Wang Youfa, Yan Alice Fang, Shi Xinyu, Wang Huijun, Wang Zhiyong, Gittelsohn Joel, Xu Fei
Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. Email:
Community and Behavioral Health Promotion, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, USA.
Asia Pac J Clin Nutr. 2017;26(5):888-898. doi: 10.6133/apjcn.112016.01.
Obesity has become a global epidemic. In China, 42% of adults and about onefifth of children are overweight or obese. In major cities, about one-third of boys are overweight or obese. This study aimed to understand how children and parents in China make eating and physical activity (PA) decisions, considering individual, family, community, social, and environmental factors, and to collect parents' recommendations for interventions to promote healthy eating and physical activity.
Children (n=41, aged 10-15 years) and their parents (n=41) participated in eight semi-structured focus groups (FGs) in Beijing (in North China) and Nanjing (South China). Each site conducted two FGs with children and two FGs with parents. A framework analysis of FG data was conducted with NVivo.
Three main themes were identified: Children chose food based on flavor, and consumption of unhealthy snacks was prevalent; there were inconsistent standards and practices of school lunch services across schools; students had limited PA time due to academic demand. Students favored high-calorie snacks over fruits or vegetables. Students' and parents' perceptions of school lunch services varied among schools in terms of operation, price, quality, nutritious options, and food taste. Most students reported enjoying PA but spent little time in PA, due to study burdens. Parents made recommendations for improving school food services and increasing PA during and after school.
These findings will help develop family- and school-targeted health promotion interventions. Intervention framing must consider the unique Chinese social and cultural context.
肥胖已成为全球性的流行病。在中国，42%的成年人以及约五分之一的儿童超重或肥胖。在大城市，约三分之一的男孩超重或肥胖。本研究旨在了解中国的儿童和家长如何做出饮食及身体活动（PA）决策，考虑个体、家庭、社区、社会及环境因素，并收集家长对促进健康饮食和身体活动干预措施的建议。
儿童（n = 41，年龄10 - 15岁）及其家长（n = 41）参与了在北京（中国北方）和南京（中国南方）举行的八个半结构化焦点小组（FGs）。每个地点针对儿童进行了两个焦点小组讨论，针对家长也进行了两个焦点小组讨论。使用NVivo对焦点小组数据进行了框架分析。
确定了三个主要主题：儿童根据口味选择食物，不健康零食的消费很普遍；各学校的学校午餐服务标准和做法不一致；由于学业需求，学生的身体活动时间有限。学生更喜欢高热量零食而非水果或蔬菜。学生和家长对学校午餐服务的看法在不同学校之间在运营、价格、质量、营养选择和食物口味方面存在差异。大多数学生表示喜欢身体活动，但由于学习负担，花在身体活动上的时间很少。家长对改善学校食品服务以及增加在校期间和放学后的身体活动提出了建议。
这些发现将有助于制定针对家庭和学校的健康促进干预措施。干预框架必须考虑独特的中国社会和文化背景。
