Table 2 Themes from analyses and supporting excerpts/quotes
Themes/sub-themes | Supporting excerpts & quotes | Contributing studies |
|---|---|---|
Vegetables characteristics | ||
Sensory attributes | “Cut [up] fresh, not old fruits or vegetables. If it smells good, then it will make you want to eat more.” [45] | |
Personal factors | ||
Cognitive factors | Like parents, many children reported that the foods they disliked were legumes, cooked vegetables and fish. [48] | |
Participants’ knowledge of food groups was minimal. Several did not distinguish between fruits and vegetables. [39] | ||
Family histories of obesity, diabetes, and heart disease were listed as factors motivating adolescents to consume food identified as healthy, such as fruits and vegetables. [47] | ||
About a third of participants said they did not consume more fruits and vegetables because they did not think about it. Several mentioned that they did not actively prioritize healthy eating behaviors, as illustrated by the following quote in response to the question about reasons for not eating more fruits and vegetables: “I don’t think about it.” [51] | ||
Other noted perceived barriers to fruit and vegetable consumption included taste preferences: “Yeah, cauliflower is nasty.” [51] | ||
Lifestyle factors | ““If [fruit and vegetables are] cut up or something and there, it’s ready to eat, I’ll eat it.” [52] | |
Although all key informants noted that it is easy to buy many different kinds of vegetables and fruits at the Asian grocery stores, some Hmong Americans are not eating as many vegetables and fruits because of lack of time and money to purchase the vegetables and fruits with which to prepare traditional meals with fresh ingredients. [45] | ||
“Vegetables and fresh food is far dearer.” [48] | ||
Fast-food vs vegetables | “I do think emm to buy fresh fruit emm and fresh vegetables is a lot more expensive than them going to buy beans and chips.” [49] | |
Students also said it is difficult to eat as recommended because taste is very important to them and "junk food" tastes better than more healthful options (e.g., fruits, vegetables, dairy products, and lower-fat products). [37] | ||
They discussed cost as an issue and said that they like fast food because it is inexpensive, and they can get filled up for a few dollars, whereas eating salads or eating at another kind of restaurant with more healthful foods costs more. [37] | ||
Family, home & friends | ||
Home food environment | “The more children you have, the tighter your money is when it comes to buying groceries.” [45] | |
Only three students mentioned eating cooked vegetables during dinner at home. [39] | ||
A majority of participants cited their home environment as an important source of healthy food, such as fruits and vegetables. [51] | ||
Parental influence | ““I told her that this is how we always eat. She has to eat this to help her body, so that she doesn’t have diabetes and high blood pressure.” [45] | |
“I tell my child, ‘Eat vegetables so you’ll be strong,’ then he eats it. [45] | ||
A participant described how food consumption at home was heavily influenced by parents’ choices and the availability of food items [51] | ||
Several felt they ate healthier if adults at school and home provided healthy foods and encouraged their consumption [44] | ||
Participants noted children ate more fruits and vegetables if their families were eating more fruits and vegetables. [38] | ||
A major feedback structure identified was the normalization of more fruits and vegetables at home, which increased when the family ate more fruits and vegetables together, with adults role-modelling healthy eating. [38] | ||
External encouragement/support | Rather than purchasing fast food, families could also be encouraged to prepare healthy versions of fast foods, alternatively they could be encouraged to purchase a healthier meal option, e.g. charcoal chicken with a home-made salad. [52] | |
Friends’ influence | Foods such as fruits and vegetables were not listed as items purchased in the presence of friends [47] | [47] |
School | ||
Nutrition education | “Teachers at school talk about it. We watch some videos on vegetables and needing to exercise’’ [47] | [47] |
Teachers’ support/encouragement | Several felt they ate healthier if adults at school and home provided healthy foods and encouraged their consumption [44] | [44] |
School food environment | Many students said that they would eat fruits and vegetables if schools offered a variety and served them fresh. [40] | |
Students voiced awareness that fruits and vegetables were healthy but believed that current school food was “greasy” and unhealthy. [42] | ||
Most participants said school lunch meals were a key source of healthy food and regularly offered fruits and vegetables in their community. [51] | ||
Community | ||
Local produce | Overwhelmingly, students across groups said that the best way to get students to care about eating local produce is to make it ‘‘tastes good’’ and ‘‘looks good.’’ [50] | [50] |
Community nutrition knowledge & practices/norms | Participants identified the effect of community practices and norms on children’s fruit and vegetable intake, mentioning food prepared for community gatherings at church and on the marae (Maori meeting grounds) which could be either positive or negative in aiding fruit and vegetable intake. [38] | [38] |
Local stores/restaurants | Most stated they would make healthier choices if “quality” restaurants and markets were available in their community. Examples offered included grocery stores that supply organic, fresh produce and natural foods. [39] | |
In their description of corner stores and carry-outs, many indicated that fruits and vegetables are not readily accessible at these locations. Participants also indicated that when fruits or vegetables are available in nearby stores, the products are of poor quality and ’’nasty‘‘. [47] | ||
A majority of participants perceived fruits and vegetables to be highly available in their community and said they could easily access these items at nearby grocery stores, their home, or their school. [51] | ||
Fast-food restaurants | Most participants ate only salads that included lettuce and tomatoes or had this added to a sandwich at school lunch or a fast-food restaurant meal. [39] | |
Participants stated that they seldom order salads or milk at a fast-food restaurant because they are not available or not promoted; they are not as visible as other options. Furthermore, if salad is available, they expressed concerns about its quality. [37] | ||