Perceived barriers and facilitators to healthy eating and physical activity in endoscopic bariatric patients: a qualitative study

Background: Sleep is emerging as an important factor that impacts dietary habits, physical activity, and metabolism. However, minimal attention is typically given to sleep in traditional lifestyle interventions. The purpose of these analyses was to examine baseline associations between sleep and physical activity and perceived barriers to healthy eating, which are two common lifestyle intervention targets, in a sample of apparently healthy adults enrolled in a behavioral weight loss intervention study. Methods: 150 overweight adults (51.1±10.2 y; 91% female; 79% Caucasian) participated in a 12-month lifestyle intervention that featured adaptive ecological momentary assessment. Sleep, physical activity, barriers to healthy eating and body habitus/composition were assessed prior to the intervention. Objective sleep was estimated with 7 days of wrist-worn actigraphy (Philips Actiwatch 2); sleep onset latency (SOL; the amount of time it takes to fall asleep after going to bed), sleep efficiency (SE; the percentage of time in bed that is spent asleep), and total sleep time (TST; total time spent asleep) served as the primary actigraphic sleep variables. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Physical activity was assessed with 7 days of waist-worn accelerometry (ActiGraph GT3x). Perceived barriers to healthy eating were assessed with the Barriers to Healthy Eating questionnaire. Body mass index (BMI) served as the measure of body habitus, and body fat was assessed with bioelectrical impedance. Results: Mean BMI and body fat for the sample were 34.0±4.6 kg/m2 and 43.7±5.5%, respectively. Mean TST was 6.6±0.8 h/night; approximately 23% of the sample averaged less than 6 hours of sleep. Mean SOL and SE for the sample were 15.3±16.2 min and 85.7±6.1%, respectively. Based on the PSQI, 52.0% of the sample had poor sleep quality. Following adjustment for age, sex, and race, longer SOL was associated with fewer steps/day (β=-.19, p=.02) and less time spent in moderate to vigorous physical activity (MVPA; β=-.16, p=.03), and lower SE was related to less MVPA (β=.15, p=.04). Shorter TST was associated with greater barriers to healthy eating (β=-.16, p=.05). Longer SOL was associated with higher BMI (β=.16, p=.05) and body fat % (β=.15, p=.03), and lower SE was related to higher body fat % (β=-.13, p=.06). Conclusions: Short sleep duration and sleep disturbance were highly prevalent in this sample of overweight adults. Significant associations were observed between sleep and measures of body habitus/composition and eating and physical activity habits. Efforts to improve sleep during a behavioral intervention for weight loss may reduce barriers to healthy eating and improve physical activity habits as well as weight loss outcomes.

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Barriers and facilitators to healthy eating and physical activity postpartum: A qualitative systematic review

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2021.11.015 ◽

2021 ◽

Author(s):

Rachel A. Ryan ◽

Hope Lappen ◽

Jessica Dauz Bihuniak

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Healthy Eating ◽

Barriers And Facilitators ◽

Qualitative Systematic Review

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Identifying perceived barriers and enablers of healthy eating in college students in Hawai’i: a qualitative study using focus groups

BMC Nutrition ◽

10.1186/s40795-019-0280-0 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 2

Author(s):

Lucia Amore ◽

Opal Vanessa Buchthal ◽

Jinan C. Banna

Keyword(s):

College Students ◽

Qualitative Study ◽

Focus Groups ◽

Healthy Eating ◽

Perceived Barriers ◽

Barriers And Enablers

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Perceptions of eating practices and physical activity among Malaysian adolescents in secondary schools: a qualitative study with multi-stakeholders

Public Health Nutrition ◽

10.1017/s1368980020002293 ◽

2020 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Shooka Mohammadi ◽

Tin Tin Su ◽

Angeliki Papadaki ◽

Muhammad Yazid Jalaludin ◽

Maznah Dahlui ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Secondary Schools ◽

