Table 3.
Qualitative results from focus group discussions among of the adolescent participants by SES level, Austin, TX, USA, 2012
| Sub-themes | Levels of socio-ecological model | Quotes from adolescents living in higher-SES communities | Quotes from adolescents living in lower-SES communities | |
|---|---|---|---|---|
| Nutrition knowledge | ||||
| A | Nutrition knowledge | Individual | When asked how many calories a high-school student needs in a day, answers included: ‘There is a baseline of 2000 but if you're an athlete you need more.’ ‘I know I need to eat 2000, but it would be nice to understand it better but I don’t really worry about it.’ ‘I think it's like 2000 calories.’ | When asked how many calories a high-school student needs in a day, answers included: ‘600 I think?’ ‘It depends because like if you are very active you can eat a lot more.’ ‘Ain’t it about twenty a day?’ ‘I thought it was like 1000 to 3000.’ |
| Menu labelling awareness and use | ||||
| B | Menu label awareness | Individual | When asked about noticing nutrition information on menus: ‘I have never seen nutrition [information].’ ‘Apart from meals marked vegan or gluten free, no.’ ‘Never.’ ‘I have never seen calories on a menu.’ ‘I’ve seen it in Subway… they have their weight loss meals.’ ‘I have noticed it on menus but I don’t look at it.’ | When asked about noticing nutrition information on menus: ‘No, I don’t notice it.’ ‘Yeah I’ve seen it and I barely notice it because I’m only looking at the menu.’ ‘I don’t even notice that stuff.’ ‘At Subway it looks like it’s all over the menu.’ ‘Just don’t care.’ |
| C | Menu label use | Individual | ‘I look at food and if it’s actually… I know how many calories there are in a dish... I will base how good it is worth eating or not. Because if it’s just a really crappy burger that is 1000 calories that are like empty calories then I am not going to eat that.’ ‘I don’t really look at it.’ ‘I don’t think guys our age care about nutrition, unless it becomes a personal problem for them such as obesity or diabetes.’ | ‘I know there are tons of fat people. I mean if it becomes an issue and starts affecting me and there are a ton of people around me that are fat, then I would be like we need to fix this.’ ‘It wouldn’t change what I order because I order off the dollar menu so it don’t matter they all little.’ ‘Just don’t care.’ ‘I’m skinny so I’m opposite I’m trying to get fat.’ ‘It doesn’t really matter to me, I just eat food.’ |
| Influences on food purchasing decisions | ||||
| D | Characteristics of food | Individual | ‘Quality is more important over taste.’ ‘Maddie’s because it’s tasty… good food and it’s not very expensive.’ ‘We like new places.’ ‘When I eat fast food I always feel guilty. So I try and eat healthier at fast-food restaurants.’ ‘I look at what’s in it. Not so much calories, but the ingredients.’ | ‘I'm the type of person I usually get the same thing.’ ‘It’s just what I’m used to ordering.’ ‘The taste.’ ‘Taste, if it don’t taste good, then I want a refund.’ ‘I want to be full, that’s what I want to be.’ |
| E | Parental influence | Interpersonal | When asked if parents influence meal choices: ‘My parents [influence me] kind of a lot. Because if you get something they don’t approve of, you get that judging stare and you know you are doing something you shouldn't be doing.’ ‘They influence on picking where we go out.’ ‘My Mom’s vegetarian. So I never get anything with meat, so that she can try some too.’ ‘My parents don’t let me eat out because it’s like not healthy.’ | When asked if parents influence meal choices: ‘Like it depends if she pays, she’ll be like: “You better get off the dollar menu”.’ ‘Me and my momma eat the same, but she likes to try whatever we are eating.’ ‘My family, we don't worry about calories.’ ‘No, I pretty much get what I want…’ ‘No, unless they got something for everybody, then you have no choice.’ |
