Fusi Sela Ki Folau, Crocetti Alessandro, Cameron Adrian J, Ferguson Megan, Backholer Kathryn, Browne Jennifer
Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Melbourne, Victoria, 3125, Australia.
School of Public Health, The University of Queensland, Brisbane, Australia.
BMC Public Health. 2025 Jun 5;25(1):2096. doi: 10.1186/s12889-025-23210-4.
An unhealthy diet is the leading preventable risk factor for the development of diet-related non-communicable diseases, and the food environment is considered a major determinant of dietary intake. Food-purchasing decisions in retail settings are influenced by a range of individual, environmental, and interpersonal factors. The aim of this study was to explore the perceived influences on food-purchasing decisions among Tongan parents.
This qualitative study involved semi-structured interviews in 2023 with 21 Tongan parents aged 27 to 51 years in Tongatapu, Tonga, a Pacific Island country. Parents were asked questions about the factors that determine where they do their grocery shopping and what influences their food-purchasing decisions. Interview transcripts were analysed using reflexive thematic analysis, informed by the socio-ecological model of food and beverage intake.
Four themes were constructed from the interview data across the different levels of the socio-ecological model of food and beverage intake, each of which represented parents' perceived influences on how they purchased foods from retail outlets. At the micro level, we found that parents often struggle to prioritise healthy food when balancing financial and time constraints, as well as family and cultural expectations regarding food provision. At the meso level, we found that food availability in local retail outlets was important, while at the macro level, the cost of healthy food relative to unhealthy food was a key factor driving purchasing decisions.
Health promotion efforts and public health policies should recognize the multi-dimensional nature of the factors influencing Tongan parents' food-purchasing decisions. Given the prevalence of diet-related non-communicable diseases in Tonga, the social, cultural, commercial and environmental factors driving unhealthy food-purchasing and population diets in Tonga should be a priority for governments and health promotion practitioners.
不健康饮食是与饮食相关的非传染性疾病发展的主要可预防风险因素，而食物环境被认为是饮食摄入的主要决定因素。零售环境中的食品购买决策受到一系列个人、环境和人际因素的影响。本研究的目的是探讨汤加父母认为对食品购买决策有影响的因素。
这项定性研究于2023年对汤加这个太平洋岛国汤加塔布的21名年龄在27至51岁之间的汤加父母进行了半结构化访谈。父母们被问及决定他们在哪里购买食品杂货的因素以及影响他们食品购买决策的因素。访谈记录采用反思性主题分析法进行分析，该分析以食品和饮料摄入的社会生态模型为依据。
根据食品和饮料摄入社会生态模型不同层面的访谈数据构建了四个主题，每个主题都代表了父母认为对他们从零售店购买食品的方式有影响的因素。在微观层面，我们发现父母在平衡经济和时间限制以及家庭和文化对食物供应的期望时，往往难以优先选择健康食品。在中观层面，我们发现当地零售店的食品供应很重要，而在宏观层面，健康食品相对于不健康食品的成本是推动购买决策的关键因素。
健康促进努力和公共卫生政策应认识到影响汤加父母食品购买决策的因素具有多维度性质。鉴于汤加与饮食相关的非传染性疾病普遍存在，推动汤加不健康食品购买和居民饮食的社会、文化、商业和环境因素应成为政府和健康促进从业者的优先事项。
