Lessons learned in designing and conducting a mixed methods study to explore the health of rural children

Abstract

In Canada, the increase in childhood obesity has been greater in youth than in adults and in rural populations versus urban. The prevention of childhood obesity is crucial and warrants an approach that increases our understanding of children's perspectives of health. This study used an emic perspective to discover children's meaning of health and determined health behaviors of children in rural Saskatchewan, Canada. An explanatory sequential design and Creswell's five criteria for designing mixed methods studies provided a framework for this study, which addressed (a) What are the health characteristics of the study population?, (b) What is the rural context of children participating in the study, (c) What is the cultural meaning of health from the perspectives of this group of children?, and (d) Is the meaning of health thematically congruent from the perspective of healthy weight and unhealthy weight children? The prevalence of overweight and obesity was high. The meaning of health was multidimensional with the psychosocial dimension being most important to children. The rural environment contributed to children's health. Obesity places the present and future health of rural children at risk. The findings illustrate children are adept research participants. A mixed methods approach enhanced our understanding of children's health and provided insight into potential approaches for future health promotion programs. The study design was straightforward and practical to use with children.

Keywords:

• rural
• childhood obesity
• intervention
• mixed methods

Acknowledgments

This research was supported, in part, by CIHR Strategic Training Program in Public Health and the Agricultural Rural Health Ecosystem (PHARE). Special thanks is extended to the school officials of the participating school and specifically to the rural children and parents whose knowledge and participation were most valuable.