264710 Youth-generated policy recommendations regarding the urban nutrition and tobacco environments: Results from a photo-documentation study in Philadelphia

Monday, October 29, 2012

Elizabeth FitzGerald , University of Pennsylvania, Philadelphia, PA
Rosemary Frasso, PhD, MSc, CPH , Center for Public Health Initiatives, University of Pennsylvania School of Medicine, Philadelphia, PA
Lorraine Dean, ScD , Tobacco Policy and Control Program, Philadelphia Department of Public Health, Philadelphia, PA
Sara Solomon, MPH, RD, LDN , Nutrition and Physical Activity, Get Healthy Philly initiative, Philadelphia Department of Public Health, Philadelphia, PA
Terry Johnson , Philadelphia Department of Public Health, Philadelphia, PA
Giridhar Mallya, MD, MSHP , Policy and Planning, Philadelphia Department of Public Health, Philadelphia, PA
Sydney Axson , Public Health Program, University of Pennsylvania, Philadelphia, PA
Carolyn Cannuscio, ScD , Department of Family Medicine and Community Health, Philadelphia VAMC and University of Pennsylvania, Philadelphia, PA
INTRODUCTION: In 2010, 25.2% of Philadelphians smoked—the highest rate in any of the ten largest American cities—and 66.3% were overweight or obese. To address these health threats, the Philadelphia Department of Public Health and the Centers for Disease Control and Prevention launched Get Healthy Philly, an initiative focused on improving the city's tobacco and food environments. Here we report findings from one element of that initiative: a photo-documentation project engaging Philadelphia youth to understand their perspectives on unhealthy nutrition- and tobacco-related behaviors and relevant policy interventions. METHODS: With community based photography, study participants examined Philadelphia's food and tobacco environments. Using participant-generated photographs we conducted 20 photo-elicitation interviews with youth ages 15-18. Interviews were transcribed verbatim and analyzed using Nvivo9 software. RESULTS: Regarding nutrition, participants spontaneously articulated the need for policy change and intervention. However, participants suggested few tobacco-related interventions. Participants photographed and discussed nutrition-related health concerns over eight times more frequently than tobacco-related health concerns. DISCUSSION: Philadelphia youth were eager to discuss issues surrounding nutrition and the need for policy intervention. In comparison, they infrequently discussed tobacco and often did so only after interviewer prompting. This relative lack of emphasis on tobacco may reflect social desirability bias (smoking is illicit, stigmatized behavior among youth participants) or it may reflect that the youth are in the "pre-contemplation" stage described by the Transtheoretical model. Philadelphia youth may be primed and ready for change regarding nutrition but may not have yet considered tobacco prevention as an important personal or community health goal.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs

Learning Objectives:
1. Assess the value of community based photography and photo-elicitation interviewing for understanding community health concerns and developing appropriate policy solutions. 2. Explain urban youth perspectives on nutrition and tobacco environments.

Keywords: Nutrition, Tobacco

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a qualitative methodologist working with a team of experts in the content area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.