Journal List > J Korean Acad Nurs > v.49(3) > 1129517

Park and Lee: Environment Factors Affecting Childhood Obesity: Voices from Students, Parents, and Teachers with Photograph



This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community.


Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion.


School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity.


To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.


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Figure 1.
School store: an example photo of this study.
Figure 2.
The part of results: categorizing and naming on environmental factors on child obesity of high school students.
Table 1.
General Characteristics of Study Participants
Gender Age Exercise class in school/week Cafeteria in school

Male 17 2 hours O
Female 18 1 hour O
Male 17 2 hours O
Female 18 1 hour O
Female 18 1 hour O
Male 16 3 hours X

Gender Age Education Number of children

Female 43 University 2
Female 50 University 1
Female 36 Graduate school 2
Female 43 Graduate school 2
Female 49 Graduate school 1
Female 35 University 2
Female 52 University 1

Gender Age School type Size of school (classes) Career (years)

Female 31 High 19~24 <5
Female 36 Elementary >37 <5
Female 30 Elementary <18 5~10
Female 30 Elementary <18 5~10
Female 30 High 31~36 <5
Female 36 Middle 25~30 10~15
Female 42 High <18 10~15
Table 2.
Factors Related with Adolescents Obesity
Categories High school students Parents Teachers
School environments - School exercise programs to enjoy - School programs for promoting - School cafeteria
activities physical activities (walking, exercise) - Adulterated food (junk food,
- Good school facilities to encourage - School garden unsanitary food)
exercising - Barriers preventing physical activities - High calorie snacks
- Unfriendly walking roads for students around school - Cheap foods that are easy to share
to go to school - Many convenience stores near - Short break time for school meals
- School cafeterias or stores causing schools
students to become obese - Lack of healthy snacks (in school)
- Vending machines that tempt
students to buy a drink every break
- Short breaks for school meals
- Lack of physical activity classes at
- Early school hours
Community - Commuting by car even though the - Excessive use of cars (reducing - Excessive use of cars
environments distance is short activities) - Uncomfortable public transportation
- Neglected exercise facilities - Uncomfortable public transportation - Unfriendly walking roads
- Convenience stores open all 24 hours - Dangerous walking environments - Environments preventing physical
instant foods; easy and convenient - Marketing strategies of convenience activities
- Attracting cusotrmers to buy displayed stores (one plus one etc.) - Environments supporting exercises
food - Increasing dessert cafes - Convenience stores
- Burden of preparing for an entrance - The rapid increase of delicious - Fast food joints
examination for a university resulting restaurants causing frequent eating - Marketing foods in large packages
in ignoring meal times out - Many beverage options
- Busy schedules from school to private - Many delicious restaurant options
institutes (snacking on junk foods) - Excessive study hours
- Frequent meetings - Lack of sleep
- Social trends more concerned with
foods and cooking
- Advertisement to enhance obesity
Home - Food delivery at any time and any - Food delivery - Food delivery or take-out
environments place - Instant food options and busy - Late dinner time
- High-calorie snacks mothers - Korean culture to encourages eating a
- Smartphones lot of food
- Smartphones preventing physical
- Environments preventing people from
focusing on eating
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