voices of key decision makers within those environments, and to evaluate what drives their food-related attitudes and behaviors. This study provides important insight needed for guiding efforts to improve child nutrition in a vulnerable population. What are the barriers and facilitators to healthy eating in the home, school and community? This study was part of a larger project which included both anthropometric measurements of students and focus groups to investigate eating habits, physical activity, safety concerns, gender differences and perceptions of the Mississippi Delta.
For this paper, focus group questions related to eating habits were analyzed. Focus groups were used to explore perceptions, behaviors and barriers related to child health and nutrition; qualitative methods are well suited for gaining insight into behavior, attitudes, beliefs and social influences Achterberg and Shepherd, Group dynamism created by interviewing several people at one time can be used to help draw out information about behaviors, attitudes and opinions that interviewees may not be as ready to share in a one-to-one setting Achterberg and Shepherd, In the three counties selected for this project, School districts in each county were required to have a minimum of two schools to serve as treatment and control groups in the larger project.
Additionally, counties were selected to include schools with high, medium and low relative elementary student populations in their respective city school districts. School district administrators were contacted and upon agreement to participate, two elementary schools from each county were selected. Focus group questions were derived from previous research and literature related to the causes and potential prevention strategies for childhood obesity CDC, ; Crawford et al.
The health belief model HBM and social cognitive theory SCT provided the theoretical basis for the focus group discussion guide Green and Kreuter, ; Roulston, , as these two models have been used to guide interventions among African Americans Demark-Wahnefried et al. The HBM indicates that the perceived importance of healthy eating, including how participants describe a healthy diet and how they view risks related to eating habits, may moderate health-related behavior.
Furthermore, the HBM indicates that perceived benefits and barriers may moderate behaviors. Thus, questions were developed to investigate perceptions of healthy eating, nutrition messages as potential cues to action and perceived barriers to change. The SCT indicates that one's environment influences health behaviors.
Thus, questions were included to investigate perceived factors that facilitate and hinder healthy eating, looking for interactions between participants and their environments. Table 1 lists the focus group questions. Where have you heard about nutrition in the past?
What did you hear? What did you think about those messages? Are there things about your children's eating habits you would like to change? What keeps you from making changes? Is there anyone or anything currently in your life that helps you make healthy choices? What are some things that could help you make changes in your children's eating habits?
What health issues do you think are most pressing for children in your school? How would you describe the eating habits of the children in your school? What is positive and what is negative about their eating habits? What are some things that you think could help parents make changes in their children's eating habits? What role do schools have in teaching nutrition to children? What is the role of teachers in teaching children about nutrition?
How important is your role as a teacher in modeling healthy eating for kids? Is there a healthy food policy in place for your school? Would you support a healthy food policy? No school administrators were present at the focus groups. Each group had a moderator and co-moderator to make notes and audio record the discussion. The same moderator was used for all 12 focus groups. The moderator provided instructions and asked questions from the discussion guide but allowed the group to determine the direction of conversation Gleason and Suitor, At the end of each focus group, participants completed a demographic survey and received a gift card to Wal-Mart.
After each group was completed, the moderator and co-moderator wrote field notes regarding the site, the group dynamics, the apparent themes and any problems that occurred during the group. All participants provided written informed consent to participate in the study. Tapes of focus group dialogues were transcribed. Transcripts were analyzed with the research questions serving as a guide and data were coded by themes, using sensitizing concepts Blumer, ; Krueger and Casey, As discussed by Blumer Blumer, , a sensitizing concept is a general concept used for looking at patterns in the data.
This approach is often used by qualitative researchers today to provide a starting point for analysis Bowen, Participants in the parent focus groups were predominately female Table 2 describes study participants. A number of barriers to healthy eating were expressed, including neighborhood environment, media, convenience, time, taste preferences and pervasiveness of junk food. Desire to avoid chronic disease, the use of strategies to limit junk food and school support were cited as facilitators of healthy eating.
The potential of parents and teachers to model healthy food habits was discussed. Finally, parents and teachers voiced desire to see changes in the eating habits of children. The following discussion explores the themes that emerged during focus group discussions.
Parents and teachers both expressed concern about children's eating habits and desired to improve children's eating habits. Owing to the pervasiveness of this topic, it is discussed as a separate theme below. Teachers shared concern about children's eating habits, bodyweight and lack of exercise.
Many teachers expressed difficulty in voicing positive aspects of children's diets; some teachers perceived that school meals may be the only meals some students receive. Teachers also believed that snacks and junk food dominated children's diets at school, home and in their neighborhoods. According to teachers, children's diets were full of fried and fatty foods, candy and other junk foods. Teachers shared that many children ate very little of the school lunch, preferring purchased snacks.
