Ecological Factors and Strategies for Childhood Obesity Prevention Targeting Vulnerable Children: Using Community-Based Participatory Research

Purpose: This study aimed to explore ecological factors and strategies for childhood obesity prevention targeting vulnerable children using a community-based participatory research (CBPR) methodology. Methods: The CBPR was conducted by following basic process steps. Participants were 12 community stakeholders such as community child center directors (n=4), vulnerable children's mothers (n=3), community health center officials (n=2), and lay health advisors (n=4); they were purposively sampled from K municipal county in Seoul, South Korea. The qualitative content analysis was performed to explore main themes of the ecological factors and strategies by using data obtained from 5 times of focus group interview. Results: Twelve ecological factors associated with childhood obesity prevention were identified: Intrapersonal factors including emotional overeating; interpersonal factors including permissive parenting style of children's eating behaviors; organizational factors including social workers' less educational opportunities; and community/policy factors including less government financial support. Four ecological strategies for childhood obesity prevention were addressed: Developing obesity prevention programs targeting vulnerable children' lifestyles; promoting parents' active participation in education; building healthy meal service environments through empowering social workers; and building supportive community environment and securing community resources for child obesity prevention. Conclusion: Our findings may be informative in terms of providing a comprehensive understanding of multi-level ecological barriers against vulnerable children' obesity prevention and, moreover, guiding multi-level strategies for preventing childhood obesity targeting children enrolled in community child centers.