Adolescent diet and physical activity in the context of economic, social and nutrition transition in rural Maharashtra, India: a qualitative study

Abstract Objective: To explore the perceptions of adolescents and their caregivers on drivers of diet and physical activity in rural India in the context of ongoing economic, social and nutrition transition. Design: A qualitative study comprising eight focus group discussions (FGD) on factors affecting eating and physical activity patterns, perceptions of health and decision-making on food preparation. Setting: Villages approximately 40–60 km from the city of Pune in the state of Maharashtra, India. Participants: Two FGD with adolescents aged 10–12 years (n 20), two with 15- to 17- year-olds (n 18) and four with their mothers (n 38). Results: Dietary behaviour and physical activity of adolescents were perceived to be influenced by individual and interpersonal factors including adolescent autonomy, parental influence and negotiations between adolescents and caregivers. The home food environment, street food availability, household food security and exposure to television and digital media were described as influencing behaviour. The lack of facilities and infrastructure was regarded as barriers to physical activity as were insufficient resources for public transport, safe routes for walking and need for cycles, particularly for girls. It was suggested that schools take a lead role in providing healthy foods and that governments invest in facilities for physical activity. Conclusions: In this transitioning environment, that is representative of many parts of India and other Lower Middle Income Countries (LMIC), people perceive a need for interventions to improve adolescent diet and physical activity. Caregivers clearly felt that they had a stake in adolescent health, and so we would recommend the involvement of both adolescents and caregivers in intervention design.

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Exploring influences on adolescent diet and physical activity in rural Gambia, West Africa: food insecurity, culture and the natural environment

Public Health Nutrition ◽

10.1017/s1368980020002669 ◽

2020 ◽

pp. 1-11

Author(s):

Ramatoulie E Janha ◽

Polly Hardy-Johnson ◽

Sarah H Kehoe ◽

Michael B Mendy ◽

Isatou Camara ◽

...

Keyword(s):

Physical Activity ◽

West Africa ◽

Digital Media ◽

Dental Health ◽

Local Environment ◽

Data Set ◽

Adolescent Diet ◽

Diet And Physical Activity ◽

Adolescent Engagement ◽

Social And Cultural Factors

Abstract Objective: To explore, from the perspectives of adolescents and caregivers, and using qualitative methods, influences on adolescent diet and physical activity in rural Gambia. Design: Six focus group discussions (FGD) with adolescents and caregivers were conducted. Thematic analysis was employed across the data set. Setting: Rural region of The Gambia, West Africa. Participants: Participants were selected using purposive sampling. Four FGD, conducted with forty adolescents, comprised: girls aged 10–12 years; boys aged 10–12 years; girls aged 15–17 years, boys aged 15–17 years. Twenty caregivers also participated in two FGD (mothers and fathers). Results: All participants expressed an understanding of the association between salt and hypertension, sugary foods and diabetes, and dental health. Adolescents and caregivers suggested that adolescent nutrition and health were shaped by economic, social and cultural factors and the local environment. Adolescent diet was thought to be influenced by: affordability, seasonality and the receipt of remittances; gender norms, including differences in opportunities afforded to girls, and mother-led decision-making; cultural ceremonies and school holidays. Adolescent physical activity included walking or cycling to school, playing football and farming. Participants felt adolescent engagement in physical activity was influenced by gender, seasonality, cultural ceremonies and, to some extent, the availability of digital media. Conclusions: These novel insights into local understanding should be considered when formulating future interventions. Interventions need to address these interrelated factors, including misconceptions regarding diet and physical activity that may be harmful to health.

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What shapes adolescents’ diet and physical activity habits in rural Konkan, India? Adolescents’ and caregivers’ perspectives

Public Health Nutrition ◽

10.1017/s1368980020001731 ◽

2020 ◽

pp. 1-10

Author(s):

Ulka Banavali ◽

Suvarna Patil ◽

Rupali Chavan ◽

Swati Sonawane ◽

Charudatta Joglekar ◽

...