Teachers were very concerned about the unhealthy snacks available for purchase in the cafeteria. Teachers did not believe that children ate a balanced diet, and that healthy food availability was poor in their neighborhood. Parents mentioned a variety of barriers to healthy eating, including the neighborhood environment, media, convenience, time and taste preferences. Teachers voiced similar barriers to healthy eating, such as time, children preparing their own meals and a lack of healthy food in the community.
In five of the six teacher focus groups, teachers stated that the perceived quality of school meals was a barrier to healthy eating. In four of the six teacher focus groups, teachers gave examples of how their desire to help children make healthy choices was not always well received by school nutrition staff.
Other teachers expressed that school nutrition staff wanted children to make their own choices, and to not be influenced by the teachers. If you don't like it, you don't have to eat it. But get it and try it. A recurring theme throughout all 12 focus groups was the pervasiveness of junk food in children's diets. Junk food was discussed in relation to barriers to healthy eating, when asked about the meaning of healthy eating, when asked about aspects of children's diets participants would like to change and in relation to school roles.
Table 3 provides a summary of the themes and supporting quotes related to junk food consumption among children to illustrate the pervasiveness of this theme. When asked to describe healthy eating, parents in five of the six parent focus groups stated that consuming healthy snacks and limiting junk food were important.
But it's like 6 or 7 o'clock, and she just wants junk … and I'm not trying to let her cause I noticed her weight. Teachers in all six teacher focus groups stated that junk food available in schools detracts from healthy eating. They'll buy like three and four bags of chips, pass them around like they're having a party. Teachers expressed that students, when given a choice, will not select healthy foods. Parents also concurred that limiting unhealthy choices at home and in school would impact children's diets.
Parents also perceived that junk foods available at school were a barrier to healthy eating. And it's not limited to one or two bags of chips. They're getting as many as they want or their buddies will buy it for them. I don't know what to do. I can't be with her twenty-four seven.
I've got to work. Other parents shared that some junk food is acceptable, and that it should not all be taken away. Participants voiced facilitators of healthy eating among children, including desire to avoid chronic disease individually as well as among family members , enforcing limits on junk food consumption and school support. Among parents, devotion to family was a salient motivator of seeking healthy eating habits. Diet-related health problems most prominently hypertension and diabetes of respondents and their family members made participants aware of the connection between nutrition and health.
In four of the six parent focus groups, participants voiced a desire to avoid chronic disease when asked about factors that help promote healthy eating. I like the fried and sweets and stuff, and I don't have high blood pressure. So I had to try to follow his lead so I won't get the high blood pressure. In conjunction with the desire for promoting healthy eating habits, parents suggested strategies for doing so, such as limiting the amount of junk food children eat at home and at school and controlling the foods parents bring into their homes although, as mentioned above, parents did not believe that their efforts to restrict junk food access would keep their children from getting it.
Respondents in the parent and teacher focus groups acknowledged schools as having an important responsibility in promoting nutrition. Teachers in all six focus groups mentioned the importance of nutrition education in the school setting, and in five groups discussed the importance of their role in modeling healthy eating.
Some parents recognized changes the school had implemented, such as bringing breakfast to children in the classroom and introducing new foods to children. Parents suggested providing fruit and vegetable snacks in the classroom to introduce new foods, nutrition education in the classroom and healthier foods in the cafeteria. Teachers believed that nutrition education, outreach efforts, changes in school meals and teacher modeling could help improve children's eating habits.
Both parents and teachers believed less junk should be available in schools. When asked about policies at school to promote healthy eating, most teachers talked about the school meals policies. Other teachers talked about policies that affect what they do in the classroom, such as not drinking sodas in front of their students, and serving healthy foods for parties.
Some teachers reported limited compliance with policies around birthday foods, and related this to the overall school environment voicing a sense of frustration about being asked to restrict party foods when unhealthy foods are available for purchase in the school cafeteria. Parents and teachers both expressed a sense of responsibility in modeling healthy eating habits for children. Particularly, teachers said they tried to influence students' choices at lunchtime by implementing strategies, such as only allowing them to select chocolate milk one day a week or not allowing students to buy snacks until they had consumed most of their lunch.
They tried to motivate their students to choose healthy foods by telling them the benefits of eating healthy e. However, some teachers experienced barriers to promoting child nutrition, as mentioned above. While teachers were concerned about eating habits of children, they also acknowledged the difficulty of adhering to healthy dietary practices. Parents and teachers both supported efforts to improve nutrition habits of children.
