Research Centre for Health through Physical Activity, Lifestyle & Sport, Division of Physio-Logical Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.
Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
Int J Environ Res Public Health. 2022 Feb 14;19(4):2160. doi: 10.3390/ijerph19042160.
Overweight and obesity increase the risk of a range of poor physiological and psychosocial health outcomes. Previous work with well-defined cohorts has explored the determinants of obesity and employed various methods and measures; however, less is known on the broader societal drivers, beyond individual-level influences, using a systems framework with adolescents. The aim of this study was to explore the drivers of obesity from adolescents' perspectives using a systems approach through group model building in four South African schools. Group model building was used to generate 4 causal loop diagrams with 62 adolescents aged 16-18 years. These maps were merged into one final map, and the main themes were identified: (i) physical activity and social media use; (ii) physical activity, health-related morbidity, and socio-economic status; (iii) accessibility of unhealthy food and energy intake/body weight; (iv) psychological distress, body weight, and weight-related bullying; and (v) parental involvement and unhealthy food intake. Our study identified meaningful policy-relevant insights into the drivers of adolescent obesity, as described by the young people themselves in a South African context. This approach, both the process of construction and the final visualization, provides a basis for taking a novel approach to prevention and intervention recommendations for adolescent obesity.
超重和肥胖会增加一系列生理和心理社会健康不良后果的风险。先前对明确界定的队列进行的研究已经探讨了肥胖的决定因素，并采用了各种方法和措施；然而，利用系统框架并以青少年为研究对象，对除个人层面影响之外的更广泛的社会驱动因素了解较少。本研究旨在通过在南非的四所学校进行小组模型构建，从系统的角度探讨青少年肥胖的驱动因素。小组模型构建用于生成 4 张因果回路图，涉及 62 名 16-18 岁的青少年。这些地图被合并为一张最终地图，并确定了以下主要主题：（i）体育活动和社交媒体使用；（ii）体育活动、与健康相关的发病率和社会经济地位；（iii）不健康食品的可及性和能量摄入/体重；（iv）心理困扰、体重和与体重相关的欺凌；以及（v）父母参与和不健康的食物摄入。我们的研究从南非青少年的角度确定了对青少年肥胖驱动因素的有意义的政策相关见解。这种方法，无论是构建过程还是最终的可视化，都为青少年肥胖的预防和干预建议提供了一种新颖的方法。
