Caregiver Perceptions of Environmental Facilitators and Barriers to Healthy Eating and Active Living during the Summer: Results from the Project SWEAT Sub-Study

Abstract

Objective: The aim of this study was to examine caregiver perceptions of summertime neighborhood-level environmental barriers and facilitators to healthy eating and active living in their elementary-age racial minority children. Methods: Caregivers with students in the prekindergarten–fifth grade were recruited from two schools located in low-income urban neighborhoods of Columbus, OH, with a predominantly Black population. Participants engaged in the research portion of the Healthy Eating Active Living: Mapping Attribute using Participatory Photographic Surveys (HEALth MAPPSTM) protocol, which included (1) orientation; (2) photographing and geotagging facilitators and barriers to HEALth on daily routes; (3) in-depth interview (IDI) discussing images and routes taken; (4) focus groups (FG). IDIs and FGs were transcribed verbatim. Analyses were guided by grounded theory and interpretive phenomenology and were coded by researchers (n = 3), who used comparative analysis to develop a codebook and determine major themes. Results: A total of 10 caregivers enrolled and 9 completed the IDIs. Five caregivers participated in focus groups. A majority (77.8%, n = 7) of caregivers identified as Black, female (88.9%, n = 8), and low income (55.6%, n = 5). IDI and FG themes included (1) walkway infrastructure crucial for healthy eating and active living; (2) scarce accessibility to healthy, affordable foods; (3) multiple abandoned properties; (4) unsafe activity near common neighborhood routes. Conclusions: Caregivers perceived multiple neighborhood-level barriers to healthy eating and activity during the summer months when school is closed. Findings from this study provide initial insights into environmental determinants of unhealthy summer weight gain in a sample of predominantly racial minority school-age children from low-income households.

Citizen science approaches to crowdsourcing food environment data: A scoping review of the literature

“…Most studies had a majority of female participants (58%) and 69% of studies crowdsourced food environment data by engaging priority populations (i.e., those that experience social and/or economic exclusion). This included 14 studies engaging citizens with low incomes, [27][28][29][30][31]33,40,42,44,[53][54][55][56]60 12 engaging children (<18 years), [27][28][29][30][31]37,42,48,60,61 eight engaging residents in rural areas, 19,26,34,35,39,40,43,46 three engaging First Nations/tribal populations, 47,49,58 three engaging African American population, 31,35,42 three engaging older adults, 18,53,56 and one engaging migrant populations. 51 Most studies engaged external stakeholders to assist with the recruitment of participants (87%).…”

“…51 Most studies engaged external stakeholders to assist with the recruitment of participants (87%). Eleven engaged community partners 19,26,29,35,36,44,48,50,[54][55][56] ; nine recruited participants from schools 24,27,28,30,31,37,[60][61][62] ; seven utilized existing study samples 33,38,40,42,49,52,53 ; five created relationships with community champions and stakeholders 39,41,43,46,51 ; and four worked with external collaborators (e.g., a health insurance company). 25,[57][58][59] Only five studies utilized traditional methods such as phone calls or flyers.…”

“…18,32,34,45,47 Thirty-two of the studies involved training participants to complete the study. Twenty-two of these studies had one training session, 18,19,24,25,[29][30][31][32][33][36][37][38]40,45,47,[49][50][51]56,61 with seven of these studies conducting one-on-one training and the remaining employing either group or digital training. 18,19,33,37,38,56,61 Fifteen studies involved training participants over two to six sessions.…”

“…Photovoice 64 was the most popular method of doing this (n = 25 studies), [26][27][28][29][30][31][32][33][34][35][36][37]42,[45][46][47][48][49][51][52][53][54][55]58,60 followed by the "Our Voice" Discovery Tool 65 developed by Stanford University (n = 5 studies), 18,19,38,56,61 and the HEALMAPPS 66 (n = 4 studies). [39][40][41]43 Photovoice Photovoice is a visual community participatory action method that enables participants to autonomously capture images and reflect on the strengths and concerns within their community. 64 Photovoice enables individuals' perspectives and voices to be represented through images, often capturing the voices of people experiencing disadvantage.…”

“…The HEALMAPPS tool was created to organize the communities to identify assets and barriers to healthy eating through photomapping, group decision making and mobilizing community conversation and action. [39][40][41]43 Between nine and 33 community members collected images of barriers and facilitators to accessing healthy foods in their community. [39][40][41]43 All four studies indicated that the availability of healthy food was low, [39][40][41]43 particularly in school environments where sugary snacks and beverages are readily available.…”