A qualitative examination of home and neighborhood environments for obesity prevention in rural adults. International Journal of Behavioral Nutrition and Physical Activity, 5, 65

Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
International Journal of Behavioral Nutrition and Physical Activity (Impact Factor: 4.11). 01/2009; 5(1):65. DOI: 10.1186/1479-5868-5-65
Source: PubMed


The home and neighborhood environments may be important in obesity prevention by virtue of food availability, food preparation, cues and opportunities for physical activity, and family support. To date, little research has examined how home and neighborhood environments in rural communities may support or hinder healthy eating and physical activity. This paper reports characteristics of rural homes and neighborhoods related to physical activity environments, availability of healthy foods, and family support for physical activity and maintaining an ideal body weight.
In-depth interviews were conducted with 60 African American and White adults over 50 years of age in two rural counties in Southwest Georgia. Interviews were transcribed verbatim and coded independently by two members of the research team using standard methods of qualitative analysis. Themes were then identified and data matrices were used to identify patterns by gender or race.
Neighborhood features that supported physical activity were plenty of land, minimal traffic and living in a safe and friendly neighborhood. The major barrier was lack of recreational facilities. The majority of participants were not physically active with their family members due to schedule conflicts and lack of time. Family member-initiated efforts to encourage physical activity met with mixed results, with refusals, procrastination, and increased activity all reported. Participants generally reported it was easy to get healthy foods, although cost barriers and the need to drive to a larger town for a supermarket with good variety were noted as obstacles. Family conversations about weight had occurred for about half of the participants, with reactions ranging from agreement about the need to lose weight to frustration.
This study suggests that successful environmental change strategies to promote physical activity and healthy eating in rural neighborhoods may differ from those used in urban neighborhoods. The findings also provide insight into the complexities of family support for physical activity and maintaining a healthy weight. Addressing socio-ecologic factors has the potential to increase healthy behaviors and decrease the prevalence of obesity among rural residents.

