RESUMO
@#Introduction: Nutrition education (NE) is a promising intervention in promoting behavior change. However, in developing countries where it is not included in the national curriculum, many barriers arise. The study aimed to explore the teachers’ perceived barriers of implementing a nutrition education program for adolescents in rural Indonesian schools. Methods: A qualitative participatory action research approach was applied in three selected schools in Bogor, Indonesia. Focus group discussion was used as the main method of data collection, involving 12 teachers who have implemented the Health and Nutrition Program for Adolescents. Triangulation was conducted through observation and feedback questionnaire from students. Data from multiple sources were coded, categorized, and thematically analyzed. Results: Three themes and six subthemes emerged, these include 1) capacity of teachers (lack of training and lack of nutrition knowledge), 2) school support (time constraints and lack of funding), and 3) external environment (unhealthy street vendors and parent’s lack of nutrition awareness). These identified barriers could be minimized by establishing a strong commitment of school principals, the inclusion of street-food vendors and parents, and also ensuring sufficient training of teachers. Conclusion: This study highlights the need for schools and program implementers to identify potential barriers prior to commencing NE and also strengthen opportunities within it. The barriers found in this study emphasizes the need for advocacy, sufficient training of teachers, and consideration of the external food environment. Further studies are suggested to confirm these findings, involving more informants and different settings, such as in the urban population.
RESUMO
@# Introduction: Urbanisation in Indonesia has been associated with a transition in nutrition which has been, in part, marked by an increased purchasing of readyto-eat, energy-dense, nutrient-poor foods. Women are responsible for purchasing and preparing food for the family. Their purchasing behaviours differ in various environments and population groups. This qualitative study was undertaken to explore the food environmental factors that influenced food purchasing behaviour of women who were the household food gatekeepers. Methods: The study was conducted in a slum area in East Jakarta. Eighteen overweight-obese and nonobese women who fulfilled the study’s inclusion criteria were recruited for interviews that used a semi-structured questionnaire. Emic observations were conducted in order to identify typical food purchasing activities. The data were coded and categorised using qualitative data analysis and research software (Atlas.ti 7 for Windows). Results: Most of the women purchased ready-to-eat foods rather than cook at home, either for the family or their own consumption. Several food environmental factors influenced women’s purchasing behaviour, including time and cost efficiency, food availability, family, exposure to ready-to-eat foods and food store marketing strategies. These factors led to the consumption of unhealthy foods that were high in fat, carbohydrate, sugar and salt that some of which may cause obesity. Conclusion: Purchasing unhealthy food was observed to be strongly linked with food-related environmental factors. This study provides an understanding of women’s food purchasing behaviour and highlight potential ways to foster healthier purchasing behaviour among urban slum dwellers.