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Needs and perceptions regarding healthy eating among people at risk of food insecurity: a qualitative analysis.

ABSTRACT: BACKGROUND:Healthy eating behaviour is an essential determinant of overall health. This behaviour is generally poor among people at risk of experiencing food insecurity, which may be caused by many factors including perceived higher costs of healthy foods, financial stress, inadequate nutritional knowledge, and inadequate skills required for healthy food preparation. Few studies have examined how these factors influence eating behaviour among people at risk of experiencing food insecurity. We therefore aimed to gain a better understanding of the needs and perceptions regarding healthy eating in this target group. METHODS:We conducted a qualitative exploration grounded in data using inductive analyses with 10 participants at risk of experiencing food insecurity. The analysis using an inductive approach identified four core factors influencing eating behaviour: Health related topics; Social and cultural influences; Influences by the physical environment; and Financial influences. RESULTS:Overall, participants showed adequate nutrition knowledge. However, eating behaviour was strongly influenced by both social factors (e.g. child food preferences and cultural food habits), and physical environmental factors (e.g. temptations in the local food environment). Perceived barriers for healthy eating behaviour included poor mental health, financial stress, and high food prices. Participants had a generally conscious attitude towards their financial situation, reflected in their strategies to cope with a limited budget. Food insecurity was mostly mentioned in reference to the past or to others and not to participants' own current experiences. Participants were familiar with several existing resources to reduce food-related financial strain (e.g. debt assistance) and generally had a positive attitude towards these resources. An exception was the Food Bank, of which the food parcel content was not well appreciated. Proposed interventions to reduce food-related financial strain included distributing free meals, facilitating social contacts, increasing healthy food supply in the neighbourhood, and lowering prices of healthy foods. CONCLUSION:The insights from this study increase understanding of factors influencing eating behaviour of people at risk of food insecurity. Therefore, this study could inform future development of potential interventions aiming at helping people at risk of experiencing food insecurity to improve healthy eating, thereby decreasing the risk of diet-related diseases.

SUBMITTER: van der Velde LA

PROVIDER: S-EPMC6880580 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Needs and perceptions regarding healthy eating among people at risk of food insecurity: a qualitative analysis.

van der Velde Laura A LA Schuilenburg Linde A LA Thrivikraman Jyothi K JK Numans Mattijs E ME Kiefte-de Jong Jessica C JC

International journal for equity in health 20191127 1

<h4>Background</h4>Healthy eating behaviour is an essential determinant of overall health. This behaviour is generally poor among people at risk of experiencing food insecurity, which may be caused by many factors including perceived higher costs of healthy foods, financial stress, inadequate nutritional knowledge, and inadequate skills required for healthy food preparation. Few studies have examined how these factors influence eating behaviour among people at risk of experiencing food insecurit ...[more]

PMID: 31775770

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Project description:China's government and its people have for a long time focused on food security for its population as one of the most important issues in economic and social development. Many older people in China have lived in times when food security was not stable. Thus, while food has a central position in Chinese culture for all Chinese people, it is of particular pertinence to older people. In this paper we explore the meaning of food and eating in the lives of older Chinese people in China and how it contributes to healthy, thus happy aging. Focus groups and qualitative interviews were used in this study. Participants were recruited from the rural Yongfu Province of Southwest China, and the urban Fangzhuang and Haidan districts in Beijing. Forty-two participants were recruited aged 62-83 years of age. All focus groups and interviews were conducted in Mandarin and audiotaped with the participants' permission. Audio-tapes were transcribed by a Chinese speaking researcher and then were translated into English. Data were analyzed continuously and comparatively, transcripts were coded, and themes and sub-themes were identified. The initial analysis and interpretation were then presented and discussed at a workshop with all the authors. Two major themes emerged-the quantity of food and the quality of food required to have a happy old age. Participants discussed the desire to eat "until you are full" because of their experiences of famine during childhood. However, they also believed that as an older person they should eat less for their health, particularly less high fat foods. The importance of the food quality and food affordability was also discussed. Grain and meat were characterized as "good" foods and important in their diets for a happy old age. The participants, especially those from urban areas, were concerned with food safety. The high cultural importance of food for older Chinese in China was confirmed in this study. Social and economic lifespan experiences continue to impact on the food and eating attitudes and practices of older Chinese. The food related life experiences of older Chinese in China are quite different from younger Chinese and health promotion messaging needs to be informed by these unique perspectives in order to maximize its effectiveness.

