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英格兰黑人和亚裔少数族裔父母对儿童肥胖和合并症的看法和经验:一项定性研究。

Childhood obesity and comorbidities-related perspective and experience of parents from Black and Asian minority ethnicities in England: a qualitative study.

机构信息

School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom.

James Cook University Hospital, South Tees Hospital Trusts, Middlesbrough, United Kingdom.

出版信息

Front Public Health. 2024 Aug 5;12:1399276. doi: 10.3389/fpubh.2024.1399276. eCollection 2024.

DOI:10.3389/fpubh.2024.1399276
PMID:39175897
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11340680/
Abstract

BACKGROUND

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualized factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority populations.

METHODS

Following ethical approval, families ( = 180) from ethnic minority populations in the Northeast of England were contacted through flyers, community social groups and online forum. Of the 180 families contacted, 22 expressed interests, of whom 12 parents were eligible to participate in the study, and one family dropped out due to time constraints. Therefore 11 parents from ethnic minority communities living with at least one child with obesity were interviewed. Each family was separately visited at home and took part in a semi-structured interview based on the study's qualitative, descriptive phenomenological design. Nine of the families had one child who was diagnosed with an obesity-related comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems or respiratory disorder). Semi-structured interviews were standardized around parents' perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity impact on their lives. All interviews were analyzed using qualitative thematic analysis.

RESULTS

Parents' perspectives revealed 11 themes centered around experience of living with a child with obesity, risks, and impact of obesity related Non-Communicable Diseases; and access to support, and barriers unique to minority ethnic groups. Parents revealed social disadvantages, fear of victimization by social services, perceptions on their cultural and religious traditions, and racial stigmatization related to their child's weight. Parents reported closer bonding with their children to protect them from the untoward consequences of overweight, and little awareness of healthcare obesity prevention programs. Work pressure, lack of time, absence of guidance from professionals were seen as barriers to healthy lifestyle, while support from friends and closer family bond in adopting healthy lifestyle behaviors were facilitators. However, there was little awareness or access to current healthcare obesity preventive offerings.

CONCLUSION

Minority ethnic communities' perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle interventions are needed beyond those administered by the primary healthcare system.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e5c/11340680/576fdb6078b9/fpubh-12-1399276-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e5c/11340680/be91d1f653af/fpubh-12-1399276-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e5c/11340680/576fdb6078b9/fpubh-12-1399276-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e5c/11340680/be91d1f653af/fpubh-12-1399276-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e5c/11340680/576fdb6078b9/fpubh-12-1399276-g002.jpg

背景

少数民族群体在医疗保健方面的不平等往往阻碍了儿童肥胖症及其相关合并症的预防。本研究从少数民族群体家长的角度和经验出发,了解影响儿童肥胖症和相关合并症的因素。

方法

在获得伦理批准后,通过传单、社区社会团体和在线论坛联系了英格兰东北部少数民族群体的家庭。在联系的 180 个家庭中,有 22 个表示有兴趣,其中 12 个家长有资格参加研究,有一个家庭因时间限制而退出。因此,采访了 11 名来自少数民族社区的家长,他们至少有一个孩子患有肥胖症。每个家庭都在家中单独接受采访,并根据研究的定性、描述性现象学设计进行半结构化访谈。其中 9 个家庭有一个孩子被诊断出患有肥胖相关的合并症(非酒精性脂肪肝、肌肉骨骼问题或呼吸障碍)。半结构化访谈以家长对孩子肥胖及其合并症的影响、包括生活方式体力活动和营养在内的预防干预措施以及解决肥胖对他们生活影响的看法为重点。所有访谈均采用定性主题分析进行分析。

结果

家长的观点揭示了 11 个主题,围绕着与肥胖儿童一起生活的经历、肥胖相关非传染性疾病的风险和影响,以及少数民族群体特有的获得支持和障碍。家长们揭示了社会劣势、对社会服务的恐惧、对他们的文化和宗教传统的看法,以及与孩子体重相关的种族污名化。家长们报告说,他们与孩子更亲近,以保护他们免受超重的不利影响,对医疗保健肥胖预防计划的认识很少。工作压力、缺乏时间、缺乏专业人员的指导被视为健康生活方式的障碍,而来自朋友和更亲密家庭的支持在采用健康生活方式行为方面则是促进因素。然而,他们对当前医疗保健肥胖预防产品的认识或获得很少。

结论

少数民族群体对儿童肥胖预防的看法与医疗保健系统的预防措施不一致。需要针对少数民族群体开展社区和家庭为导向的肥胖预防方法,特别是生活方式干预,而不仅仅是初级保健系统提供的干预方法。

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