Attitudes, norms and behaviors enhancing unhealthy food choices of high school students in Armenia

Abstract

Abstract Background Negative attitudes towards healthy eating behaviors are common among school-aged children. Given the scarcity of studies investigating eating behaviors among adolescents in Armenia, the current study sought to explore eating behaviors among high school students and assess the attitudes, norms and behaviors enhancing unhealthy food choices among them. Theory of Planned Behavior (TPB) was applied as a theoretical framework. Methods A qualitative study with focus group discussions and in-depth interviews was conducted using semi structured interview guides developed based on TPB framework. The study covered high school students aged 15-18 years old, their parents, teachers and school canteen staff, residing in cities and villages of Shirak province, Armenia. Direct content analysis with deductive approach was used for data analysis. Results The most preferred foods by the adolescents were fast foods, sweets, salads and sugar sweetened beverages. Taste was the most powerful attitudinal factor influencing their food choices. Friends and advertisements were the main role models affecting adolescents’ eating behaviors. Knowledge on unhealthy food choices and the consequences of unhealthy diet on one’s health were adequate among all participants, but unlike rural participants, this factor did not result in healthy eating behavior among urban participants. Lack of time, high cost of food, seasonal changes in food availability, limited food choices in school canteens and low coverage of schools with canteens, especially in the villages, had considerable impact on adolescent’s food choices. Conclusions According to the study results, most of the TPB constructs played role in shaping unhealthy eating behaviors among adolescents. Based on the findings, recommendations were made to conduct social advertising of healthy food choices and healthy eating behaviors among adolescents, empower school cafeterias and increase the coverage of schools with cafeterias. Key messages In Armenia, adolescents’ eating behaviors are mainly influenced by taste, availability, and affordability of food choices, eating behavior of peers and advertisements. Government needs to increase the coverage of schools with cafeterias and empower school cafeterias, so that they suggest healthy, tasty and affordable food choices.