TY - JOUR
T1 - Better understanding determinants of dietary guideline adherence among Dutch adults with varying socioeconomic backgrounds through a mixed-methods exploration
AU - Stuber, Josine M.
AU - Lakerveld, Jeroen
AU - Beulens, Joline W. J.
AU - MacKenbach, Joreintje D.
N1 - Funding Information: This mixed methods study was conducted according to a convergent parallel design(18). We used data of the cross-sectional Eet & Leef study(11;17), in which quantitative and qualitative data were collected independently from the same study sample during the same phase of the study process. The Eet & Leef study was part of the ‘Healthy Food Environments’ project funded by the Netherlands Organisation for Scientific Research (NWO Veni grant received by JDM). The overall aim of this three-year project was to study several aspects of food choices, the food environment and health outcomes. For the current study, results from both the quantitative and qualitative data were analysed independently and compared following an integrated analytical approach described further down, to determine to what extent quantitative measurements of dietary guideline adherence and its determinants reflect the perceptions individuals with varying socioeconomic backgrounds thereof. The data comparison and interpretation of findings followed an iterative process, in which we compared qualitative and quantitative findings in a reflexive manner without pre-established criteria for corresponding, complementary, or contradictory findings(19). Reporting of this paper is in accordance with the Mixed Methods Article Reporting Standards published by the American Psychological Association(20). Funding Information: Financial Support: JMS and JDM are supported through the Supreme Nudge program funded by the Dutch Heart Foundation and the Netherlands Organization for Health Research and Development (CVON2016-04). The Eet & Leef study was part of the ‘Healthy Food Environments’ project funded by an NWO VENI grant (451-17-032). Funders have no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript, nor have they authority on the decision to submit the manuscript for publication. Publisher Copyright: © The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society.
PY - 2023/6/26
Y1 - 2023/6/26
N2 - Objective: Low dietary guideline adherence is persistent, but there is limited understanding of how individuals with varying socio-economic backgrounds reach a certain dietary intake. We investigated how quantitative and qualitative data on dietary guidelines adherence correspond and complement each other, to what extent determinants of guideline adherence in quantitative data reflect findings on determinants derived from qualitative data and which of these determinants emerged as interdependent in the qualitative data. Design: This mixed-methods study used quantitative questionnaire data (n 1492) and qualitative data collected via semi-structured telephone interviews (n 24). Quantitative data on determinants and their association with total guideline adherence (scored 0-150) were assessed through linear regression. Directed content analysis was used for qualitative data. Setting: Dutch urban areas. Participants: Adults aged 18-65 years. Results: A range of determinants emerged from both data sources, for example higher levels of cognitive restraint (β 5·6, 95 % CI 4·2, 7·1), habit strength of vegetables (β 4·0, 95 % CI 3·3, 4·7) and cooking skills (β 4·7, 95 % CI 3·5, 5·9), were associated with higher adherence. Qualitative data additionally suggested the influence of food prices, strong dietary habits and the social aspect of eating, and for the determinants cognitive restraint, habit strength related to vegetables, food prices and home cooking, some variation between interviewees with varying socio-economic backgrounds emerged in how these determinants affected guideline adherence. Conclusions: This mixed-methods exploration provides a richer understanding of why adults with varying socio-economic backgrounds do or do not adhere to dietary guidelines. Results can guide future interventions promoting healthy diets across populations.
AB - Objective: Low dietary guideline adherence is persistent, but there is limited understanding of how individuals with varying socio-economic backgrounds reach a certain dietary intake. We investigated how quantitative and qualitative data on dietary guidelines adherence correspond and complement each other, to what extent determinants of guideline adherence in quantitative data reflect findings on determinants derived from qualitative data and which of these determinants emerged as interdependent in the qualitative data. Design: This mixed-methods study used quantitative questionnaire data (n 1492) and qualitative data collected via semi-structured telephone interviews (n 24). Quantitative data on determinants and their association with total guideline adherence (scored 0-150) were assessed through linear regression. Directed content analysis was used for qualitative data. Setting: Dutch urban areas. Participants: Adults aged 18-65 years. Results: A range of determinants emerged from both data sources, for example higher levels of cognitive restraint (β 5·6, 95 % CI 4·2, 7·1), habit strength of vegetables (β 4·0, 95 % CI 3·3, 4·7) and cooking skills (β 4·7, 95 % CI 3·5, 5·9), were associated with higher adherence. Qualitative data additionally suggested the influence of food prices, strong dietary habits and the social aspect of eating, and for the determinants cognitive restraint, habit strength related to vegetables, food prices and home cooking, some variation between interviewees with varying socio-economic backgrounds emerged in how these determinants affected guideline adherence. Conclusions: This mixed-methods exploration provides a richer understanding of why adults with varying socio-economic backgrounds do or do not adhere to dietary guidelines. Results can guide future interventions promoting healthy diets across populations.
KW - Dietary pattern
KW - Prevention
KW - Qualitative research
KW - Socio-economic status
UR - http://www.scopus.com/inward/record.url?scp=85147377424&partnerID=8YFLogxK
U2 - https://doi.org/10.1017/S1368980023000228
DO - https://doi.org/10.1017/S1368980023000228
M3 - Article
C2 - 36700250
SN - 1368-9800
VL - 26
SP - 1172
EP - 1184
JO - Public health nutrition
JF - Public health nutrition
IS - 6
ER -