How Social and Physical Environments Influence Obesity: A Qualitative Study of Youth in South Korea

Background: Environmental factors may contribute to the increased obesity prevalence in South Korean children. Valid and reliable instruments are needed to document key environmental factors, and their influence on health behaviors.

Methods: In-depth interviews and focus groups with 9 parents, 16 teachers, and 3 children (4th~7th graders, all boys) were conducted (21 interviews and 2 focus groups). Participants were purposively selected from metropolitan areas of South Korea. Recorded interviews were transcribed and coded using Atlas-ti (Ver 6.0), and analyzed using Framework Analysis.

Results: Main themes that emerged were: 1) home environments (e.g. what is available at home) and exposure to healthy foods at an early age by other family members (e.g. grand parents) are the most important factors in having healthy eating habits among youth, 2) families with working mothers tend to eat out more often than families with stay-at-home mothers, 3) easy access to street foods, unhealthy foods at stores in and outside of schools are very common among older children, 4) poor physical and social environments prevent teens from being physically active (e.g. small playground, emphasis on academic achievement), 5) lack of nutrition education in elementary schools results in low vegetable intake at school lunch. The above information is included in the instruments that are being developed to measure social and physical environments.

Policy implications: Future studies that utilize the environmental assessment instruments can suggest new policy initiatives that attempt to modify obesity-related behaviors through changes in social and physical environments.