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    • "Extensive research was conducted on obesity but their findings have been contradictory, and there is no single effective approach in maintaining long-term weight control.[13] It is important to work with obese people from where they are, and it is important to know how they feel and want and how they are interacting in different scenarios to set achievable and realistic goals.[1415] "
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    ABSTRACT: Since weight management is affected by various factors, including social and behavioral ones, this study aimed to explore the peoples' experience of barriers and facilitators of weight management. This qualitative content analysis was conducted as the initial step of TABASSOM Study. Participants, who tried to reduce their weight at least once, were selected by purposeful sampling method from aerobic fitness clubs, parks, and public offices in Isfahan in 2010. Data saturation was reached after indepth unstructured interviews with 11 participants. Data analysis was done by conventional content analysis method. The participants have intermittently followed weight loss program. Barriers such as physical problems, lack of motivation, lack of work and family support and lack of time have resulted in their failures and outages. The main facilitator to start or restart after stopping such programs for a while was positive psychologic effect. Findings showed that many problems could prevent weight loss. It is important to identify obstacles that hinder weight management and regimen programs and to discuss them with people before planning for their weight management.
    Iranian journal of nursing and midwifery research 03/2012; 17(3):205-10.
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    • "Other studies in urban environments have documented the association of obesity with neighborhood deprivation and access to fast food retailers [30,45] or examined the spatial patterns of both supermarkets and fast food and/or convenience store locations in the context of nutrition and obesity [15,21,22,29]. Studies of food environments in rural areas have become more common recently, and they have also focused on specific local communities and regions, [9,24,34-38,41]. As a result, it is difficult to generalize their results beyond the local study areas. "
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    ABSTRACT: Limited access to supermarkets may reduce consumption of healthy foods, resulting in poor nutrition and increased prevalence of obesity. Most studies have focused on accessibility of supermarkets in specific urban settings or localized rural communities. Less is known, however, about how supermarket accessibility is associated with obesity and healthy diet at the national level and how these associations differ in urban versus rural settings. We analyzed data on obesity and fruit and vegetable (F/V) consumption from the Behavioral Risk Factor Surveillance System for 2000-2006 at the county level. We used 2006 Census Zip Code Business Patterns data to compute population-weighted mean distance to supermarket at the county level for different sizes of supermarket. Multilevel logistic regression models were developed to test whether population-weighted mean distance to supermarket was associated with both obesity and F/V consumption and to determine whether these relationships varied for urban (metropolitan) versus rural (nonmetropolitan) areas. Distance to supermarket was greater in nonmetropolitan than in metropolitan areas. The odds of obesity increased and odds of consuming F/V five times or more per day decreased as distance to supermarket increased in metropolitan areas for most store size categories. In nonmetropolitan areas, however, distance to supermarket had no associations with obesity or F/V consumption for all supermarket size categories. Obesity prevalence increased and F/V consumption decreased with increasing distance to supermarket in metropolitan areas, but not in nonmetropolitan areas. These results suggest that there may be a threshold distance in nonmetropolitan areas beyond which distance to supermarket no longer impacts obesity and F/V consumption. In addition, obesity and food environments in nonmetropolitan areas are likely driven by a more complex set of social, cultural, and physical factors than a single measure of supermarket accessibility. Future research should attempt to more precisely quantify the availability and affordability of foods in nonmetropolitan areas and consider alternative sources of healthy foods besides supermarkets.
    International Journal of Health Geographics 10/2010; 9(1):49. DOI:10.1186/1476-072X-9-49 · 2.62 Impact Factor
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    • "With limited-item or comprehensive household food inventories (HFIs), most researchers document household availability at a single point in time [20,22,40,43,54,57,62,63]. However, a single HFI is unable to address intra-household variation during the month in food resources, which may be influenced by weekly or bi-weekly shopping trips, economics (e.g., income cycles), demands of work outside the home, household refrigeration and storage, family events such as celebrations or family traumas and emotional events, bouts of acute illness, transformations in domicile, and food store access [64-66]. The intra-month variation in household availability may be a key factor in food intake. "
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    ABSTRACT: It has been recognized that the availability of foods in the home are important to nutritional health, and may influence the dietary behavior of children, adolescents, and adults. It is therefore important to understand food choices in the context of the household setting. Considering their importance, the measurement of household food resources becomes critical.Because most studies use a single point of data collection to determine the types of foods that are present in the home, which can miss the change in availability within a month and when resources are not available, the primary objective of this pilot study was to examine the feasibility and value of conducting weekly in-home assessments of household food resources over the course of one month among low-income Mexicano families in Texas colonias. We conducted five in-home household food inventories over a thirty-day period in a small convenience sample; determined the frequency that food items were present in the participating households; and compared a one-time measurement with multiple measurements.After the development and pre-testing of the 252-item culturally and linguistically- appropriate household food inventory instrument that used direct observation to determine the presence and amount of food and beverage items in the home (refrigerator, freezer, pantry, elsewhere), two trained promotoras recruited a convenience sample of 6 households; administered a baseline questionnaire (personal info, shopping habits, and food security); conducted 5 in-home assessments (7-day interval) over a 30-day period; and documented grocery shopping and other food-related activities within the previous week of each in-home assessment. All data were collected in Spanish. Descriptive statistics were calculated for mean and frequency of sample characteristics, food-related activities, food security, and the presence of individual food items. Due to the small sample size of the pilot data, the Friedman Test and Kendall's W were used to assess the consistency of household food supplies across multiple observations. Complete data were collected from all 6 Mexicano women (33.2y +/- 3.3; 6.5 +/- 1.5 adults/children in household (HH); 5 HH received weekly income; and all were food insecure. All households purchased groceries within a week of at least four of the five assessments. The weekly presence and amounts of fresh and processed fruits and vegetables, dairy, meats, breads, cereals, beverages, and oils and fats varied. Further, the results revealed the inadequacy of a one-time measurement of household food resources, compared with multiple measures. The first household food inventory as a one-time measure would have mistakenly identified at least one-half of the participant households without fresh fruit, canned vegetables, dairy, protein foods, grains, chips, and sugar-sweetened beverages. This study highlights the value of documenting weekly household food supplies, especially in households where income resources may be more volatile. Clearly, the data show that a single HFI may miss the changes in availability--presence and amount--that occur among low-income Mexicano households who face challenges that require frequent purchase of foods and beverages. Use of multiple household food inventories can inform the development and implementation of nutrition-related policies and culturally sensitive nutrition education programs.
    BMC Public Health 07/2010; 10(1):445. DOI:10.1186/1471-2458-10-445 · 2.26 Impact Factor
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