title: Barriers to and motivators for healthful eating as perceived by rural and urban Costa Rican adolescents.
abstract: OBJECTIVE
  To assess the perceptions of rural and urban Costa Rican adolescents about their diet and the factors they consider significant to healthful eating.
  
  
  METHODS
  Data were collected in focus group discussions.
  
  
  METHODS
  The study sample included 108 male and female adolescents aged 12 to 18 years. Adolescents were recruited among 7th to 11th grade students interested in taking part in the study.
  
  
  METHODS
  Two urban and one rural high school in San José, Costa Rica.
  
  
  METHODS
  Diet perceptions and barriers to and motivators for healthful eating.
  
  
  METHODS
  Data were reviewed for emerging themes, and themes were coded applying content analysis procedures. The conceptual model for understanding adolescent eating behavior, proposed by Story and colleagues, served as the framework for this study.
  
  
  RESULTS
  Factors perceived as barriers to adopting healthful eating practices included unavailability of healthful food in the school environment, inadequate food choices within the family diet, and the peer-group notion among males and females that healthful eating by males is effeminate. Factors perceived as motivators included improving the nutritional quality of foods available at school, adoption of healthful eating practices by the entire family, and healthful eating becoming a peer-group social norm.
  
  
  CONCLUSIONS
  This study suggests that the family, peer group, and school environment are potential targets for nutrition interventions for Costa Rican adolescents, but further studies are needed to confirm this conclusion. Future studies should explore in depth the factors associated with the family's eating pattern and the influence of adolescent socialization patterns (particularly male) in the establishment of a healthful diet.
authors.affiliation: Costa Rican Institute for Research and Education on Nutrition and Health, Ministry of Health, Tres Ríos, Costa Rica. rmonge@inciensa.sa.cr
authors.forename: Rafael
authors.initials: R
authors.lastname: Monge-Rojas
authors.forename: Carlos
authors.initials: C
authors.lastname: Garita
authors.forename: Marta
authors.initials: M
authors.lastname: Sánchez
authors.forename: Leda
authors.initials: L
authors.lastname: Muñoz
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D053198:Child Nutrition Sciences / Q000193:education*; D003364:Costa Rica; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D017144:Focus Groups; D005522:Food Services / Q000592:standards*; D005523:Food Supply; D006293:Health Promotion; D006801:Humans; D008297:Male; D010379:Peer Group; D012424:Rural Population; D012574:Schools; D012737:Sex Factors; D014505:Urban Population