Current practices and strategies to improve the food environment in low‐income schools to reduce non‐communicable risk factors in children in Guatemala City: a qualitative study (1019.21)

Abstract

Developing countries like Guatemala have recently undergone rapid transitions driven by globalization and development. These have accelerated the increase in prevalence of overweight, obesity and non‐communicable disease risk factors among children. Schools have been identified as effective settings for early intervention and favorable arenas in which to target children’s dietary behaviors, especially through structural approaches. The pilot phase of ¡Pilas!, a school‐based intervention developed by the Institute of Nutrition of Central America and Panama (INCAP), with the support of Johns Hopkins University, sought to improve children’s nutrition but was unsuccessful in its objective to facilitate positive change in school food kiosks (casetas). The aim of this qualitative study is to better understand influencing factors on nutrition within the context of low‐income elementary schools in Guatemala City and to improve the school food environment by identifying strategies targeted at casetas. In‐depth interviews with school principals (n=4) and food vendors (n=4) and focus groups involving interactive activities with children (n=48) were conducted. The current food environment is shaped by school and government regulations and enforcement, products available at casetas, food and/or money brought from home and school provided snack (refacción). Other determinants of dietary behavior include children’s preferences, product pricing, and parental time and concern for nutrition. The degree to which regulations are understood and enforced at each school, as well as evident vendor challenges, are necessary to consider in identifying appropriate intervention level and design. Hopeful strategies to be further piloted include enforcement policies, healthy and creative food preparation, price manipulation and promotions, raffles and games, as well as government and big company involvement.Grant Funding Source: Institute of Nutrition of Central America and Panama (INCAP)