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家庭内健康两极分化:在有学龄前儿童和肥胖初现的家庭中,多样化的健康关注点如何成为健康行为改变的障碍。

Intra-familial health polarisation: how diverse health concerns become barriers to health behaviour change in families with preschool children and emerging obesity.

机构信息

Department of Health Promotion, Steno Diabetes Centre Copenhagen, Gentofte, Denmark.

Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark.

出版信息

Sociol Health Illn. 2020 Jul;42(6):1243-1258. doi: 10.1111/1467-9566.13091. Epub 2020 Apr 18.

DOI:10.1111/1467-9566.13091
PMID:32304261
Abstract

In a disadvantaged rural area in Denmark, severe challenges have been identified concerning overweight and obesity in families with preschool-age children. The present paper examines how families with young children and emerging obesity issues perceive 'healthy living' and barriers to practising it. Using data from qualitative workshops with families and professionals working with them, we reveal health perceptions and related family dynamics. Drawing on P. Bourdieu's theory of habitus and 'tastes of necessity', K.L. Frohlich et al.'s notion of 'collective lifestyles' and E. Lindbladh and C. H. Lyttken's theory of preconditions for health behaviour change and reactions to risk-related information, we analyse how risk perceptions and related health practices within the families are influenced by the local contexts in the disadvantaged area under study. Despite shared perceptions of 'healthy living', we found that diverse health-risk perceptions created family dynamics in which parents performed opposed health behaviours, which became a huge barrier to becoming a healthier family. Based on our theoretical approach, we propose that risk perceptions and reactions are highly context dependent, as illustrated in both micro-contexts (family dynamics) and the macro-context (the disadvantaged area).

摘要

在丹麦一个贫困的农村地区,学龄前儿童家庭的超重和肥胖问题已经成为严重的挑战。本文探讨了有年幼子女且面临肥胖问题的家庭如何看待“健康生活”以及实践健康生活的障碍。我们利用来自与家庭和从事相关工作的专业人员开展的定性研讨会的数据,揭示了健康观念和相关的家庭动态。借鉴 P. Bourdieu 的习惯和“必需品的品味”理论、K.L. Frohlich 等人的“集体生活方式”概念以及 E. Lindbladh 和 C. H. Lyttken 的健康行为改变的前提条件和对与风险相关信息的反应理论,我们分析了在研究的贫困地区的当地背景下,家庭内部的风险感知和相关健康实践是如何受到影响的。尽管对“健康生活”有着共同的认识,但我们发现,不同的健康风险感知导致了父母表现出相反的健康行为的家庭动态,这成为了家庭变得更健康的巨大障碍。基于我们的理论方法,我们提出风险感知和反应高度依赖于情境,这在微观情境(家庭动态)和宏观情境(贫困地区)中都得到了体现。

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