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A Conceptual Framework for Healthy Eating Behavior in Ecuadorian Adolescents: A Qualitative Study  [PDF]
Roosmarijn Verstraeten, Kathleen Van Royen, Angélica Ochoa-Avilés, Daniela Penafiel, Michelle Holdsworth, Silvana Donoso, Lea Maes, Patrick Kolsteren
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0087183
Abstract: Objective The objective of this study was to identify factors influencing eating behavior of Ecuadorian adolescents - from the perspective of parents, school staff and adolescents - to develop a conceptual framework for adolescents' eating behavior. Study design Twenty focus groups (N = 144 participants) were conducted separately with adolescents aged 11–15 y (n (focus groups) = 12, N (participants) = 80), parents (n = 4, N = 32) and school staff (n = 4, N = 32) in rural and urban Ecuador. A semi-structured questioning route was developed based on the ‘Attitude, Social influences and Self-efficacy’ model and the socio-ecological model to assess the relevance of behavioral and environmental factors in low- and middle-income countries. Two researchers independently analyzed verbatim transcripts for emerging themes, using deductive thematic content analysis. Data were analyzed using NVivo 8. Results All groups recognized the importance of eating healthily and key individual factors in Ecuadorian adolescents' food choices were: financial autonomy, food safety perceptions, lack of self-control, habit strength, taste preferences and perceived peer norms. Environmental factors included the poor nutritional quality of food and its easy access at school. In their home and family environment, time and convenience completed the picture as barriers to eating healthily. Participants acknowledged the impact of the changing socio-cultural environment on adolescents' eating patterns. Availability of healthy food at home and financial constraints differed between settings and socio-economic groups. Conclusion Our findings endorse the importance of investigating behavioral and environmental factors that influence and mediate healthy dietary behavior prior to intervention development. Several culture-specific factors emerged that were incorporated into a conceptual framework for developing health promotion interventions in Ecuador.
Evaluation of Diet Quality of Egyptian Children and Adolescents using Healthy Eating Index
Mervat A. Esmail - Wafaa M.A.Saleh -Nebal A.R.Aboul Ella - Asmaa M. Abd
Egyptian Journal of Hospital Medicine , 2009,
Abstract: Background: Healthful eating is essential for development and well-being. Some dietary patterns are associated with 4 of the 10 leading causes of death (coronary heart disease, certain types of cancer, stroke, and type 2 diabetes). Major improvements in the health of the public can, therefore, be made by improving people's dietary patterns. The U.S. department of Agriculture has developed an index, called the Healthy Eating Index (HEI) that was updated in the year 2002. It is based on different aspects of a healthful diet; the Index is designed to provide a measure of overall dietary quality, and the compliance with specific Dietary Guidelines recommendations. The aim of our study is to use the healthy eating index to assess the diet quality of a representative sample of the Egyptian children and adolescents and to examine the association between body mass index and caloric intake of the studied sample. Materials & Methods: This study is a part of National Egyptian survey, Diet, Nutrition and Prevention of Chronic Non-communicable Diseases. The Healthy Eating Index was applied with slight modifications to measure how well the studied Egyptian students' diet conforms to recommended healthy eating pattern. The data were based on representative sample (2145) of children and adolescents (10 -18) years in 7 governorates from. One day of dietary intake data (24 hours recall) was collected, during an in-person interview. The Healthy Eating Index measures how well the studied children and adolescents' diets conform to the American Dietary Guidelines recommendations and the Food Guide Pyramid applied in our country. Ten dietary components have been identified and the overall Index has a total possible score ranging from zero to 100. Results: Our results showed that the average Healthy Eating Index score was 59.1 out of a possible 100 and it ranged from 20 to 86, Only 0.5 percent of the students had Healthy Eating scores above 80; while 16.9 percent of them received scores below 50 and the majority (82.5 percent) had scores on the Healthy Eating Index between 51 and 80. In an effort to provide a "rating" of the overall student's diet, a grading scale was developed, the majority of students had diets rated as "Needs Improvement", only 0.5 % received diets rated as "Good" and 16.9 % had diets rated as "Poor". Males achieved a slightly higher average Index than females (59.7 Vs 58.2). The average score for food groups is much lower than that for dietary guidelines (23.5 Vs 35.6) out of total score of 50 for each. There was a significant positive correlation of BMI wi
