Abstract

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 (N = 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.

 抽象的

过去25年来，美国成人肥胖率增加了70%，肥胖给非裔美国人带来了不成比例的慢性疾病负担。本研究采用 Photovoice 方法，旨在：(1) 从阿拉巴马州伯明翰两个种族隔离程度不同的低收入城市居民的角度探讨导致肥胖的社会决定因素，(2) 更好地了解居民对肥胖贡献者的看法(3) 调查居民对可能有效促进积极变化的干预措施的看法。按种族和社区划分的焦点小组 ( N = 10) 由训练有素的主持人主持。通过理论主题分析对转录进行分析。研究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。这项研究的结果支持了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，快餐店和不安全的步行条件等建筑环境因素导致了肥胖，学校和教堂应在解决这一问题中发挥积极作用。