title: A qualitative study exploring how school and community environments shape the food choices of adolescents with overweight/obesity.
abstract: This study explored perceived barriers and facilitators to healthful eating in schools and communities among overweight teens who completed an E-health intervention. Twenty-two teens were recruited to a photovoice study and asked to take pictures of things that made it easier or harder to make healthful food choices at school and in their community. Digital photographs were reviewed using semi-structured interviews. Transcribed audio-recordings were analyzed using constant comparative analysis. Similar themes emerged from the school and community environments with food/beverage availability emerging most frequently, followed by peer influence, accessibility/convenience, price, classroom practices, marketing and online influences. Teens described an obesity-promoting environment and perceived very limited healthful options. Policy-driven environmental changes as well as strategies that help teens navigate food choices in their schools and communities are needed to support healthful eating.
authors.affiliation: School of Population and Public Health, University of British Columbia, F508-4480 Oak Street, Vancouver, BC, V6H 3V4, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. Electronic address: awwatts@umn.edu.
authors.forename: Allison W
authors.initials: AW
authors.lastname: Watts
authors.affiliation: School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. Electronic address: chris.lovato@ubc.ca.
authors.forename: Chris Y
authors.initials: CY
authors.lastname: Lovato
authors.affiliation: Food Nutrition & Health, University of British Columbia, FNH244-2205 East Mall, Vancouver, BC, V6T 1Z4, Canada. Electronic address: susan.barr@ubc.ca.
authors.forename: Susan I
authors.initials: SI
authors.lastname: Barr
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada. Electronic address: rhanning@uwaterloo.ca.
authors.forename: Rhona M
authors.initials: RM
authors.lastname: Hanning
authors.affiliation: School of Population and Public Health, University of British Columbia, F508-4480 Oak Street, Vancouver, BC, V6H 3V4, Canada; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. Electronic address: lmasse@cfri.ubc.ca.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Mâsse
mesh_terms: D000293:Adolescent; D002648:Child; D002755:Choice Behavior; D004777:Environment; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology; D036301:Qualitative Research; D012111:Residence Characteristics; D012574:Schools; D012931:Social Environment
keywords: Adolescent overweight; Community environment; Food choice; School environment