Keyword(s):

Physical Activity ◽

Digital Media ◽

Economic Transition ◽

Group Discussions ◽

Rural Villages ◽

Adolescent Diet ◽

Diet And Physical Activity ◽

The Status ◽

Physical Activity Recommendations ◽

Activity Recommendations

Abstract Objective: To explore, adolescents’ and caregivers’ perspectives, about shaping of diet and physical activity habits in rural Konkan, India. Design: Five focus group discussions (FGD) were conducted with adolescents and two with caregivers. Data were analysed using thematic analysis. Setting: FGD were conducted in secondary schools located in remote rural villages in the Ratnagiri district, Konkan region, Maharashtra, India. Participants: Forty-eight adolescents were recruited including twenty younger (10–12 years) and twenty-eight older (15–17 years) adolescents. Sixteen caregivers (all mothers) were also recruited. Results: Three themes emerged from discussion: (i) adolescents’ and caregivers’ perceptions of the barriers to healthy diet and physical activity, (ii) acceptance of the status quo and (iii) salience of social and economic transition. Adolescents’ basic dietary and physical activity needs were rarely met by the resources available and infrastructure of the villages. There were few opportunities for physical activity, other than performing household chores and walking long distances to school. Adolescents and their caregivers accepted these limitations and their inability to change them. Increased use of digital media and availability of junk foods marked the beginning of a social and economic transition. Conclusion: FGD with adolescents and their caregivers provided insights into factors influencing adolescent diet and physical activity in rural India. Scarcity of basic resources limited adolescent diet and opportunities for physical activity. To achieve current nutritional and physical activity recommendations for adolescents requires improved infrastructure in these settings, changes which may accompany the current Indian social and economic transition.

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Understanding Barriers and Facilitators to Changing Diet and Physical Activity Patterns in South Asian Women at Risk of Gestational Diabetes Mellitus: A Pilot Qualitative Study (DESI-GDM Q)

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2018.01.075 ◽

2018 ◽

Vol 34 (4) ◽

pp. e17-e18

Author(s):

S. Kandasamy ◽

L. Nyguen ◽

D. Sherifali ◽

P. Ritvo ◽

S.S. Anand ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Qualitative Study ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

South Asian ◽

Activity Patterns ◽

Asian Women ◽

South Asian Women ◽

Diet And Physical Activity

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‘I should be disease free, healthy and be happy in whatever I do’: a cross-country analysis of drivers of adolescent diet and physical activity in different low- and middle-income contexts

Public Health Nutrition ◽

10.1017/s1368980020001810 ◽

2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Susie Weller ◽

Polly Hardy-Johnson ◽

Sofia Strommer ◽

Caroline Fall ◽

Ulka Banavali ◽

...

Keyword(s):

Physical Activity ◽

Nutrition Education ◽

Urban Areas ◽

Economic Transition ◽

Cultural Influences ◽

Sub Saharan Africa ◽

Middle Income ◽

Adolescent Diet ◽

Diet And Physical Activity ◽

Low And Middle Income

Abstract Objective: To explore perceptions of how context shapes adolescent diet and physical activity in eight low- and middle-income (LMIC) sites at different stages of societal and economic transition. Design: Novel qualitative secondary analysis of eight data sets generated as part of the international Transforming Adolescent Lives through Nutrition (TALENT) collaboration. Setting: Diverse sites in India and Sub-Saharan Africa. Participants: Fifty-two focus group discussions with 491 participants (303 adolescents aged 10–17 years; 188 caregivers). Results: Analysis of pooled qualitative data identified three themes: (1) transitions in generational nutrition education and knowledge; (2) transition in caregiver–adolescent power balance and (3) the implications of societal and economic transition for diet and physical activity. Adolescents in urban and peri-urban areas could readily access ‘junk’ food. Diets in rural settings were determined by tradition, seasonality and affordability. Physical activity was inhibited by site-specific factors including lack of space and crime in urban settings, and the prioritisation of academic performance. Gender influenced physical activity across all sites, with girls afforded fewer opportunities. Conclusions: Interventions to improve adolescent diet and physical activity in LMIC need to be complex, context-specific and responsive to transitions at the individual, economic and societal levels. Moreover, solutions need to acknowledge gender inequalities in different contexts, as well as structural and cultural influences on diet and physical activity in resource-limited settings. Programmes need to be effective in engaging and reconciling adolescents’ and caregivers’ perspectives. Consequently, there is a need for action at both the community-household level and also through policy.

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Diet and Physical Activity Patterns of Obese and Nonobese Elementary School Children

Research Quarterly American Association for Health Physical Education and Recreation ◽

10.1080/10671188.1968.10613439 ◽

1968 ◽

Vol 39 (4) ◽

pp. 922-928 ◽

Cited By ~ 2

Author(s):

Charles B. Corbin ◽

Philip Pletcher

Keyword(s):

Physical Activity ◽

Elementary School ◽

School Children ◽

Elementary School Children ◽

Activity Patterns ◽

Physical Activity Patterns ◽

Diet And Physical Activity

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What do children, parents and staff think about a healthy lifestyles intervention delivered in primary schools? a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-038625 ◽

2020 ◽

Vol 10 (8) ◽

pp. e038625

Author(s):

Joanna Goldthorpe ◽

Tracy Epton ◽

Chris Keyworth ◽

Rachel Calam ◽

Joanna Brooks ◽

...

