Mediators of parental educational differences in the intake of carbonated sugar-sweetened soft drinks among adolescents, and the moderating role of neighbourhood income.

BACKGROUND: Existing evidence suggests that the intake of sugar-sweetened beverages (SSB) among adolescents remains a public health concern and that socioeconomic differences in intake exist. Tackling these challenges requires identifying the factors associated with SSB intake and the mediators of socioeconomic differences in SSB intake among adolescents. Thus, this study aimed to explore (i) factors at different levels of the ecological model associated with the intake of carbonated soft drinks with added sugar (hereafter called soft drinks), (ii) mediators of the association between parental education and the intake of soft drinks(iii) whether neighbourhood income moderates the indirect effect of parental education on adolescents' soft drink intake through potential mediators. METHODS: Data from 826 7th graders in Oslo, Norway, who participated in the TACKLE cross-sectional study conducted in 2020 were used. The association between factors at the individual, interpersonal and neighbourhood food environment levels and the intake of soft drinks among adolescents was assessed, as well as the mediating roles of these factors for the differences in intake by parental education, using multiple logistic regression and mediation analysis, respectively. Moderated mediation analyses were used to explore whether an indirect effect of parental education on adolescents' soft drink intake through potential mediators varies across neighbourhood income areas. RESULTS: Higher perceived accessibility of SSB at home, increased parental modelling for SSB intake, and increased frequency of food/drink purchased from the neighbourhood store were associated with a higher intake of soft drinks among adolescents and mediated the differences in intake by parental education. Neighbourhood food environment factors were neither statistically significantly associated with adolescents' higher intake of soft drinks nor explained the differences in intake by parental education. Moderated mediation analysis showed that the mediating effect of perceived accessibility of SSB at home on the association between parental education and adolescent soft drink intake was stronger among those living in low neighbourhood income. CONCLUSIONS: Our study identified modifiable factors at the intrapersonal level (perceived accessibility of SSB at home and frequency of food/drink purchased from neighbourhood shops) and interpersonal levels (parental modelling for SSB intake) associated with a higher intake of soft drinks among adolescents and mediated the differences in the intake by parental education. The modifiable factors identified in this study could be targeted in public health initiatives among adolescents aimed at reducing the intake of soft drinks and the related differences by parental education.

Does the socioeconomic positioned neighbourhood matter? Norwegian adolescents' perceptions of barriers and facilitators for physical activity.

BACKGROUND AND AIMS: A higher proportion of adolescents from lower socioeconomic position families tend to be less physically active than their counterparts from higher socioeconomic position families. More research is needed to understand the causes of these differences, particularly the influence of the neighbourhood environment. This qualitative study aims to explore how adolescents and their parents from higher and lower socioeconomic neighbourhoods perceive the social, organisational and physical environment influencing adolescents' physical activity behaviours. METHOD: We conducted six semi-structured focus groups with 35 13-14-year-olds and eight interviews with some of their parents. The interviewees were recruited from one higher and two lower socioeconomic neighbourhoods in Oslo, Norway. Theme-based coding was used for analysis, and the results discussed in light of an ecological framework. RESULTS: The results indicate that factors like social norms in a neighbourhood could shape adolescents' physical activity behaviour, and a social norm of an active lifestyle seemed to be an essential facilitator in the higher socioeconomic neighbourhood. Higher availability of physical activity and high parental engagement seemed to facilitate higher physical activity in this neighbourhood. In the lower socioeconomic neighbourhoods, the availability of local organised physical activity and volunteer engagement from parents varied. Programmes from the municipality and volunteer organisations seemed to influence and be essential for adolescents' physical activity behaviour in these neighbourhoods. CONCLUSIONS: The results illustrate the complexity of behaviour and environment interaction, and a limitation in explaining the phenomenon by focusing primarily on the individual level rather than an ecological perspective.

Perceptions of the social and physical environment of adolescents' dietary behaviour in neighbourhoods of different socioeconomic position.

A higher proportion of adolescents from families in a lower socioeconomic position (SEP) tends to have more unhealthy dietary behaviours, and overweight and obesity, than their counterparts in higher SEPs. More research is needed to understand the causes of these differences, in particular the influence of the neighbourhood environment, which has been explored less. The presented qualitative study explores how adolescents and their parents from higher and lower SEP neighbourhoods perceive the social and physical environment influencing adolescents' dietary behaviours. We conducted 6 semi-structured focus groups with 35 13-14 year olds and 8 interviews with some of their parents. The interviewees were recruited from one higher and two lower SEP neighbourhoods in Oslo, Norway. Theme-based inductive coding was used for analysis, and the results discussed in light of an ecological framework. The results indicate that all the adolescents experience several barriers to healthy dietary behaviours. For adolescents in the lower SEP neighbourhood, one or both parents desired their cultural cuisine served at home, whereas the adolescents wanted and often consumed western dishes. Fast-food restaurants or hanging out at the mall was perceived as the preferred social arena, often due to lack of involvement in either leisure-time physical activities or youth clubs as a safe, engaging option. The adolescents in the higher SEP neighbourhood perceived social norms which accentuated healthy dietary choices. When more possibilities for activities were present and the adolescents expressed being highly engaged in leisure-time physical activity, this also seemed to facilitate healthier dietary behaviours. These findings indicate how several factors simultaneously can influence dietary behaviour. Use of a multi-layered approach when exploring the environmental influences could increase knowledge about tackling social inequalities in dietary behaviours among adolescents.

Mediators of socioeconomic inequalities in dietary behaviours among youth: A systematic review.

Children and adolescents with a lower socioeconomic position have poorer dietary behaviours compared to their counterparts with a higher socioeconomic position. A better understanding of the mechanisms behind such socioeconomic inequalities is vital to identify targets for interventions aimed at tackling these inequalities. This systematic review aimed to summarize existing evidence regarding the mediators of socioeconomic differences in dietary behaviours among youth. A systematic literature search of MEDLINE, Embase, PsycINFO, and Web of Science databases yielded 20 eligible studies. The dietary behaviours included in the reviewed studies were the intake of fruit and vegetables, sugar-sweetened beverages, unhealthy snacks/fast food and breakfast. The consistent mediators of the effects of socioeconomic position on dietary behaviours among youth were: self-efficacy, food preferences and knowledge at the intrapersonal level; and availability and accessibility of food items at home, food rules and parental modelling at the interpersonal level. Few studies including mediators at the organisational, community or policy levels were found. Our review found several modifiable factors at the intrapersonal and interpersonal levels that could be targeted in interventions aimed at combating inequalities in dietary behaviours among youth. Rigorous studies exploring organisational, community and policy level mediators are warranted.