Perceptions on the use of pricing strategies to stimulate healthy eating among residents of deprived neighbourhoods: a focus group study
Wilma E Waterlander, Anika de Mul, Albertine J Schuit, Jacob C Seidell, Ingrid HM Steenhuis
International Journal of Behavioral Nutrition and Physical Activity , 2010, DOI: 10.1186/1479-5868-7-44
Abstract: We conducted seven focus groups among 59 residents of deprived neighbourhoods in two large Dutch cities. The focus group topics were based on insights from Rogers' Diffusion of Innovations Theory and consisted of four parts: 1) discussion on factors in food selection; 2) attitudes and perceptions towards food prices; 3) thinking up pricing strategies; 4) attitudes and perceptions regarding nine pricing strategies that were nominated by experts in a former Delphi Study. Analyses were conducted with Atlas.ti 5.2 computer software, using the framework approach.Qualitative analyses revealed that this group of consumers consider price to be a core factor in food choice and that they experience financial barriers against buying certain foods. Price was also experienced as a proficient tool to stimulate healthier food choices. Yet, consumers indicated that significant effects could only be achieved by combining price with information and promotion techniques. In general, pricing strategies focusing on encouraging healthy eating were valued to be more helpful than pricing strategies which focused on discouraging unhealthy eating. Suggested high reward strategies were: reducing the price of healthier options of comparable products (e.g., whole meal bread) compared to unhealthier options (e.g., white bread); providing a healthy food discount card for low-income groups; and combining price discounts on healthier foods with other marketing techniques such as displaying cheap and healthy foods at the cash desk.This focus group study provides important new insights regarding the use of pricing strategies to stimulate healthy eating. The observed perceptions and attitudes of residents of deprived neighbourhoods can be integrated into future experimental studies and be used to reveal if and how pricing strategies are effective in stimulating healthy eating.The prevalence of overweight and obesity is rising worldwide, with the largest burden among lower socio-economic groups [1-3].
Perceptions of Preventive Health Care and Healthy Lifestyle Choices for Low Income Families: A Qualitative Study  [PDF]
Sasha A. Fleary,Reynolette Ettienne-Gittens,Robert W. Heffer
ISRN Preventive Medicine , 2013, DOI: 10.5402/2013/189180
Abstract: This paper examines Head Start parents’ perceptions of preventive health and healthy lifestyle choices and Head Start administrators’ perceptions of the needs of parents they serve. To address the preventive health of the population, it is necessary that we explore perceptions, risks, and protective factors of preventive health. Focus groups were conducted with parents and administrators to elicit this information and to obtain suggestions for improving preventive health and healthy lifestyle choices among this group. Overall, nutrition and physical activity emerged as themes in parents’ definition of preventive health and healthy lifestyle choices. They further identified social support and education as major protective factors for engaging in preventive health and healthy lifestyle choices. Results of this study can be used to inform research and practice to develop interventions to increase preventive health and healthy lifestyle choices among low income families. 1. Introduction Low income persons in the USA are less likely to seek preventive health care and have low health literacy, which places them at risk for poorer health outcomes and increased use of treatment services [1–3]. Health literacy may impact on individual’s ability to successfully use the health care system and to engage in preventive care and disease management [4]. In the case of parents of young children, low health literacy may compromise their ability to seek or engage in preventive care for themselves and their children. According to the Institute of Medicine [1], older adults, racial and ethnic minorities, individuals with less than a 12th grade education, GED certificate recipients, nonnative English speakers, and individuals with low incomes are all more likely to have low health literacy. Individuals with these demographic characteristics are also more likely to be socially disadvantaged and thus further disadvantaged on health. Although a plethora of research exists on the effects of health literacy on adult health, relatively less research has been conducted to address the impact of parental health literacy on the health and well-being of children. Children, especially preschool-aged children, are vulnerable to their environment [5] and rely heavily on their parents to ensure their health and well-being. Based on the adult studies, therefore, parents’ health literacy is postulated to influence the preventive health measures parents pursue for their children. 2. The Head Start Program The Head Start Program was established in 1964 as part of the “war on poverty.” This
