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

Establishing healthy and sustainable dietary habits in childhood is necessary for the prevention of obesity and chronic diseases, as well as for the growing pressure on our ecosystems. Considering that parents are the most important actors in affecting dietary behaviors of their children, and that there is a social gradient for obesity, this study aims to investigate differences in determinants of both healthy and sustainable food choices among parents with a higher and lower socioeconomic status (SES). Fifteen focus groups and four individual interviews (n = 78) with parents of children aged 6 to 12 were conducted in Belgium. A semi-structured interview guide based on a socioecological model was used. The interviews were recorded, transcribed and thematic content analysis was performed using NVivo 1.0. Findings indicate some differences in determinants of healthy and sustainable food choices among higher and lower SES parents. Generally, higher SES parents reported more barriers for sustainable than for healthy food choices. They showed more positive attitudes towards healthy than sustainable food choices, and reported low knowledge and self-efficacy to make sustainable food choices, while a lack of time was a barrier to cook both healthy and sustainable meals. Lower SES parents, like higher SES parents, showed more positive attitudes towards healthy food choices. They reported high prices and a lack of inspiration and skills as barriers for both food choices, while also being influenced by their cultural backgrounds. For both SES types of parents, children had a strong influence on their healthy and sustainable food choices. The findings suggest socioeconomic differences in determinants of healthy and sustainable food choices. Hence, these differences should be taken into account when developing intervention strategies to improve food choices in parents.