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Focus Groups ◽

Primary Schools ◽

Health Behaviours ◽

Research Approach ◽

Successful Implementation ◽

Management Interventions ◽

Diet And Physical Activity ◽

Home And School

ObjectivePrimary schools are crucial settings for early weight management interventions but effects on children’s weight are small and evidence shows that deficiencies in intervention implementation may be responsible. Very little is known about the roles of multiple stakeholders in the process of implementation. We used a multiple-stakeholder qualitative research approach to explore the implementation of an intervention developed to improve the diet and increase the levels of physical activity for children living in some of the most deprived areas of England.DesignFor this qualitative study, interviews and focus groups were carried out using semi-structured topic guides. Data were analysed thematically.SettingSeven primary schools (pupils aged 4 to 11) in Manchester, England.ParticipantsWe conducted 14 focus groups with children aged 5 to 10 years and interviews with 19 staff members and 17 parents.InterventionManchester Healthy Schools (MHS) is a multicomponent intervention, developed to improve diet and physical activity in schools with the aim of reducing and preventing childhood obesity.ResultsThree themes were developed from the data: common understandings of health and health behaviours; congruence and consistency of messages; negotiations of responsibility.ConclusionAll participant groups had a common conceptualisation of health as having physical and psychological components and that action could be taken in childhood to change behaviours that protect long-term health. When parents and staff felt a shared sense of responsibility for children’s health and levels of congruence between home and school norms around diet and physical activity were high, parents and children were more likely to accept the policies implemented as part of MHS. Effective two-way communication between home and school is therefore vital for successful implementation of this intervention.

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Diet and Physical Activity Patterns of School-Aged Children

Journal of the American Dietetic Association ◽

10.1016/j.jada.2008.10.012 ◽

2009 ◽

Vol 109 (1) ◽

pp. 145-151 ◽

Cited By ~ 30

Author(s):

Maya Vadiveloo ◽

Lei Zhu ◽

Paula A. Quatromoni

Keyword(s):

Physical Activity ◽

Activity Patterns ◽

Physical Activity Patterns ◽

School Aged Children ◽

Diet And Physical Activity

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How do we improve adolescent diet and physical activity in India and sub-Saharan Africa? Findings from the Transforming Adolescent Lives through Nutrition (TALENT) consortium

Public Health Nutrition ◽

10.1017/s1368980020002244 ◽

2020 ◽

pp. 1-9

Author(s):

ME Barker ◽

P Hardy-Johnson ◽

S Weller ◽

A Haileamalak ◽

L Jarju ◽

...

Keyword(s):

Physical Activity ◽

Nutritional Status ◽

Peer Group ◽

Sub Saharan Africa ◽

Vulnerable Groups ◽

Easy Access ◽

Activity Levels ◽

Middle Income ◽

Adolescent Diet ◽

Diet And Physical Activity

Abstract Objective: Adolescent diet, physical activity and nutritional status are generally known to be sub-optimal. This is an introduction to a special issue of papers devoted to exploring factors affecting diet and physical activity in adolescents, including food insecure and vulnerable groups. Setting Eight settings including urban, peri-urban and rural across sites from five different low- and middle-income countries. Design: Focus groups with adolescents and caregivers carried out by trained researchers. Results: Our results show that adolescents, even in poor settings, know about healthy diet and lifestyles. They want to have energy, feel happy, look good and live longer, but their desire for autonomy, a need to ‘belong’ in their peer group, plus vulnerability to marketing exploiting their aspirations, leads them to make unhealthy choices. They describe significant gender, culture and context-specific barriers. For example, urban adolescents had easy access to energy dense, unhealthy foods bought outside the home, whereas junk foods were only beginning to permeate rural sites. Among adolescents in Indian sites, pressure to excel in exams meant that academic studies were squeezing out physical activity time. Conclusions: Interventions to improve adolescents’ diets and physical activity levels must therefore address structural and environmental issues and influences in their homes and schools, since it is clear that their food and activity choices are the product of an interacting complex of factors. In the next phase of work, the Transforming Adolescent Lives through Nutrition consortium will employ groups of adolescents, caregivers and local stakeholders in each site to develop interventions to improve adolescent nutritional status.

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