Perceptions of Health among adolescents in Ethiopian immigrant families living in Finland
Jembere Berhanu,Paivi Kankkunen,Merja Nikkonen
International Journal of Caring Sciences , 2010,
Abstract: Aims: From the developmental perspectives children acquire and widen their perceptions of health as they mature and grow up. The main purpose of this study was to describe health through the eyes of adolescents in immigrant Ethiopian families living in Finland.Methods: Ten boys and five girls participated. The adolescents’ ages ranged from 12 to17. Theme interviews were used in data collection. Snowball sampling technique was used. Consent was obtained from the adolescents and adolescents’ parents. Inductive content analysis technique was used to analyse the data.Results: Adolescents indicated that health is the wellbeing of all dimensions that make us intact and complete. Adolescents believed relaxation, physical activity, good hygiene, good social relationship, avoiding consumption of poison substances, green nature, hygienic environment and peace are health supportive elements. On the contrary adolescents said insufficient resting, violent behaviors, difficulty, irritation, being inactive physically, addiction to alcohol and smoking, eating fatty food, not respecting meal time and use of drugs are health damaging behaviors. Adolescents consumed soft drink and alcohol frequently ,were physical inactive, practiced unhealthy eating habits, felt lazy to go and grab food from food store, faced financial difficulty to pay for Gym and healthy food that threatened their health. Adolescents used sport, socialization, moderate alcohol intake, avoid eating unhealthy food and smoking as their strategies to enhance their health.Conclusions: Adolescents were able to identify unhealthy lifestyles and healthy lifestyles. However adolescents were engaged in healthy and unhealthy lifestyles simultaneously. Thus family, school, neighbours and health care workers should work together and vigilant in assessing and removing factors that prevent adolescents from adopting healthy lifestyles.
Endogenous factors that relate to the eating habits of adolescents
G Bester, ND Schnell
South African Journal of Education , 2004,
Abstract: The aim in this research was to determine how endogenous factors such as gender, intelligence, self-concept, and personality relate to the eating habits of adolescents. An empirical investigation was conducted using 340 secondary school learners, 162 boys and 178 girls. From the results it appeared that girls tend to have more unhealthy eating habits than boys and adolescents with high intelligence are at risk of developing unhealthy eating behaviour. A strong relationship existed between the physical self and eating habits. The most important personality factors associated with eating habits were social boldness and individualism. South African Journal of Education Vol.24(3) 2004: 189-193
"New Choices" for women with addictions: perceptions of program participants
Wendy Sword, Alison Niccols, Aimei Fan
BMC Public Health , 2004, DOI: 10.1186/1471-2458-4-10
Abstract: A qualitative, exploratory design was used to guide data collection and analysis. Four women participated in a focus group interview and seven women agreed to individual interviews over the course of the program evaluation (N = 11). A semi-structured interview guide was used to explore women's experiences in New Choices and their perceptions of the program and its impact. The interview data were analyzed using NVivo software and an inductive approach to data analysis.The emergent themes captured women's motivations for attending New Choices, benefits of participation, and overall quality of the program. Children were the primary motivating factor for program enrollment. Perceived benefits included decreased substance use, improved maternal health, enhanced opportunity for employment, increased access to other resources, enhanced parenting skills, and improved child behaviour and development. Women highly valued the comprehensive and centralized approach to service delivery that provided a range of informal and formal supports.Interview findings endorse the appropriateness and potential efficacy of a collaborative, centralized approach to service provision for women with substance use issues. Although the findings provide insight into an alternative model of service delivery for women with addictions, future research is needed to evaluate the effectiveness of the intervention. Research also is needed to determine which program components or constellation of components contribute to desired outcomes, and to learn more about processes that underlie changes in behaviour.Substance use in pregnancy is a major public health problem. Measuring prevalence of substance abuse in pregnant women is problematic because it can involve single or multiple substances, including alcohol, prescription and over-the-counter medications, and illegal drugs such as cocaine, marijuana, heroin, and barbiturates [1-3]. Additionally, self-reported substance use underestimates the extent of the