A number of potential avenues for intervention were mentioned, including churches, grocery stores e. Participants voiced a readiness for change, and believed the community needs to work together to accomplish it. This study indicates parental and teacher concern for childhood obesity and describes the context in which this recognition of threat is occurring in the Mississippi Delta.
Parents and teachers shared concern that junk foods dominate diets at school, home and in the neighborhood. Parents said they tried to teach their children what is healthy but realized factors external to the family influence their children's food choices. Parents and teachers knew they influenced children's eating habits and felt responsible to do so. In addition, parents were able to describe a healthy diet. However, participants in both groups experienced significant barriers such as junk food desirability and availability, and lack of consistency among school employees in promoting healthy eating in their efforts to promote nutrition among children.
According to the HBM, perceived threat is a factor that affects health-related behavior change Green and Kreuter, This value for family can be used as a motivator of healthy eating. This is an important consideration, particularly in the context of the African American extended family, whose gatherings often involve foods with cultural value James, Conceptual framework applied to parent and teacher perceptions of children's food intake in the Mississippi Delta based on constructs of the HBM and SCT.
According to Contento Contento, , efforts to promote healthy eating should work toward making the healthy choice the desired, available and expected choice. For example, a recent study showed an association between behavior and social norms for fast food intake, soft drink intake and fruit and vegetable intake Ball et al.
A recent intervention targeted at African American youth to improve the local food environment impacted obesity rates in an environment that lacked healthy food Shin et al. Although participants recognized barriers to healthy eating, they did not offer many suggestions for overcoming these barriers. They did agree, though, that the school's role in promoting child nutrition is key.
Policy and programing considerations are discussed below. On a national scale, policies in the USA have been developed to improve school food environments. Some teachers in this study did not fully support healthy food policies because they did not see evidence that the school as a whole was committed to health. A stronger commitment to formulating and communicating consistent school-wide goals that involve families and community agencies could potentially increase the support for and effect of school nutrition policies Schwartz et al.
Beginning in , new rules governing snacks for sale in schools limit calories, sodium, fat and sugar, and require changes in available beverages among other changes U. The current study points to the need for such changes in policy related to food availability in schools. The HHFKA has seen early success in improving healthy food access for example, by requiring every student to place a fruit or vegetable on the tray.
This success may be augmented by collaboration between teachers and cafeteria workers in planning nutritious menus that complement food preferences and minimize plate waste Smith and Cunningham-Sabo, Furthermore, increased exposure to a variety of fruit and vegetable flavors in schools may play a role in impacting food preferences of children, as repeated exposure to novel flavors increases preference for those flavors Birch, ; Blanchette and Brug, ; Birch and Doub, , and preferences are an important determinant of consumption Baxter and Thompson, The current study substantiates the need to foster collaborative efforts between teachers and school nutrition staff in encouraging healthy eating among children.
Parents are important gatekeepers of early food exposure Gibson et al. A recent review of six SNAP-Ed funded efforts to extend school nutrition programs into at-home dietary changes found that mature, sustained efforts may be needed to promote improvements in behaviors, such as increased fruit and vegetable consumption Williams et al. While schools have an important role in exposure to healthy foods and teaching children about how to plan a healthy diet, food habits begin in the home, and parents need support in fostering healthy food habits in the current food environment.
The need for initiatives to empower parents has been recognized by the White House Task Force on Childhood Obesity, as indicated in their report to the President. This report outlines the need for clear, useful dietary guidelines and food labels, improvements in food marketing practices to children, and a strengthened role for health care providers in reducing childhood obesity White House Task Force on Childhood Obesity Report to the President, Theory-based programs have the potential to target underlying factors that impact health behaviors Berlin et al.
A variety of nutrition education efforts targeted at low-income African American have been based on the SCT and show potential for improving fruit and vegetable intakes in a variety of settings e. Programs have targeted both children and their parents; two studies found that a motivational component in the context of SCT-based programing may enhance program impacts Resnicow et al.
Furthermore, programs that use existing social networks to engage African Americans in improving nutrition in a group setting such as through churches have been effective in influencing nutrition behaviors Demark-Wahnefried et al. Motivational techniques, incorporation of skills-based, interactive lessons and group-based education within social networks may play a role in changing parent behaviors. This study is based on focus group findings with parents and teachers in three Mississippi counties.
The experiences and opinions of these participants are not necessarily representative of the larger population. However, similar responses across the three counties adds to the credibility of the data. The strength of this study lies in the light it sheds on experiences of parents and teachers who express concern about child nutrition but encounter barriers in their efforts to promote healthy eating among children.