Focus Groups ◽

Healthy Eating ◽

Rural Schools ◽

School Based ◽

Adolescent Participation ◽

Depth Interviews ◽

Malaysian Adolescents

Abstract Objective: To conduct formative research using qualitative methods among stakeholders of secondary schools to explore their perceptions, barriers and facilitators related to healthy eating and physical activity (PA) among Malaysian adolescents. Design: A qualitative study involving eight focus groups and twelve in-depth interviews. Focus groups and interviews were recorded and transcribed verbatim. An inductive thematic analysis approach was used to analyse the data. Setting: Four secondary schools in Perak and Selangor states (two urban and two rural schools) in Malaysia. Participants: Focus groups were conducted with seventy-six adolescents aged 13–14 years, and in-depth interviews were conducted with four headmasters, four PA education teachers and four food canteen operators. Results: Stakeholders thought that adolescents’ misperceptions, limited availability of healthy options, unhealthy food preferences and affordability were important challenges preventing healthy eating at school. Low-quality physical education (PE) classes, limited adolescent participation and teachers’ commitment during lessons were perceived as barriers to adolescents being active at school. Affordability was the main challenge for adolescents from rural schools. Stakeholders perceived that a future school-based intervention should improve the availability and subsidies for healthy foods, provide health education/training for both adolescents and PE teachers, enhance active adolescent participation in PE and develop social support mechanisms to facilitate engagement with PA. Conclusions: These findings provide important insights into developing school-based lifestyle interventions to improve healthy eating and strengthening PA of Malaysian adolescents.

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Perceived Barriers and Facilitators to Healthy Eating in Middle-Aged Hispanic Men (P04-125-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.p04-125-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Shandel Vega-Soto ◽

Cheryl Der Ananian ◽

Hector Valdez ◽

Ferdinand Delgado ◽

Steven Hooker ◽

...

Keyword(s):

Healthy Eating ◽

Eating Habits ◽

Food Choices ◽

Cultural Factors ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Theory Approach ◽

Middle Aged ◽

Increased Risk ◽

Hispanic Men

Abstract Objectives Dietary behaviors contribute to an increased risk of cardiometabolic disease in Hispanic men. Few studies have assessed Hispanic men's perspectives on healthy eating. The purpose of this qualitative study was to identify perceived barriers and facilitators to healthy eating in middle-aged, Hispanic men of Mexican descent. Methods Six focus groups (FGs) with Hispanic men were primarily conducted in Spanish (n = 5 FGs), audio-recorded, transcribed, then translated verbatim to English. A grounded theory approach was used to identify common themes. Results Participants (n = 34; mean age: 54.4 ± 7.0 years) primarily self-identified as Mexican (71%) or Mexican-American (10%). In preliminary findings, the main barriers to healthy eating were competing responsibilities (n = 6 FGs), lack of nutrition knowledge (n = 6 FGs), cultural factors (n = 5 FGs), habits (n = 5 FGs), and available food choices (n = 5 FGs). A demanding work schedule was considered a barrier because it contributes to “eating on the run” and the selection of fast or convenient foods. Cultural factors perceived as barriers to healthy eating included the need to have food at social gatherings and the “Mexican diet.” Food at gatherings was perceived as leading to an increased availability of unhealthy food items and the consumption of large portions. “Mexican foods”, including tortillas, tacos, pozole, meat and cooking fats were considered unhealthy but central to the diet. Family (n = 5 FGs), health reasons (n = 6 FGs), portion control (n = 5 FGs), and nutrition education (n = 5 FGs), were reported as facilitators to healthy eating. Men reported the importance of longevity to support their family as an essential motivator to engage in healthy eating. Participants (n = 3 FGs) also indicated their spouse/partner enabled healthy eating by providing healthy food choices and encouragement or support. Health reasons (e.g., a diagnosis of diabetes or cardiovascular disease, improving health) were an important catalyst to improving eating habits. Conclusions Findings suggest that MA men have an active interest in behavior change affecting healthy eating habits. Our research provides invaluable insight to construct tailored strategies to improve dietary behavior in this vulnerable population. Funding Sources National Institute of Aging.

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