| F | Friend influence | Interpersonal | ‘In general we eat more unhealthy with our friends… whenever we go to our friend’s house we can walk to the corner store and gets tons of chips and cookies… yeah and on sleepovers.’ ‘Junk food is fun, it’s one of the forbidden foods and not something you eat every day. It’s fun to eat with other people… with friends...’ ‘Well a lot of my [girl] friends we all like to eat everything, and so we’re going to share because it’s a lot cheaper.’ ‘It depends what my friends are getting because if they are all getting salad then I am definitely not going to be the one eating nachos [girl].’ ‘My friends we like everything, so we are going to share.’ ‘No, I just get what I was going to get.’ ‘No.’ | ‘Well a lot of my friends we all like to eat everything, and so we’re going to share because it’s a lot cheaper.’ ‘No see how we do it is, I gets a fry, she gets a fry, she gets three cookies, and I gets two apple pie.’ ‘A lot of different things so we can all try something different.’ ‘We split everything so then everyone gets what they want, you know.’ ‘Me and my best friend would order the same thing.’ ‘We want the same thing.’ ‘No.’ ‘If they say it’s good I might wanna try it.’ ‘I’m the type of person I usually get the same thing. I already know how it tastes.’ ‘No I stick to what I know.’ |
| G | Location | Environmental | ‘We like to look for new places…’ | ‘McDonalds, Jack in the Box because it is good food and it’s cheap.’ ‘Same thing, McDonalds.’ ‘We walk down the trail and when you walk down, Jack and the Box is right there and then there is a store and then it’s McDonalds.’ ‘We walk down the trail.’ ‘Yea and Taco Bell too.’ |
| H | Cost | Environmental | ‘It will vary where I go with parents or friends because I don’t have as much money to spend on myself with friends.’ ‘Large quantity of food and it’s affordable.’ ‘Because it’s not too expensive.’ ‘… It’s a Chinese restaurant and it’s cheap, and you can order a lot of food for not that much… it’s not too unhealthy.’ | ‘The number one thing that influences my decision is cost.’ ‘If I had more money I would buy it, but if I don’t have money I’m not.’ ‘When I buy something new and I don’t like it I think it’s a waste of money… so I usually get the same thing.’ |
| Strategies for effective menu labels | ||||
| I | Relevance | When asked if knowledge about exercise required to burn off calories would make a difference in meal choice: ‘Yeah, that would be terribly effective.’ ‘So I would keep eating, but I would feel horrible. It would ruin the eating experience.’ ‘Oh yeah, you eat that meal but I have to do this much to burn that off, maybe I won’t take it.’ When asked what adolescents would put on a menu label: ‘It would be a goodness scale. Does it taste good, yeah, is it good for me, yeah or no. It would have yes or no questions because you don’t want to have all the information you just want to look at it and see yes or no.’ ‘Something simple, is it healthy or not?’ ‘I had the idea of possibly doing a much smaller print, most people wouldn’t notice, but the people that actually did, would, having side-effects like on that on medication. I think that would be great. Like possible diarrhoea, constipation, or like even prolonged use risk of death or heart attack. So when you are reading this you are like I don’t want to have diarrhoea or a heart attack so I am just not going to eat this.’ ‘The grading if it’s good.’ | When asked if knowledge about exercise required to burn off calories would make a difference in meal choice: ‘I would die if I had to walk an hour.’ ‘Yeah, but it still wouldn’t matter because I won’t gain weight.’ When asked what adolescents would put on a menu label: ‘Tell them what everything means, like calories, fat, sodium this is what it does to me.’ ‘Why should I have more or less of it, then I would probably be convinced, if they make it sound bad you aren’t gonna want it.’ ‘How many chips were in a bag, and how many we can eat in a day.’ ‘If y’all talked about the outcome situation, then yeah, they won’t do it.’ | |
| J | Pictures | ‘Show everything with a picture, you don’t have to read anything.’ | ‘Pictures and photographs would be helpful.’ ‘I would put fat kids on the one like that.’ ‘How it looks is important.’ | |
| K | Stop light system | ‘… So apparently they label all their food as green, yellow, or red. Like a stoplights. Like red is like bad for you, yellow you like can eat some of the time, and green is eat this all of the time. So having something like that on food labels would be helpful because it would tell people how much to eat.’ ‘Kind of what he said, like the green, yellow, or red. … design it so it is pretty easy to read even if it was pie charts. Simple.’ | ||
| L | Simple | ‘Straightforward, familiar, colourful.’ ‘Big writing.’ ‘Nothing too small.’ ‘Just something easy to read, something that you could read in just a second. Like good, bad, or ok.’ ‘I know how they have at Chili’s they have peppers marking the spiciness, so you could just have different colour of circles…’ ‘It’s nice to look at it quickly, you don’t have to stare at it.’ | ||
SES, socio-economic status.