text: Childhood obesity perceptions among African American caregivers in a rural Georgia community: a mixed methods approach.
  Given the pivotal role of African American caregiver's perceptions of childhood obesity in rural areas, the inclusion of caregiver's perceptions could potentially reduce childhood obesity rates. The objective of the current study was to explore childhood obesity perceptions among African Americans in a rural Georgia community. This concurrent mixed methods study utilized two theoretical frameworks: Social Cognitive Theory and Social Ecological Model. Using a convenience sample, caregivers ages 22-65 years completed a paper-based survey (n = 135) and a face-to-face interview (n = 12) to explore perceptions of obesity risk factors, health complications, weight status, built environment features, and obesity prevention approaches. Descriptive statistics were generated and a six-step process was used for qualitative analysis. Participants commonly cited behavioral risk factors; yet, social aspects and appearance of the community were not considered contributing factors. Chronic diseases were reported as obesity health complications. Caregivers had a distorted view of their child's weight status. In addition, analysis revealed that caregivers assessed child's weight and height measurements by the child's appearance or a recent doctor visit. Environmental barriers reported by caregivers included safety concerns and insufficient physical activity venues and programs. Also, caregivers conveyed parents are an imperative component of preventing obesity. Although this study found caregivers were aware of obesity risk factors, health complications, built environment features, and prevention approaches their obesity perceptions were not incorporated into school or community prevention efforts. Findings suggest that children residing in rural areas are in need of tailored efforts that address caregiver perceptions of obesity.