Center for Global Health Research, Kenya Medical Research Institute, P. O. Box 1578, Kisumu, 40100, Kenya.
MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge, P.O Box 285, Cambridge, CB2 0QQ, UK.
BMC Public Health. 2022 Jun 14;22(1):1186. doi: 10.1186/s12889-022-13580-4.
Non-communicable diseases have risen markedly over the last decade. A phenomenon that was mainly endemic in high-income countries has now visibly encroached on low and middle-income settings. A major contributor to this is a shift towards unhealthy dietary behavior. This study aimed to examine the complex interplay between people's characteristics and the environment to understand how these influenced food choices and practices in Western Kenya.
This study used semi-structured guides to conduct in-depth interviews and focus group discussions with both male and female members of the community, across various socioeconomic groups, from Kisumu and Homa Bay Counties to further understand their perspectives on the influences of dietary behavior. Voice data was captured using digital voice recorders, transcribed verbatim, and translated to English. Data analysis adopted an exploratory and inductive analysis approach. Coded responses were analyzed using NVIVO 12 PRO software.
Intrapersonal levels of influence included: Age, the nutritional value of food, occupation, perceived satiety of some foods as opposed to others, religion, and medical reasons. The majority of the participants mentioned location as the main source of influence at the community level reflected by the regional staple foodscape. Others include seasonality of produce, social pressure, and availability of food in the market. Pricing of food and distance to food markets was mentioned as the major macro-level influence. This was followed by an increase in population and road infrastructure.
This study demonstrated that understanding dietary preferences are complex. Future interventions should not only consider intrapersonal and interpersonal influences when aiming to promote healthy eating among communities but also need to target the community and macro environments. This means that nutrition promotion strategies should focus on multiple levels of influence that broaden options for interventions. However, government interventions in addressing food access, affordability, and marketing remain essential to any significant change.
在过去的十年中，非传染性疾病显著上升。这种主要发生在高收入国家的现象，现在已经明显侵入了低收入和中等收入国家。造成这种现象的一个主要原因是人们的饮食行为变得不健康。本研究旨在探讨人与环境之间的复杂相互作用，以了解这些因素如何影响肯尼亚西部的食物选择和习惯。
本研究使用半结构化指南，对基苏木县和霍马贝县的不同社会经济群体的社区男性和女性成员进行深入访谈和焦点小组讨论，以进一步了解他们对饮食行为影响的看法。使用数字语音记录器捕获语音数据，逐字转录，并翻译成英文。数据分析采用探索性和归纳性分析方法。使用 NVIVO 12 PRO 软件对编码的回复进行分析。
个人层面的影响因素包括：年龄、食物的营养价值、职业、对某些食物的饱腹感感知、宗教和医疗原因。大多数参与者提到社区层面的位置是主要影响因素，反映在区域主食景观上。其他因素包括农产品的季节性、社会压力和市场上食物的供应情况。食物的价格和距离市场的远近是主要的宏观层面影响因素。其次是人口增长和道路基础设施的改善。
本研究表明，理解饮食偏好是复杂的。未来的干预措施不仅应该在旨在促进社区健康饮食时考虑个人和人际影响，还应该针对社区和宏观环境。这意味着营养促进策略应该关注多种影响因素，为干预措施提供更多选择。然而，政府在解决食品获取、可负担性和市场营销方面的干预仍然是任何重大变革的必要条件。
