Perceptions of Health among Latinx and Mexican Young Children in San Luis Potosí, Mexico and Illinois, United States: A Qualitative Study Público

Abstract

Background: Childhood obesity remains a critical global health issue that has been steadily increasing within the last 30 years. Although multiple interventions and programs have been implemented to limit the development of childhood obesity, most have failed. The failure of these programs is often attributable to the lack of engagement with the populations targeted. To increase the population’s engagement, it is recommended to understand their motivations, barriers of implementation, and overall perceptions of health. Yet, little is known about perceptions of health among young children, in particular children from Latinx/Mexican background, who are at disproportionately higher risk for early childhood obesity.

Goal: This qualitative study aimed to identify the perceptions of health related to nutrition and physical activity of Latinx/Mexican children ages 4 – 6 in Mexico and the United States. Bandura’s Social Learning Theory was used as a guiding framework to understand the reciprocal determinism factors and identify the cognitive, environmental, and behavioral influences that inform overall children’s perceptions of health.

Methods: Mexican children in San Luis Potosi, Mexico and Latinx children in Champaign, Illinois, United States, were recruited as part of the Holistic Obesity Prevention Study (HOPS). In total, 12 Mexican children and 12 Latinx children were interviewed. Verbatim transcripts of the semi-structured interviews (n = 24) were analyzed as secondary de-identified data. Key themes of perceptions of health were identified through thematic analysis. Relational analysis of individual codes was categorized using reciprocal determinism factors of the Social Learning Theory.

Results: Four themes were identified: (1) differentiation among self/child and adults, (2) social interactions with others, (3) differences between healthy and unhealthy behaviors and habits, and (4) importance of preferences. We found that all reciprocal determinism factors were present, however, the environmental factor in the perceptions of health in Latinx/Mexican children was the most prominent.

Conclusion: Findings establishes that the environment is a key contributor—more than cognitive/personal and behavioral factors—to Latinx and Mexican children’s perceptions of health. These findings highlight the importance of the environment and emphasize the need to consider the context when developing childhood obesity primordial prevention programs geared to improve the health of Latinx/Mexican children.

Table of Contents

Chapter I: Introduction 1

1.1 Introduction and Rationale 1

1.2 Problem Statement 1

1.3 Purpose Statement 3

1.4 Significance Statement 4

1.5 Definition of Terms 4

Chapter II: Literature Review 6

2.1 Introduction 6

2.2 Obesity among Latinx and Mexican Population 6

2.3 Early Life as a Critical Window in Childhood Obesity 8

2.4 Systematic Reviews on Obesity Prevention 10

2.5 Existing Perceptions of Health Among Latinx and Mexican children and Adolescents 11

2.6 Social Constructivism Theory and Social Learning Theory 13

2.6a Social Learning Theory in Obesity Prevention 14

2.7 Social Learning Theory in the Childhood Obesity Literature 14

2.8 Conclusion and Study Aims 16

Chapter III: Methods 17

3.1 Study Design 17

3.2 Recruitment and Eligibility 17

3.3 Data Collection Procedures 18

3.4 Theoretical Framework 18

3.5 Data Analysis 19

3.6 Reflexivity 20

Chapter IV: Results 21

4.1 Thematic Analysis on Perceptions of Health 21

4.1a Differentiation among self/child and adults 21

4.1b Social Interaction with Others 23

4.1c Differences between Health and Unhealthy Behaviors and Habits 25

4.1d Importance of Preferences 28

4.2 Relational Analysis on Reciprocal Determinism Factors 28

4.2a Reciprocal Determinism Factors Identified in Individual Codes 28

4.2b Relationship between Reciprocal Determinism Factors 29

Chapter V: Discussion 30

5.1 Overall Findings 30

5.2 Environmental Factor in Perceptions of Health 30

5.3 Latinx/Mexican Children’s Perceptions of Health 31

5.4 Strengthens and Limitations   32

Chapter V1: Public Health Implications 33

References 34

Table 1: Codes, Code Description and Frequency of the Codebook 42

Table 2: Codes and Their Corresponding Reciprocal Determinism Factor(s) 44

Table 3: Subthemes, Codes, and Direction Quotations for The Theme – Differentiation Among Self/Child and Adults   45

Table 4: Subthemes, Codes, and Direction Quotations for The Theme – Social Interaction with Others 46

Table 5: Subthemes, Codes, and Direction Quotations for The Theme - Differences between Health and Unhealthy Behaviors and Habits 47

Figure 1: Relational Analysis of Reciprocal Determinism Factors 48

Appendix A: HOPS Interview Guide   49

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	qualitative health perceptions child health development
Committee Chair / Thesis Advisor	Liliana Aguayo, Emory University

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