Department of Pediatrics, School of Medicine, University of California San Francisco, USA.
Division of Research, Kaiser Permanente Northern California, USA.
Appetite. 2019 Jul 1;138:215-222. doi: 10.1016/j.appet.2019.04.004. Epub 2019 Apr 4.
The objective of this study was to explore barriers and facilitators to healthy eating among low-income Latino adolescents using an intervention development framework.
Semi-structured interviews (n = 30) were conducted with Latino youth ages 13-17 who had overweight or obesity at a safety-net clinic in San Francisco, CA. Adolescent beliefs and attitudes regarding healthy eating and individual, family, and community level barriers and facilitators were elicited. Interviews were analyzed using an inductive approach and the Capability-Opportunity-Motivation (COM-B) model.
Participants had capability gaps; while they demonstrated basic nutrition knowledge, they also held significant misconceptions about healthy eating, equating "organic" with healthy and failing to recognize sugar in a number of beverages and foods. Families were a source of support through role modeling and purchasing fresh produce, yet in many cases also undermined adolescents' healthy eating goals through purchases of high calorie low nutrient food, an opportunity facilitator and challenge. By contrast, peers were mostly a negative influence due to frequent consumption of high calorie low nutrient food. The school environment posed opportunity challenges as participants found school lunch unpalatable and had ready access to unhealthy options nearby. Participants were motivated to improve their eating habits but often not resilient in the face of obstacles.
Interventions to promote healthy eating among low-income Latino adolescents should address common nutritional misconceptions, target families as well as teens, consider peer influences, and advocate for policy approaches that improve the school food environment.
本研究旨在使用干预发展框架探讨低收入拉丁裔青少年健康饮食的障碍和促进因素。
在加利福尼亚州旧金山的一家医疗服务机构中，对超重或肥胖的 13-17 岁拉丁裔青少年进行了半结构化访谈（n=30）。了解青少年对健康饮食的信念和态度，以及个人、家庭和社区层面的障碍和促进因素。使用归纳法和能力-机会-动机（COM-B）模型对访谈进行分析。
参与者存在能力差距；虽然他们具备基本的营养知识，但对健康饮食存在重大误解，将“有机”等同于健康，并且未能识别许多饮料和食品中的糖。家庭通过树立榜样和购买新鲜农产品提供支持，但在许多情况下，通过购买高热量低营养的食物来破坏青少年的健康饮食目标，这是一个机会促进因素和挑战。相比之下，由于经常食用高热量低营养的食物，同龄人大多是负面影响。学校环境构成机会挑战，因为参与者发现学校午餐不可口，并且附近有很多不健康的选择。参与者有改善饮食习惯的动机，但在面对障碍时往往缺乏韧性。
针对低收入拉丁裔青少年的健康饮食干预措施应解决常见的营养误解，针对家庭和青少年，考虑同伴影响，并倡导改善学校食品环境的政策方法。
