(P24-056-24) Understanding Adolescent Food Purchasing Decisions, Food Insecurity Coping Strategies and Their Aspirations for the School Food Environment: A Photovoice Study

Objectives: Adolescents have increasing autonomy over their food choices and habits formed during this period may have lasting impacts. Junior high school students in Ghana do not have access to government-run school meal programs and must purchase food or bring food from home to eat at school. We assessed factors influencing adolescent food choice, food insecurity coping strategies, and their aspirations for their school food environment.

Methods: We selected 4 public junior high schools in the Cape Coast metropolitan region, Ghana. From each school, 7-10 students were purposely selected to participate in this photovoice study carried out over 5 workshops. Students were provided with a camera and were given photo prompts each week. After each assignment, students met with group facilitators and discussed their photos and the themes.

Results: Five major themes emerged regarding food purchasing influences: food vendor hygiene and safety, affordability, time, taste, and school policies. Key vendor hygiene considerations included clean water for washing, trash storage and burning, proximity to a sewer or site of open defecation, and protection of the food from insects/dust. For affordability, students reported that their small amounts of money constrained them to make less preferred choices, unhealthy choices, or eat smaller quantities. Time was a barrier to eating as the lunch break was too short to buy and eat a full meal. Finally, school policies restricted students from leaving campus to buy food, but students reported off-campus vendors often had cheaper, more hygienic, and more preferred foods. Students reported managing food insecurity through financial support from peers and teachers and taking on work for money/food. Students aspired for more input on the foods sold on campus, clean and defined areas to eat on campus, and more affordable preferred foods.

Conclusions: Adolescents’ aspirations for their school food environments align with health and nutrition recommendations, but they face many barriers in obtaining preferred and healthy foods while at school. Changes to school food environments that match adolescent needs and desires could have a meaningful impact on health and nutrition outcomes.

Funding Sources: NIH FIC & OBSSR, UC Global Health Institute, Fulbright US Student Program