Healthy eating and obesity prevention for preschoolers: a randomised controlled trial
Helen Skouteris, Marita McCabe, Boyd Swinburn, Briony Hill
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-220
Abstract: This randomised controlled trial will be conducted with 200 parents and their 2-4 year old children who attend the MEND 2-4 program in metropolitan and regional Victoria. Parent-child dyads will attend ten 90-minute group workshops. These workshops focus on general nutrition, as well as physical activity and behaviours. They are typically held at community or maternal and child health centres and run by a MEND 2-4 trained program leader. Child eating habits, physical activity levels and parental behaviours and cognitions pertaining to nutrition and physical activity will be assessed at baseline, the end of the intervention, and at 6 and 12 months post the intervention. Informed consent will be obtained from all parents, who will then be randomly allocated to the intervention or wait-list control group.Our study is the first RCT of a healthy eating and childhood obesity prevention intervention targeted specifically to Australian parents and their preschool children aged 2-4 years. It responds to the call by experts in the area of childhood obesity and child health that prevention of overweight in the formative preschool years should focus on parents, given that parental beliefs, attitudes, perceptions and behaviours appear to impact significantly on the development of early overweight. This is 'solution-oriented' rather than 'problem-oriented' research, with its focus being on prevention rather than intervention. If this is a positive trial, the MEND2-4 program can be implemented as a national program.Australian New Zealand Clinical Trials Registry ACTRN12610000200088Epidemiological studies indicate that childhood overweight is a serious problem in Australia, with an estimated 1 in 4 Australian school aged children and adolescents either overweight or obese [1]. Alarmingly, obesity is seen in even younger children, with rates of overweight and obesity almost doubling in a sample of 114,669 Australian 4-year-olds over the period 1995-2002 [2]. More recently, data from
Assessment of night eating syndrome among late adolescents  [cached]
Suri S,Pradhan R
Indian Journal of Psychological Medicine , 2010,
Abstract: With the increase in the trend of social networking, celebrations, over a couple of decades weather in the hostel or at home. Snacking has become an important aspect of activity. Today teen prefer snacks more than a proper meal. Skipping of meal and nibbling in between meal is a common practice. The main meals (breakfast, lunch and dinner) are missed and total proportions of calories are consumed from the snacks eaten. Hence, this disordered eating behavior when continued may further lead to development of serious syndrome i.e., night eating syndrome. A purposive random sample comprising 188 males and 192 females (N=380), adolescents (18-22 years) were selected including hostlers and day scholars. The subjects were administered with self-organized questionnaire so to analyze the pattern of NES among them. Out of total 380 respondents, the numbers of hostlers were 211 and day scholars 169, while boys were 188 and girls were 192 in number. Results indicated that nearly half the percentage of adolescents snacked at night, out of which very few respondents met the criteria of NES, in which the number of hostlers were quite more than the day scholars, i.e.,76.3%.
Negotiating food choice: parents’ perception of children’s eating behaviour  [PDF]
E. Mei-Li Roberts
Anthropological Notebooks , 2006, DOI: 1234567
Abstract: This article is based on a qualitative study exploring parents’ attitudes and perceptions of their role in their children’s eating habits in schools in Angus, Scotland. Parents believed they had different degrees of influence on their children’s eating habits. This article will examine these different perceptions of parental responsibility for children’s eating habits to explore how parents viewed their influence over their children’s food choices. I argue that although parents influence the degree of ‘choice’ that children have in their food choices, particularly ‘healthy’ or ‘unhealthy’ choices, children as competent decisionmakers, may not always choose to follow their parents’ choice but instead find ways to negotiate their own aims, needs and wishes for food choices, suggesting that decisions regarding food choices are part of a negotiated process between parent and child.
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