Exploring childhood obesity through multiple levels of influence: An examination of the social and environmental context for healthy weight among minority youth and parents

Childhood obesity is a major public health problem disproportionately affecting low-income minority populations. Although obesity is prevalent in these communities, little is known about how social and environmental factors affect behaviors related to achieving and maintaining a healthy weight among minority youth and parents. In this dissertation, two studies were conducted on data from 14 focus groups with African American, Hispanic and Latino, and American Indian parents over the age of 18 and youth ages 11-17 across the country to better understand the multiple levels of influence affecting minority youths' ability to achieve and maintain a healthy weight. In study 1, youth and parents identified four behaviors related to healthy weight: engaging in primary prevention, taking care of your mental health, eating healthy foods, and being physically active. Several community level barriers, such as cost, time constraints, and safety, were identified, but few societal level barriers were discussed. Community and societal level facilitators (e.g. school resources, government assistance, heritage-based foods) were limited. Interestingly, youth and parents across all racial and ethnic groups experienced similar barriers and facilitators, which imply socioeconomic status, may be the important variable rather than race and ethnicity. In study 2, focus group data was examined to understand how media (e.g. television, movies, texting, social media, Internet, radio) influences behaviors related to healthy weight and explore preferred digital/ social media communication strategies. Analyses highlighted positive associations with media through information and encouragement, negative relationships between media and unhealthy behaviors, and problematic perceptions about the influence of marketing in media. Preferred digital/ social media communication strategies were discussed in terms of source, message, channel, and receivers. Participants wanted to see people who looked like them and had similar experiences. Many of the same communication strategies successful in traditional media would work for digital and social media. Community-based conversations provide first-hand knowledge about how youth and parents think and feel regarding healthy weight. Through this discourse, practitioners, researchers, and community advocates gain insight into how to develop interventions and policies that can result in long-term behavior change to improve healthy weight in minority populations