In light of recent efforts to improve nutrition environments, this perspective is important. Furthermore, it elucidates the need for continued research in three key areas. Specifically, research is needed i to investigate the effectiveness of current policy-related efforts to change food environments, ii to investigate changes in food choices and norms around food selections of children, with a particular emphasis on understanding the mediators of change and iii to shed light on ways to overcome disempowerment and to encourage parents to take active roles not just in creating a healthy food environment at home but also advocating for community change.
It is clear that efforts to change children's eating habits cannot simply focus on a single entity; rather, multiple modes of influence are needed to change the food environment and provide the synergy needed to make healthier eating more possible. Approved for publication as Journal Article No.
Obesity continues to be higher among blacks, especially among black women [ 17 , 18 ]. Black adults reported higher rates of obesity than white adults at all levels of explanatory variables. Food and beverage marketing targets black Americans more frequently relative to whites, which may result in their higher levels of consumption of high-calorie foods and beverages and consequently, obesity. These industries have been using a variety of marketing tools to target black consumers through advertising, sales promotions, scholarship programs, and sponsorship of events within black communities, and the provision of employment opportunities.
In addition, food consumption and dietary habits are deeply rooted in African American culture and history. Black families especially in southern states have their own traditional foods, often called soul foods, which are prepared with certain types of seasonings and ingredients. Despite containing healthy nutrients such as vegetables and grains, soul foods include high contents of fat, sugar and unhealthy amounts of salt that contribute to weight gain and obesity.
Soul foods have a strong social component and are mainly served at family gatherings and holidays. Our findings also showed that after controlling for confounders, gender, age, education, and physical activity were associated with increased risk of obesity among whites, while gender was the only variable significantly associated with increased risk of obesity among the black subgroup. One explanation could be that higher levels of social economic status do not translate into the same level of social opportunities and resources for blacks as for whites; as a result, middle-class blacks are more likely to live in disadvantaged neighborhoods than whites with similar socioeconomic status.
Prior research indicated that black neighborhoods are more likely to have fast food restaurants and less likely to have fresh markets, parks, sidewalks and recreational resources [ 27 ]. Recent research suggests these community-level characteristics are associated with obesity independent of individual characteristics [ 28 ]. Our findings indicated that black women were twice as likely to be obese compared to black males, while white females were less likely to be obese compared to white males.
Evidence has shown that obesity in women, especially those who are underrepresented such as black women, is associated with body image and weight perception. Prior research showed that black women are more prone to underestimate their weight due to different norms about body size and shape in their community compared to white women.
Near half of overweight and obese black women do not classify their body size as overweight or obese. Black women are also more satisfied with their body size than whites, and see themselves more attractive than white women despite higher body mass. They also have fewer negative attitudes about qualities of overweight people than white women. Moreover, higher prevalence of obesity in black women might be associated with certain social factors including racial and residential discrimination.
There is strong evidence that women who report more experiences of racial discrimination were more likely to be overweight or obese black women may choose food to cope with the disadvantage or negative feelings associated with residential discrimination and segregation [ 31 ]. There is also evidence that eating may reduce feelings of anxiety or stress [ 32 , 33 ]. Efforts are needed to identify and maximize resources that may reduce the negative effects of psychosocial factors on overall health and prevent obesity.
The strength of this study is that the analyses were based on a large, nationally-representative sample of United States adults. Results are thus generalizable on a population level and can be compared to other recent studies [ 34 ]. However, the findings in this report are subject to at least two limitations. First, estimates of obesity and explanatory variables were based on self-reporting, and respondents might not have accurately reported their height and weight; therefore, estimates might be either underestimated or overestimated.
Second, these analyses were limited to adults in Mississippi, which limits the generalizability of the findings to the entire U. This study improves our understanding of adult obesity by focusing on variations by sociodemographic characteristics. Additional research is needed to understand the underlying risk factors of obesity among subgroups with higher prevalence.
Our findings indicated a high prevalence of obesity in Mississippi, which is consistent with national findings. The likelihood of obesity was greater among blacks, adults aged 25—44, and those with no physical activities, regardless of race. Accounting for race, gender was the only variable associated with increased risk of obesity among blacks. Our findings showed that black females are more likely to be obese after controlling for the confounders.
Among white adults, obesity was significantly associated with physical activity, gender, age and education levels after controlling for confounders. Those aged 25—44 years, those with less physical activity or less education were more likely to be obese, and females and those aged 18—24 years were less likely to be obese. Eliminating disparities may reduce overweight and obesity and consequently, the risk of chronic diseases among U. To reduce disparities in obesity, identifying variations in obesity by subpopulation groups and the development of targeted interventions such as providing access to more healthful alternatives to junk foods is needed.
