Vegetable intake determinants in disadvantaged adolescents: systematic review of qualitative studies

Abstract

Abstract Background Evidence available on the determinants of vegetable intake in young populations is inconsistent. No review has particularly focused on this topic in disadvantaged adolescents. This systematic review aimed to investigate the determinants of vegetable intake in disadvantaged adolescents reported in qualitative studies. Methods Five electronic databases were searched until October 2020 using combinations of synonyms for vegetable intake, adolescents, and qualitative methodologies. Studies published in peer-reviewed journals were included if they used qualitative methods (e.g., interviews, focus groups, etc.), targeted disadvantaged individuals aged 12-18 years, investigated determinants, motivators and barriers to vegetable intake, and were conducted in urban settings of high-income countries. Two reviewers independently and systematically summarized the papers, assessed their quality and synthesized the findings across studies. Results Sixteen studies meeting the inclusion criteria were included. The synthesis of findings identified the following determinants for vegetable intake: sensory attributes of vegetables; psychosocial factors (nutrition knowledge, preferences/liking, self-efficacy, motivation); lifestyle factors (cost/price, time, convenience); fast food properties (taste, cost, satiety); home environment; parental influence; encouragement/support outside the household; friends' influence; school nutrition education; teachers' support; school food environment; local produce; community nutrition knowledge; and availability and accessibility of vegetables in local stores, restaurants and fast-food outlets. Conclusions Multiple determinants of vegetable intake were identified which complement those investigated in quantitative studies. Future large scale quantitative studies should attempt to examine the relative importance of these determinants in order to guide the development of successful interventions in disadvantaged adolescents. Key messages Vegetable intake is influenced by multiple factors in disadvantaged adolescents. Main determinants are vegetable attributes, personal factors, friends, family, school and community environment.