National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Int J Behav Nutr Phys Act. 2011 Oct 14;8:112. doi: 10.1186/1479-5868-8-112.
Large proportions of children do not fulfil the World Health Organization recommendation of eating at least 400 grams of fruit and vegetables (FV) per day. To promote an increased FV intake among children it is important to identify factors which influence their consumption. Both qualitative and quantitative studies are needed. Earlier reviews have analysed evidence from quantitative studies. The aim of this paper is to present a systematic review of qualitative studies of determinants of children's FV intake.
Relevant studies were identified by searching Anthropology Plus, Cinahl, CSA illumine, Embase, International Bibliography of the Social Sciences, Medline, PsycINFO, and Web of Science using combinations of synonyms for FV intake, children/adolescents and qualitative methods as search terms. The literature search was completed by December 1st 2010. Papers were included if they applied qualitative methods to investigate 6-18-year-olds' perceptions of factors influencing their FV consumption. Quantitative studies, review studies, studies reported in other languages than English, and non-peer reviewed or unpublished manuscripts were excluded. The papers were reviewed systematically using standardised templates for summary of papers, quality assessment, and synthesis of findings across papers.
The review included 31 studies, mostly based on US populations and focus group discussions. The synthesis identified the following potential determinants for FV intake which supplement the quantitative knowledge base: Time costs; lack of taste guarantee; satiety value; appropriate time/occasions/settings for eating FV; sensory and physical aspects; variety, visibility, methods of preparation; access to unhealthy food; the symbolic value of food for image, gender identity and social interaction with peers; short term outcome expectancies.
The review highlights numerous potential determinants which have not been investigated thoroughly in quantitative studies. Future large scale quantitative studies should attempt to quantify the importance of these factors. Further, mechanisms behind gender, age and socioeconomic differences in FV consumption are proposed which should be tested quantitatively in order to better tailor interventions to vulnerable groups. Finally, the review provides input to the conceptualisation and measurements of concepts (i.e. peer influence, availability in schools) which may refine survey instruments and theoretical frameworks concerning eating behaviours.
很大一部分儿童没有达到世界卫生组织建议的每天至少食用 400 克水果和蔬菜的标准。为了提高儿童的水果和蔬菜摄入量，必须确定影响他们消费的因素。需要进行定性和定量研究。之前的综述分析了来自定量研究的证据。本文的目的是对儿童水果和蔬菜摄入量决定因素的定性研究进行系统综述。
使用同义词组合搜索 Anthropology Plus、Cinahl、CSA illumine、Embase、国际社会科学文献索引、Medline、PsycINFO 和 Web of Science 搜索 Anthropoloyy Plus、Cinahl、CSA illumine、Embase、国际社会科学文献索引、Medline、PsycINFO 和 Web of Science，搜索词包括水果和蔬菜摄入量、儿童/青少年和定性方法，以确定相关研究。文献检索于 2010 年 12 月 1 日完成。如果研究应用定性方法调查 6-18 岁儿童对影响其水果和蔬菜消费的因素的看法，则纳入研究。排除定量研究、综述研究、报告语言非英语的研究、非同行评审或未发表的手稿。使用标准化模板对论文进行系统综述，总结论文、评估质量，并综合论文中的发现。
综述纳入 31 项研究，主要基于美国人群和焦点小组讨论。综合分析确定了以下可能影响水果和蔬菜摄入量的因素，这些因素补充了定量知识基础：时间成本；缺乏口感保证；饱腹感价值；食用水果和蔬菜的适当时间/场合/环境；感官和物理方面；种类、可见度、准备方法；获取不健康食品的机会；食物的象征价值，用于形象、性别认同和与同龄人社交互动；短期预期结果。
综述强调了许多在定量研究中没有得到充分研究的潜在决定因素。未来的大规模定量研究应尝试量化这些因素的重要性。此外，提出了性别、年龄和社会经济差异在水果和蔬菜消费方面的机制，这些机制应该通过定量研究进行检验，以便更好地针对弱势群体进行干预。最后，该综述为概念化和测量概念（即同伴影响、学校供应）提供了投入，这可能会改进有关饮食行为的调查工具和理论框架。