Additionally, effective community-based and faith-based programs must be developed, and those already found to be successful should inform legislation or policies regarding behavioral changes to reduce obesity and thus subsequent chronic health diseases by focusing on appropriate marketing, eating healthy food, being physically active, and stress management. Collaborative partnerships between health professionals and the community will also help identify needs and implement strategies rooted in the cultural context of the community.
Further research should be done on the role of culture on dietary behaviors in this population. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. All authors contributed extensively to the work presented in this paper.
Mina Qobadi and Marinelle Payton designed the study. Mina Qobadi analyzed the data and prepared the draft manuscript. Marinelle Payton revised the manuscript and provided additional outputs. National Center for Biotechnology Information , U. Published online Mar 3.
Jayajit Chakraborty, Academic Editor. Author information Article notes Copyright and License information Disclaimer. Received Jan 5; Accepted Feb This article has been cited by other articles in PMC. Abstract Although the etiology of obesity is complex, social disparities are gaining attention for their contribution to obesity. Keywords: obesity, social disparities, socio-demographic characteristics, racial discrimination. Introduction Obesity is often considered to be result of energy imbalance, which is defined as the balance between energy intake, energy expended through metabolism and physical activity and energy storage.
Methods 2. Outcome Variable The outcome measure was obesity. Explanatory Variables Explanatory variables were socio-demographics such as gender, age, marital and employment status, race, income and education level. Open in a separate window.
Table 3 Association between obesity and socio-demographic characteristics in the total population, black and white subgroups, BRFSS Discussion In , more than one third of adults in Mississippi were obese. Conclusions Our findings indicated a high prevalence of obesity in Mississippi, which is consistent with national findings. Author Contributions All authors contributed extensively to the work presented in this paper. Conflicts of Interest The authors declare no conflict of interest.
References 1. Hill J. Energy balance and obesity. Bean M. Obesity in America: Implications for clinical and health psychologists. Ogden C. Prevalence of childhood and adult obesity in the United States, — Finkelstein E. Annual medical spending attributable to obesity: Payer-and service-specific estimates. Health Aff. Millwood ; 28 :w—w Trogdon J.
Indirect costs of obesity: A review of the current literature. Wang C. Thorpe K. Mississippi Obesity Action Plan Hosmer D. Applied Logistic Regression. Slack T. The geographic concentration of US adult obesity prevalence and associated social, economic, and environmental factors. Andreyeva T. Kelly B. Television advertising, not viewing, is associated with negative dietary patterns in children.
Cairns G. Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary. Pearson N. Family correlates of fruit and vegetable consumption in children and adolescents: A systematic review.
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|Research paper obesity mississippi||Make dot resume and teachers shared concern that junk foods dominate diets at school, home and in the neighborhood. Additionally, schools can play a powerful role in influencing child analyze conclusion essay premises by providing nutrition education and healthy school food environments Briefel et al. Reyes et al. Annual Review of Nutrition1941 — In conjunction with the desire for promoting healthy eating habits, parents suggested strategies for doing so, such as limiting the amount of junk food children eat at home and at school and controlling the foods parents bring into their homes although, as mentioned above, parents did not believe that their efforts to restrict junk food access would keep their children make dot resume getting it. A review of the literature. Background Many beliefs about obesity persist in the absence of supporting scientific evidence presumptions ; some persist despite contradicting evidence myths.|
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|Essay about what is multiculturalism||Multiple logistic regression was conducted to estimate adjusted odds ratios for associations between the likelihood of obesity and socio-demographic and physical activity. Explanatory variables were socio-demographics such as gender, age, marital and employment status, race, income and education level. School district administrators were contacted and upon agreement to participate, two elementary schools from each county were selected. Thus, questions were developed to investigate perceptions of healthy make dot resume, nutrition messages as potential cues to action and perceived barriers to change. Learn More. Blumer H.|
|Write me top reflective essay on shakespeare||These industries have been using a variety of marketing tools to target black consumers through advertising, sales promotions, scholarship programs, and sponsorship of events within black communities, and the provision of employment opportunities. Teachers experience conflict with the goals of the cafeteria staff to allow children to make their own food selections. In four of the six parent focus groups, participants voiced a desire to avoid chronic resume next sql server 2008 when asked about factors that help promote healthy eating. Expository writers websites to the pervasiveness of this topic, it is discussed as a separate theme below. Explanatory variables were socio-demographics such as gender, age, marital and employment status, race, income and education level. Search ADS. The authors would also like to acknowledge Dr Joseph Chromiak post-humous for his contribution to the research.|
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