Qualitative analysis of diet, physical activity, and body image of children using focus groups and Photovoice and quantitative analysis of dietitians' perspectives on integrating sustainable agriculture into professional practice using survey methodology

This study explored the food, physical activity, and body image perspectives of low-income children living in urban Minnesota and dietitians' perceptions on including sustainable agriculture into their professional practice. The research was conducted in four phases. The first three phases used qualitative methodology and the Social Cognitive Theory (SCT) as the theoretical framework. For the first two phases of research, focus groups and Photovoice were conducted to gather information on children's food environments, dietary habits, and physical activity practices. The third phase explored low-income, African American and Native American children's perceptions on body image and body image assessment tools using focus groups and two body image assessment instruments. The fourth phase used quantitative methodology to investigate dietitians' perspectives on including sustainable agriculture in dietetics practice. The survey was informed using the Theory of Planned Behavior (TPB) and administered to registered dietitians in the U.S. Data analysis for the focus groups and interviews used the open coding method. Photographs were coded using a coding protocol that was developed and agreed upon by the two researchers. SPSS was used to analyze body dissatisfaction and the dietitian survey data. Analysis included descriptive statistics, independent t-tests, Pearson correlations, and stepwise regressions. Seven themes were identified across focus groups related to diet, health, and physical activity; four themes were identified from the food environment Photovoice data; and three themes from the physical activity Photovoice data. Three themes emerged from analysis of the body image focus groups. Quantitative data from the body image research revealed that obese and overweight children viewed themselves as healthy weight. Results of the survey with dietitians showed that all four TPB variables correlated with behavior in 2013 and that intention was the most predictive of behavior to include environmental issues into practice. Findings from the first three phases provided insight into how children view their food and physical activity environments and can inform interventions to better meet the needs of low-income, urban children of diverse ethnic backgrounds. Results from the fourth phase of research can help the Academy of Nutrition and Dietetics identify dietitians' educational needs related to sustainable agriculture.