Individual-level drivers of dietary behaviour in adolescents and women through the reproductive life course in urban Ghana: A Photovoice study.

Evidence on the individual-level drivers of dietary behaviours in deprived urban contexts in Africa is limited. Understanding how to best inform the development and delivery of interventions to promote healthy dietary behaviours is needed. As noncommunicable diseases account for over 40% of deaths in Ghana, the country has reached an advanced stage of nutrition transition. The aim of this study was to identify individual-level factors (biological, demographic, cognitive, practices) influencing dietary behaviours among adolescent girls and women at different stages of the reproductive life course in urban Ghana with the goal of building evidence to improve targeted interventions. Qualitative Photovoice interviews (n = 64) were conducted in two urban neighbourhoods in Accra and Ho with adolescent girls (13-14 years) and women of reproductive age (15-49 years). Data analysis was both theory- and data-driven to allow for emerging themes. Thirty-seven factors, across four domains within the individual-level, were identified as having an influence on dietary behaviours: biological (n = 5), demographic (n = 8), cognitions (n = 13) and practices (n = 11). Several factors emerged as facilitators or barriers to healthy eating, with income/wealth (demographic); nutrition knowledge/preferences/risk perception (cognitions); and cooking skills/eating at home/time constraints (practices) emerging most frequently. Pregnancy/lactating status (biological) influenced dietary behaviours mainly through medical advice, awareness and willingness to eat foods to support foetal/infant growth and development. Many of these factors were intertwined with the wider food environment, especially concerns about the cost of food and food safety, suggesting that interventions need to account for individual-level as well as wider environmental drivers of dietary behaviours.

The Complex Role of Cognitive and Behavioral Factors in Salt Intake Levels of Women.

Background: High salt intake is responsible for some serious health consequences. This study aims to investigate the interrelationship between salt intake cognitive and behavioral factors and urinary sodium excretion levels in women. Methods: A descriptive analytical cross-sectional study was conducted in two residential complexes in Ahvaz city, Iran. 260 female participants were selected using systematic random sampling. Data on salt-related cognitive factors, including knowledge, perceived susceptibility, perceived severity, attitude, intention, self-efficacy, and behavior, were collected using a validated questionnaire. To determine true salt intake, 24-hour urinary sodium excretion level was measured. Data was analyzed using Pearson correlation, one-way Anova, and linear regression tests. Results: 81.2% of the participants' salt intake was higher than the WHO recommended value (5 grams/day). A significant relationship between sodium excretion level and knowledge (r = -0.332, p < 0.001), attitude (r = -0.144, p = 0.02), behavior (r = -0.130, p = 0.036), and perceived severity (r = -0.135, p = 0.03) was found. An R2 of 0.134 demonstrates a 13.4% variation in urinary sodium excretion, associated with knowledge and perceived severity. Conclusion: Future interventions should aim to improve all the salt-related cognitive factors with placing an emphasis on increasing salt-related knowledge and perceived severity.