Table 2.

Ghanaian youth, parents and grandparents in New York City (NYC): socio-ecological model domains, place and themes as forces for dietary maintenance and change

Place	Theme	Youth	Convergence	Parents and Grandparents
Intrapersonal Level
New York	‘We eat the same food’a		Maintenance
Ghana	Growing up in Ghana means preference for Ghanaian food		Maintenance
New York	Preferences for rice over starchy fruits, tubers and roots	Change		Maintenance
New York	Youth who grow up in the United States rejected eating African food ‘all the time’ and developed American food preferences	Change
New York	‘Everybody wants to have a taste of whatever they like’	Change
New York	Foods higher in flavour, fat, salt, sugar and calories as more desirable	Change
Interpersonal Level
Ghana	‘Back in Africa you didn't have a choice … Whatever was put in front of you, that's what you ate’		Maintenance
New York to Ghana	Parents would send barrels with ultra-processed and packaged foods high in fat, sugar and calories and financial remittances to children still living in Ghana	Change
New York to Ghana	Monetary remittances provided purchasing power	Change
New York	Mothers would cook African foods because they want to teach them ‘what our food is’		Maintenance
New York	Youth may reject African foods to fit into United States culture	Change
New York	Mothers would cook some ‘American’ foods for youth	Change
New York	Eating together and from one bowl, but, children, men and women eat separately		Maintenance
New York	Social norms about hand hygiene affect social eating practices out of one bowl	Change		Maintenance
New York	Busy schedules change meal patterns		Change
New York	‘Anyone can eat any time they want, anywhere they want’		Change
New York	More full meals per day	Change
Organisational Level
New York	Nutrition and health education		Change
New York	School lunch is free in NYC, so parents encourage youth to try it	Change
New York	Elders and youth are trying to eat healthier to protect from diet-related diseases		Change
Ghana and New York	Global recognition of chronic disease risk means that healthier eating habits are becoming socially desirable		Change
New York	Documentaries and TV personalities promote healthier lifestyles		Change
New York	Healthier diets after graduating college	Change
Community Level
New York	Food in NYC is aplenty and may lead to larger portion sizes and more frequent meals		Change
Ghana	Foods in Ghana are fresh, clean, organic, and produced without hormones, fertilizers, pesticides and genetically modified organisms		Maintenance
New York	American foods were considered unclean, genetically modified and produced with hormones, fertilizers and pesticides		Maintenance
New York	African food ingredients are expensive		Change
New York	Ingredients to cook African foods are available in NYC Supermarkets	Maintenance
New York	Processed and packaged African foods are not ‘real’			Change
New York	Concerned about personal hygiene of the person preparing the food	Maintenance
New York	Lots of unhealthy snack options in the cultural enclave	Change
New York	Ubiquitous and affordable ‘fried rice’	Change
New York	Eating out at Ghanaian or African restaurants was equivalent to eating at home and considered an unnecessary expense		Maintenance
New York	Eating out only for special occasions: ‘Anything that wasn't our food’		Change
Public Policy and Global Forces Level
Ghana	Media influences and product placement in films and online media		Change
Ghana	Vacations and visits to Ghana expose to Ghanaian community, foods and items brought back to NYC		Maintenance
Ghana	Vacations and visits to the United States expose to American foods		Change
Ghana	Cities have more processed foods, but rural areas get to eat healthier		Maintenance and Change
Ghana	Progress and a move towards achieving higher living standards		Change
Ghana	Globalisation brought fast food, ultra-processed and packaged foods		Change

^aItalicized text in quotation marks indicates in vivo codes