Doctoral Dissertations

Orcid ID


Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Sandra J. Mixer

Committee Members

Sadie Hutson, Nan Gaylord, Hollie Raynor



Childhood obesity is an unrelenting public health problem disproportionately affecting racial and ethnic minorities. There are multiple, complex factors related to the prevalence of childhood obesity from genetics to behavior to environment. Although ethnic minorities are disproportionately affected by childhood obesity and have a variety of cultural identities, research rarely examines cultural factors. In addition, qualitative research into childhood obesity rarely seeks the perspectives of children. This research study sought to address these gaps by interviewing children from an ethnic minority. The purpose of this study was to discover cultural influences that contribute to or prevent childhood obesity from the perspectives of Burmese-American children and adolescents of Karen ethnicity in the southeast U.S. Leininger’s Culture Care Theory (CCT) was the theoretical framework. The study was designed using the ethnonursing research method developed by Leininger to be used with the CCT. Karen children between 8 and 15 years-of-age along with their parents and non-Karen community members who knew them participated in open-ended interviews. Observation and field notes contributed data. Four themes important to healthy weight care in Karen children were discovered: views of a healthy child, food and food preparation, physical activity, and mutual support among family and community. These themes included both Karen and non-Karen influences. Nurses and interprofessional health care teams may use knowledge gained from this study for promotion of healthy weight care in Karen families, and advocating for community changes which could benefit all children. Contribution to theory along with research, policy, and nursing education implications are identified and discussed.

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