Project description:BackgroundPatients' perceptions and beliefs of disease could be influenced by their lifestyle and culture. Although it is important to understand their perceptions and beliefs toward disease to prevent and manage osteoarthritis (OA) through conservative care, this topic has not been investigated in Japanese people with knee OA. Therefore, this qualitative study aims to clarify how Japanese patients with knee OA experience and perceive their symptoms and disabilities, and how they face them during conservative care.MethodsParticipants were recruited by purposive sampling. Face-to-face, semi-structured interviews were conducted with nine patients (2 men and 7 women; mean age, 74.3 ± 5.5 years) with knee OA until data saturation was reached. Interview data comprised participants' accounts of particular personal experiences of living with knee OA, including their perceptions and attitudes toward knee OA-related symptoms and disabilities. Two physiotherapists (one with extensive experience conducting qualitative studies) and four physiotherapy students conducted the interviews. Recorded interview data were transcribed verbatim in Japanese. Data analysis, including developing a coding scheme, was conducted based on a grounded theory approach.ResultsTwo core categories were extracted from the data: 'Negative experiences' and 'Coping with difficulties'. 'Negative experiences' included three main categories: 'Self-analysis on the cause of knee OA', 'Difficulties in daily life due to knee symptoms', and 'Psychological barrier'. 'Coping with difficulties' included three main categories: 'How to deal with knee pain and difficulty in moving', 'Information considered useful to cope with knee OA' and 'Importance of connecting with others'. Japanese patients with knee OA desired evidence-based information and to connect with other people in the same situation to solve problems related to their condition.ConclusionsTo address patients' concerns, medical professionals should conduct careful interviews and obtain information regarding patients' past experiences, and understand their experiences related to knee OA. Symptoms and difficulties experienced by patients with knee OA should be managed by evidence-based information integrating their perceptions and beliefs toward knee OA.

Project description:BackgroundUnhealthy dietary patterns are highly prevalent in Western countries, and they have been associated with depression, hypertension, heart disease, cancer, type 2 diabetes, and obesity. Many dietary interventions have been developed to promote healthier dietary behavior, yet most do not achieve the intended dietary change. This study aims to provide a better understanding of what Dutch consumers perceive as a healthy diet, how this relates to the current Dutch nutrition guidelines, and their preferences for how to eat more healthily. This is an essential consideration for the development of tailored interventions aimed to help people adopt changes in their dietary behavior.MethodsSeventy-eight participants filled in an online questionnaire containing both open-ended and closed-ended questions. The qualitative data was analyzed using content analysis resulting in a classification scheme. Two students then identified to which category each part of a participant's answer belonged.ResultsFor both the perception of a healthy diet and how to eat healthily, four major categories and a residual category were identified: dietary patterns, food processing, food products, content/nutrients, and non-food. These major categories consisted of several categories. The results showed that how people perceived a healthy diet was mostly represented at the level of food product (vegetables and fruit) and the content/nutrient level (carbohydrates), whereas how they would like to eat healthily was mostly represented at the level of food processing (preparation), food product (vegetables), and dietary patterns (amount).ConclusionsOur findings are mostly in line with how the Dutch dietary guidelines are communicated ("product level"). However, consumers primarily mention single aspects instead of naming the guidelines as a whole. Health policymakers can use this insight in future communications regarding the guidelines to the general public. A challenge for future (eHealth) diet interventions is how to implement and tailor dietary information that optimally connects with the perceptions of the target population.

Project description:BackgroundHealthy eating is a key element of type 2 diabetes (T2D) self-management. Digital interventions offer new avenues to reach broad audiences to promote healthy eating behaviors. However, acceptance of these interventions by socioeconomically disadvantaged people (eg, those with lower levels of education and income or from ethnic minority groups) has not yet been fully evaluated.ObjectiveThis study aimed to investigate the acceptability and usability of EatSmart, a 12-week web-based and mobile-delivered healthy eating behavior change support program, from the perspective of intervention participants living with T2D and health care providers (HCPs) involved in diabetes care.MethodsThis study used a qualitative descriptive design. Overall, 60 disadvantaged adults with T2D, as determined by receipt of either a HealthCare Card or a pension or benefit as the main source of income, were recruited. Data from participants regarding their experiences with and perceptions of the program and longer-term maintenance of any behavior or attitudinal changes were collected through a web-based self-report survey with open-ended questions administered 12 weeks after baseline (54/60, 90%) and semistructured telephone interviews administered 36 weeks after baseline (16/60, 27%). Supplementary semistructured interviews with 6 HCPs involved in diabetes care (endocrinologists, accredited practicing dietitians, and diabetes nurse educators) were also conducted 36 weeks after baseline. These interviews aimed to understand HCPs' views on successful and unsuccessful elements of EatSmart as a technology-delivered intervention; any concerns or barriers regarding the use of these types of interventions; and feedback from their interactions with patients on the intervention's content, impact, or observed benefits. All data from the surveys and interviews were pooled and thematically analyzed.ResultsIn total, 5 key themes emerged from the data: program impact on food-related behaviors and routines, satisfaction with the program, reasons for low engagement and suggestions for future programs, benefits and challenges of digital interventions, and cultural considerations. Results showed that EatSmart was acceptable to participants and contributed positively to improving food-related behaviors. Most participants (27/43, 63%) mentioned that they enjoyed their experience with EatSmart and expressed high satisfaction with its content and delivery. The educational and motivational content was considered the most useful part of the program. Benefits discussed by intervention participants included gaining health knowledge and skills, positive changes in their food purchasing and cooking, and eating greater quantities and varieties of fruits and vegetables. HCPs also described the intervention as beneficial and persuasive for the target audience and had specific suggestions for future tailoring of such programs.ConclusionsThe findings suggested that this digitally delivered intervention with supportive educational modules and SMS text messages was generally appealing for both participants and HCPs. This intervention medium shows promise and could feasibly be rolled out on a broader scale to augment usual diabetes care.International registered report identifier (irrid)RR2-10.2196/19488.

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Needs and perceptions regarding healthy eating among people at risk of food insecurity: a qualitative analysis.

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Needs and perceptions regarding healthy eating among people at risk of food insecurity: a qualitative analysis.

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