Hoeeg Didde, Frohlich Katherine L, Christensen Ulla, Grabowski Dan
Department of Health Promotion, Steno Diabetes Centre Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark.
École de Santé Publique & CRESP, Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3C 3J7, Canada.
Children (Basel). 2023 Sep 23;10(10):1590. doi: 10.3390/children10101590.
It is well established that overweight and obesity are often accompanied by stigmatization. However, the influence of stigmatization on interventions for overweight and obesity remains unknown. Stigma may be particularly harmful to children. This study aimed to examine how stigmatization affects efforts to reduce childhood overweight and obesity through family interventions. This research was conducted in a socially disadvantaged area in Denmark. Twenty-seven families and forty professionals participated in in-depth interviews or workshops. The data were analyzed using CMO configurations from a realist evaluation and the theory of stigmatization developed by Link and Phelan. Thus, an abductive approach was employed in the analysis, with its foundation rooted in the empirical data. The study found that the mechanisms of stigmatization could 1. restrain professionals and parents from approaching the problem-thereby challenging family recruitment; 2. prevent parents from working with their children to avoid eating unhealthy food for fear of labeling the child as overweight or obese; and 3. cause children with obesity to experience a separation from other slimmer family members, leading at times to status loss, discrimination, and self-stigmatization. The study showed how the mechanisms of stigmatization may obstruct prevention and treatment of childhood obesity through family interventions. It is suggested that the concept of stigma should be incorporated into the program theories of interventions meant to reduce childhood overweight and obesity.
众所周知，超重和肥胖常常伴随着污名化。然而，污名化对超重和肥胖干预措施的影响尚不清楚。污名化可能对儿童尤其有害。本研究旨在探讨污名化如何通过家庭干预影响减少儿童超重和肥胖的努力。这项研究在丹麦一个社会弱势地区进行。27个家庭和40名专业人员参与了深入访谈或研讨会。使用来自现实主义评价的CMO配置以及Link和Phelan提出的污名化理论对数据进行了分析。因此，在分析中采用了溯因法，其基础扎根于实证数据。研究发现，污名化机制可能：1. 限制专业人员和家长解决问题——从而对家庭招募构成挑战；2. 阻止家长与孩子合作以避免食用不健康食品，因为担心给孩子贴上超重或肥胖的标签；3. 导致肥胖儿童与其他较瘦的家庭成员产生隔阂，有时会导致地位丧失、歧视和自我污名化。该研究表明了污名化机制如何可能通过家庭干预阻碍儿童肥胖的预防和治疗。建议将污名化概念纳入旨在减少儿童超重和肥胖的干预措施的项目理论中。
