UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-Food Systems), CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France.
Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Matern Child Nutr. 2022 Oct;18(4):e13412. doi: 10.1111/mcn.13412. Epub 2022 Aug 8.
Evidence on the individual-level drivers of dietary behaviours in deprived urban contexts in Africa is limited. Understanding how to best inform the development and delivery of interventions to promote healthy dietary behaviours is needed. As noncommunicable diseases account for over 40% of deaths in Ghana, the country has reached an advanced stage of nutrition transition. The aim of this study was to identify individual-level factors (biological, demographic, cognitive, practices) influencing dietary behaviours among adolescent girls and women at different stages of the reproductive life course in urban Ghana with the goal of building evidence to improve targeted interventions. Qualitative Photovoice interviews (n = 64) were conducted in two urban neighbourhoods in Accra and Ho with adolescent girls (13-14 years) and women of reproductive age (15-49 years). Data analysis was both theory- and data-driven to allow for emerging themes. Thirty-seven factors, across four domains within the individual-level, were identified as having an influence on dietary behaviours: biological (n = 5), demographic (n = 8), cognitions (n = 13) and practices (n = 11). Several factors emerged as facilitators or barriers to healthy eating, with income/wealth (demographic); nutrition knowledge/preferences/risk perception (cognitions); and cooking skills/eating at home/time constraints (practices) emerging most frequently. Pregnancy/lactating status (biological) influenced dietary behaviours mainly through medical advice, awareness and willingness to eat foods to support foetal/infant growth and development. Many of these factors were intertwined with the wider food environment, especially concerns about the cost of food and food safety, suggesting that interventions need to account for individual-level as well as wider environmental drivers of dietary behaviours.
在非洲贫困城市环境中，有关个人层面饮食行为驱动因素的证据有限。需要了解如何更好地为促进健康饮食行为的干预措施的制定和实施提供信息。由于加纳超过 40%的死亡人数是由非传染性疾病造成的，该国已经处于营养转型的高级阶段。本研究的目的是确定影响加纳城市中不同生殖生命阶段的少女和妇女饮食行为的个人层面因素（生物、人口统计、认知、实践），旨在为改善有针对性的干预措施提供证据。在阿克拉和霍的两个城市社区中，对 13-14 岁的少女和 15-49 岁的育龄妇女进行了定性照片访谈（n=64）。数据分析是理论和数据驱动的，以允许出现新的主题。在个人层面的四个领域中，确定了 37 个因素对饮食行为有影响：生物（n=5）、人口统计（n=8）、认知（n=13）和实践（n=11）。一些因素被认为是健康饮食的促进因素或障碍，包括收入/财富（人口统计）；营养知识/偏好/风险感知（认知）；以及烹饪技能/在家吃饭/时间限制（实践）。怀孕/哺乳期（生物）主要通过医疗建议、对食物的意识和意愿来影响饮食行为，以支持胎儿/婴儿的生长和发育。这些因素中的许多因素与更广泛的食品环境交织在一起，特别是对食品成本和食品安全的担忧，这表明干预措施需要考虑到饮食行为的个人层面和更广泛的环境驱动因素。
