The Meaning of Health of Rural Saskatchewan Children: A Mixed Methods Approach
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Background: An understanding of the meaning of health is an integral component in the development of effective health promotion programs aimed at promoting health or preventing diseases such as childhood obesity. One group of Canadian children known to be at higher risk for obesity is those living in rural settings. The purpose of this current research was to explore the meaning of health of preadolescent children living in rural Saskatchewan. The following four research questions were addressed: (a) What are the general health characteristics of the study sample?, (b) What is the rural context of children participating in this study?, (c) What is the meaning (i.e. values, norms, beliefs, behaviors) of health from the perspectives of a group of preadolescent children?, and (d) Is the meaning of health thematically congruent from the perspectives of healthy weight and unhealthy weight children?. Study Design: Mixed methods explanatory sequential design (Participant selection model) with qualitative emphasis. Methods: Participants were recruited through classroom presentations and invitational letters sent out to all children attending a rural elementary school in Saskatchewan. Ninety-nine children (51.0% response rate) participated in the quantitative component [measurement of height and weight for purposes of determining healthy weight and unhealthy weight (overweight or obese) status and completion of health questionnaire examining dietary and physical activity patterns]. Of the children who met the selection criteria for qualitative follow up (Grade 4, 5, & 6 children who agreed to be interviewed and had a parent who agreed to be interviewed), twenty children and their parents were randomly selected to be individually interviewed for a total of 71 interviews. An observational assessment of the community was conducted by the researcher for the purpose of gaining a greater understanding of the rural context in which the study participants construct their meaning of health. Results: Prevalence of unhealthy weights in these rural children was high (34%) with gender differences evident at a very young age. Regardless of weight or health status, children described their cultural meaning of health as an integration of Knowing Stuff, Having a Working Body, and Feeling Happy. Of these three themes Feeling Happy was recognized as the most meaningful and children described that receiving encouragement and support from valued relationships contributed to their happiness and overall meaning of health. The rural environment appeared to provide a sense of safety, security, and freedom in which children frequently engaged. Significance of Findings: The high prevalence of unhealthy weights in this sample of rural children has the potential to negatively influence the present and future health of these children. Developing an understanding of the cultural meaning of health and how this culture may influence patterns of healthy behaviors may be a foundation to the development of successful interventions aimed at promoting healthy weights in rural children.
DegreeDoctor of Philosophy (Ph.D.)
DepartmentCollege of Nursing
ProgramCollege of Nursing
SupervisorDuggleby, Wendy; Rennie, Donna
CommitteeChad, Karen; Stamler, Lynnette L.; Reeder, Bruce; Kent-Wilkinson, Arlene; Chapman, Gwen