School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Department of Anthropology, Faculty of Arts, University of Alberta, Edmonton, Alberta, Canada.
Health Promot Chronic Dis Prev Can. 2016 Sep;36(9):175-84. doi: 10.24095/hpcdp.36.9.01.
Overweight and obesity are influenced by a complex interplay of individual and environmental factors that affect physical activity and healthy eating. Nevertheless, little has been reported on people's perceptions of those factors. Addressing this critical gap and community partner needs, this study explored how people perceived the influence of micro- and macroenvironmental factors on physical activity and healthy eating.
Community partners wanted the study results in a format that would be readily and easily used by local decision makers. We used photovoice to engage 35 community members across four municipalities in Alberta, Canada, and to share their narratives about their physical activity and healthy eating. A combination of inductive and deductive analysis categorized data by environmental level (micro vs. macro) and type (physical, political, economic, and sociocultural), guided by the Analysis Grid for Environments Linked to Obesity Framework.
Participants conceptualized health-influencing factors more broadly than physical activity and healthy eating to include "community social health." Participants spoke most often about the influence of the microenvironment (n = 792 ANGELO Framework coding tallies) on their physical activity, healthy eating and community social health in comparison to the macroenvironment (n = 93). Photovoice results provided a visual narrative to community partners and decision makers about how people's ability to make healthy choices can be limited by macroenvironmental forces beyond their control.
Focussing future research on macro- and microenvironmental influences and localized community social health can inform practice by providing strategies on how to implement healthy changes within communities, while ensuring that research and interventions echo diverse people's perceptions.
超重和肥胖是个体和环境因素相互作用的结果，这些因素会影响身体活动和健康饮食。然而，人们对这些因素的看法却鲜有报道。为了解决这一关键差距和社区合作伙伴的需求，本研究探讨了人们如何感知微观和宏观环境因素对身体活动和健康饮食的影响。
社区合作伙伴希望研究结果以一种易于当地决策者使用的格式呈现。我们使用影像叙事法（photovoice）让来自加拿大艾伯塔省四个城市的 35 名社区成员参与其中，分享他们关于身体活动和健康饮食的叙述。我们采用归纳和演绎分析相结合的方法，根据肥胖相关环境分析框架（Analysis Grid for Environments Linked to Obesity Framework），按环境层面（微观与宏观）和类型（物理、政治、经济和社会文化）对数据进行分类。
参与者将影响健康的因素概念化得更为广泛，不仅包括身体活动和健康饮食，还包括“社区社会健康”。与宏观环境相比（n = 93），参与者更频繁地谈到微观环境（n = 792 ANGELO 框架编码总计）对他们的身体活动、健康饮食和社区社会健康的影响。影像叙事法的结果为社区合作伙伴和决策者提供了一个关于人们做出健康选择的能力如何受到其无法控制的宏观环境力量限制的直观描述。
未来的研究集中在宏观和微观环境影响以及本地化的社区社会健康方面，可以通过提供在社区内实施健康变革的策略来为实践提供信息，同时确保研究和干预措施反映不同人群的看法。
