OP24 Eliciting children’s perceptions and experiences of health, diet, physical activity and weight through the draw, write and tell technique
Existing research exploring determinants of childhood obesity tends to overlook the experiential, contextual and cultural basis of such determinants, and lacks methodological features that support children’s own framing of issues around obesity. This study aimed to explore children’s perceptions and experiences of health, diet, physical activity and weight, with a focus on culture-specific contextual factors that may give rise to childhood obesity, in an ethnically diverse sample.
Children aged 9–10 years were recruited from primary schools in Coventry, UK, with purposive sampling of schools to ensure an ethnically diverse sample. Data were collected through a ‘draw, write and tell technique’ using semi-structured one-to-one interviews at school. Images, text and transcripts were analysed using a thematic framework approach, with themes reviewed and mapped against existing ecological models of health behaviours.
To date, six of fifteen invited schools agreed to participate, with 27 children (girls n=16) successfully recruited from three schools, all of which lived in areas of high deprivation, with 81% from minority ethnic groups. Recruitment is on-going to allow for data collection with children from ethnic groups currently under-represented in the sample. Preliminary analysis has identified seven over-arching themes: knowledge, understanding, beliefs, values, motivations, intentions and group-specific experiences. Children had a grasp of the fundamental elements of a healthy diet, physical activity and maintaining a healthy weight but understandings were simplistic and often contradictory. Children viewed health as a personal responsibility, attributed to will-power, but often described external factors affecting their own ability to be healthy e.g. social pressures to indulge and permissive parenting. Positive and negative personal characteristics were assigned to others on the basis of healthfulness and weight. Key motivations for health behaviours were avoidance of the negative social consequences of being overweight, personal success and happiness. Boys and girls differed in their perception of a healthy aesthetic, but culture-specific experiences were largely absent from the data.
The findings suggest that childhood obesity interventions could focus on the existing assets that children describe, such as friendships and supportive family environments; emphasising health benefits framed by child-based motivations e.g. personal success and happiness. The lack of culture-specific experiences in children’s accounts is inconsistent with other research in ethnically diverse child populations, which may be attributable to the methods used or lack of representation of some ethnic groups. Use of the draw, write and tell technique allowed the research to be child-led, supporting children’s own framing of issues.