Determinants of healthy and sustainable food choices in parents with a higher and lower socioeconomic status: A qualitative study

Experts' perceptions on motivators and barriers of healthy and sustainable dietary behaviors among adolescents: The SWITCH project

The interplay of influences shaping dietary behaviors of adolescents needs to be well-understood to develop effective strategies stimulating healthy and sustainable behaviors. This study aimed to identify the most relevant, urgent, changeable and effective motivators and barriers of healthy and sustainable dietary behaviors among adolescents (10-19 years), as perceived by an inter- and transdisciplinary expert panel. Experts working in practice (N = 19) and academia (N = 13) - in the field of sustainability, health, nutrition and/or education - participated in this exploratory mixed-methods study. Five online semi-structured focus groups were conducted (6-7 participants). Data was thematically analyzed by two coders independently, using the socioecological framework. Subsequently, the same experts individually selected the five most relevant determinants and rated those on their urgency, changeability and effectiveness through an online questionnaire (N = 21). Participants revealed a wide system of 31 main determinants including 173 sub-determinants that motivate or hinder healthy and sustainable eating among adolescents. This system of determinants was mapped on the different layers of the socioecological model: individual factors (25 motivators; 30 barriers), social environments (15 motivators; 13 barriers), physical environments (18 motivators; 15 barriers), macro-level environments (19 motivators; 38 barriers). 'Role of peers' (social environment) was selected most as a determinant to be targeted in interventions (N = 13; urgency (M = 6.38) changeability (M = 3.85), effectiveness (M = 5.62)), followed by 'food environment around school' (N = 9; urgency (M = 5.78) changeability (M = 3.44), effectiveness (M = 5.44)), 'social influences' (N = 7; urgency (M = 5.43) changeability (M = 4.00), effectiveness (M = 5.71)), 'autonomy in development' (N = 7; urgency (M = 6.00) changeability (M = 4.29), effectiveness (M = 5.86)) and 'food availability' (N = 7; urgency (M = 6.29) changeability (M = 3.29), effectiveness (M = 6.29)). The prioritized determinants indicate that adolescents should be provided more supportive social and physical environments that promote healthy and sustainable dietary behaviors, taking into account their growing autonomy.

When food is uncertain, how much does sustainability matter? A qualitative exploration of food values and behaviours among users of a social grocery store

A transition towards sustainable diets ensuring food security while preserving ecosystems is necessary, but remains challenging. Low-income consumers, particularly those experiencing food insecurity, require specific consideration since they face financial constraints when making food choices, leading to poorer diets. However, little is known about the place given to sustainability in their choices. This study thus aims to identify the role played by sustainability in the food values of food-insecure consumers in France. Twenty-nine semi-structured interviews with users of a social grocery store were conducted to investigate food values and actual behaviours, with a focus on the four dimensions of sustainable diets - health, economic, sociocultural and environmental. Verbatims were analysed through thematic analysis. Five core values were identified, namely health and nutrition, naturalness, trust and control, solidarity and frugality, and preferences. Participants valued all dimensions of food sustainability but notably valued less the environmental dimension. Despite various strategies, participants felt unable to adhere to their values in practice, mainly because of their socioeconomic vulnerability. They insisted on their lack of control over their food behaviour. These findings provide insights into the disempowerment experienced by consumers with low financial resources regarding more sustainable food choices. Our study calls for interventions addressing affordability issues and considering consumers' food values, while providing opportunities to make consumers feel involved in the transition of the food system.

Intervention strategies to promote healthy and sustainable food choices among parents with lower and higher socioeconomic status

BACKGROUND

A global shift towards more healthy and sustainable diets is necessary for the prevention of obesity and chronic diseases, as well as for the growing pressure on our ecosystems. Given that parents are important actors in affecting dietary behaviors of their children, developing intervention strategies targeting families and their practices is promising to reach positive behavior change among children. Also, it is important to tailor these interventions to the needs of parents with different socioeconomic statuses (SES), given that health inequalities continue to grow. This study aims to investigate perspectives of lower and higher SES parents on the usability and acceptability of various innovative intervention strategies.

METHODS

Fourteen focus groups and four individual interviews (n = 78, n_lowerSES = 17; n_higherSES = 61) were conducted in Belgium. A semi-structured interview guide was used to facilitate the discussions. The interviews were recorded, transcribed, and analyzed via thematic content analysis using NVivo.

RESULTS

To encourage healthy and sustainable food choices, interventions via online food shopping platforms and nudging strategies in grocery stores were mostly cited by higher SES parents, but these were less applicable for lower SES parents as they buy less online and mainly consider the price of products. Mobile applications that provide inspiration for healthy and sustainable recipes and easily accessible shopping lists received moderate support among lower and higher SES parents. Furthermore, both lower and higher SES parents showed interest in meal boxes delivered at home, but lower SES parents have not yet tried such meal boxes because of their higher prices. Still, both groups of SES parents mentioned many advantages of these meal boxes, such as the convenience and time-saving component, as well as the cooking inspiration aspect.

CONCLUSION

Our study reveals the preferences of lower and higher SES parents for practical intervention strategies, providing insight in what features these strategies should have to be acceptable and useful. Hence, the findings can inform the development of a tailored family-based intervention strategy to improve parental food choices in favor of increased health and sustainability.