Bateman Lori Brand, Simoni Zachary R, Oates Gabriela R, Hansen Barbara, Fouad Mona N
School of Medicine, Division of Preventive Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Sociology, The University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA.
Sociol Spectr. 2019;39(6):405-423. doi: 10.1080/02732173.2019.1704327. Epub 2020 Jan 6.
Over the past 25 years, the adult obesity rate in the U.S. has increased 70%, with obesity placing a disproportionate chronic disease burden on African Americans. Using Photovoice methodology, this study aimed to: (1) explore the social determinants contributing to obesity from the perspectives of residents of two low-income municipalities in Birmingham, Alabama with varying levels of segregation, (2) better understand residents' perceptions of contributors to obesity in their communities, and (3) examine residents' perceptions of interventions that might be effective in promoting positive change. Focus groups (=10) segmented by race and community were conducted by trained moderators. Transcriptions were analyzed by theoretical thematic analysis. The study design and data analysis analyses were guided by a conceptual framework based on the Social Determinants of Obesity model. Findings from this study lend support to the efficacy of the conceptual framework as a multilevel approach describing obesity disparities in the south. Regardless of community and race, participants believed that elements of their built environment, such as fast food restaurants and unsafe walking conditions, contributed to obesity, and that schools and churches should play an active role in addressing the issue.
在过去25年里，美国成年人肥胖率增长了70%，肥胖给非裔美国人带来了不成比例的慢性病负担。本研究采用照片声音法，旨在：（1）从阿拉巴马州伯明翰市两个隔离程度不同的低收入自治市居民的角度，探讨导致肥胖的社会决定因素；（2）更好地了解居民对其社区肥胖成因的看法；（3）研究居民对可能有效促进积极变化的干预措施的看法。由训练有素的主持人组织了按种族和社区划分的焦点小组（共10个）。通过理论主题分析对转录内容进行分析。本研究的设计和数据分析以基于肥胖社会决定因素模型的概念框架为指导。本研究结果支持了该概念框架作为描述南方肥胖差异的多层次方法的有效性。无论社区和种族如何，参与者都认为他们所处的建筑环境因素，如快餐店和不安全的步行条件，导致了肥胖，并且学校和教会应该在解决这个问题上发挥积极作用。
