Tandoh Akua, Holdsworth Michelle, Aryeetey Richmond, Agyemang Charles, Laar Amos
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France.
Matern Child Nutr. 2025 Jul;21(3):e70011. doi: 10.1111/mcn.70011. Epub 2025 Mar 6.
School food environments play an important role in shaping children's food-related decisions, including where and what foods to acquire and consume on a school day. In Ghana, evidence indicates that food environments in and around schools may limit healthy food acquisition and consumption behaviour. This study aimed to understand how children's experiences and perceptions of their school food environment influence food acquisition and consumption decisions. Data from 18 focus group discussions with children (n = 157; aged 10-17 years) attending Public Basic Schools in the Greater Accra Region of Ghana were analysed, guided by the African urban food environment framework for creating healthy nutrition policies and interventions. Children's food decisions in school were found to be influenced by experiences and perceptions at multiple food environment levels: macro, physical and social levels in combination with individual-level factors. At the macro level, exposure to food advertisements on television emerged as an influence on food-related decisions. At the physical level, experiences and perceptions of environmental sanitation, food vendor hygiene practices, affordability, and food quality were consistently reported to influence decisions. Social-level experiences including influence from friends/peers, family (mostly caregivers/parents) and social qualities of food vendors also shaped food-related decisions. Caregiver/parental dietary advice was often linked to healthier acquisition and consumption decisions by children in school. The findings highlight the need for actions that work in synergy across multiple levels of the school food environment to create conditions that support children to acquire and consume healthier diets.
学校食物环境在塑造儿童与食物相关的决策方面发挥着重要作用，包括在上学日获取和食用食物的地点及种类。在加纳，有证据表明学校内外的食物环境可能会限制健康食物的获取和消费行为。本研究旨在了解儿童对其学校食物环境的体验和认知如何影响食物获取和消费决策。以非洲城市食物环境框架为指导，分析了来自加纳大阿克拉地区公立基础学校的18组儿童（n = 157；年龄在10 - 17岁之间）焦点小组讨论的数据，该框架用于制定健康营养政策和干预措施。研究发现，儿童在学校的食物决策受到多个食物环境层面的体验和认知的影响：宏观、物理和社会层面以及个人层面的因素。在宏观层面，电视上的食品广告曝光成为影响食物相关决策的因素之一。在物理层面，环境卫生、食品摊贩卫生习惯、可承受性和食品质量的体验和认知一直被报告为影响决策的因素。包括朋友/同伴、家庭（主要是照顾者/父母）的影响以及食品摊贩的社会品质等社会层面的体验也塑造了与食物相关的决策。照顾者/父母的饮食建议往往与儿童在学校更健康的获取和消费决策相关联。研究结果强调需要采取行动，在学校食物环境的多个层面协同发挥作用，以创造条件支持儿童获取和食用更健康的饮食。
