Barriers to and motivators for healthful eating as perceived by rural and urban Costa Rican adolescents

Objective: To assess the perceptions of rural and urban Costa Rican adolescents about their diet and the factors they consider significant to healthful eating. Design: Data were collected in focus group discussions Participants: The study sample included 108 male and female adolescents aged 12 to 18 years. Adolescents were recruited among 7th to 11th grade students interested in taking part in the study. Setting: Two urban and one rural high school in San Jose, Costa Rica. Phenomena of Interest: Diet perceptions and barriers to and motivators for healthful eating. Analysis: Data were reviewed for emerging themes, and themes were coded applying content analysis procedures. The conceptual model for understanding adolescent eating behavior, proposed by Story and colleagues, served as the framework for this study. Results: Factors perceived as barriers to adopting healthful eating practices included unavailability of healthful food in the school environment, inadequate food choices within the family diet, and the peer-group notion among males and females that healthful eating by males is effeminate. Factors perceived as motivators included improving the nutritional quality of foods available at school, adoption of healthful eating practices by the entire family, and healthful eating becoming a peer-group social norm. Conclusions and Implications: This study suggests that the family, peer group, and school environment are potential targets for nutrition interventions for Costa Rican adolescents, but further studies are needed to confirm this conclusion. Future studies should explore in depth the factors associated with the family's eating pattern and the influence of adolescent socialization patterns (particularly male) in the establishment of a healthful diet.