Top

BMC Public Health

Published in:

Open Access 01-12-2014 | Research article

Perceptions on healthy eating, physical activity and lifestyle advice: opportunities for adapting lifestyle interventions to individuals with low socioeconomic status

Authors: Andrea J Bukman, Dorit Teuscher, Edith J M Feskens, Marleen A van Baak, Agnes Meershoek, Reint Jan Renes

Published in: BMC Public Health | Issue 1/2014

Abstract

Background

Individuals with low socioeconomic status (SES) are generally less well reached through lifestyle interventions than individuals with higher SES. The aim of this study was to identify opportunities for adapting lifestyle interventions in such a way that they are more appealing for individuals with low SES. To this end, the study provides insight into perspectives of groups with different socioeconomic positions regarding their current eating and physical activity behaviour; triggers for lifestyle change; and ways to support lifestyle change.

Methods

Data were gathered in semi-structured focus group interviews among low SES (four groups) and high SES (five groups) adults. The group size varied between four and nine participants. The main themes discussed were perceptions and experiences of healthy eating, physical activity and lifestyle advice. Interviews were transcribed verbatim and a thematic approach was used to analyse the data.

Results

In general, three key topics were identified, namely: current lifestyle is logical for participants given their personal situation; lifestyle change is prompted by feedback from their body; and support for lifestyle change should include individually tailored advice and could profit from involving others. The perceptions of the low SES participants were generally comparable to the perceptions shared by the high SES participants. Some perceptions were, however, especially shared in the low SES groups. Low SES participants indicated that their current eating behaviour was sometimes affected by cost concerns. They seemed to be especially motivated to change their lifestyle when they experienced health complaints, but were rather hesitant to change their lifestyle for preventive purposes. Regarding support for lifestyle change, low SES participants preferred to receive advice in a group rather than on their own. For physical activities, groups should preferably consist of persons of the same age, gender or physical condition.

Conclusions

To motivate individuals with low SES to change their lifestyle, it may be useful to (visually) raise their awareness of their current weight or health status. Lifestyle interventions targeting individuals with low SES should take possible cost concerns into account and should harness the supportive effect of (peer) groups.

Available only for authorised users

Mackenbach JP, Stirbu I, Roskam AJR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE: Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008, 358: 2468-2481. 10.1056/NEJMsa0707519.CrossRefPubMed

Stringhini S, Sabia S, Shipley M, Brunner E, Nabi H, Kivimaki M, Singh-Manoux A: Association of socioeconomic position with health behaviors and mortality. J Am Med Assoc. 2010, 303: 1159-1166. 10.1001/jama.2010.297.CrossRef

Darmon N, Drewnowski A: Does social class predict diet quality?. Am J Clin Nutr. 2008, 87: 1107-1117.PubMed

Lallukka T, Laaksonen M, Rahkonen O, Roos E, Lahelma E: Multiple socio-economic circumstances and healthy food habits. Eur J Clin Nutr. 2007, 61: 701-710. 10.1038/sj.ejcn.1602583.CrossRefPubMed

Gidlow C, Johnston LH, Crone D, Ellis N, James D: A systematic review of the relationship between socio-economic position and physical activity. Health Educ J. 2006, 65: 338-367. 10.1177/0017896906069378.CrossRef

Beenackers MA, Kamphuis CBM, Giskes K, Brug J, Kunst AE, Burdorf A, van Lenthe FJ: Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: a systematic review. Int J Behav Nutr Phys Act. 2012, 9: 116-10.1186/1479-5868-9-116.CrossRefPubMedPubMedCentral

Demarest S, Van Oyen H, Roskam AJ, Cox B, Regidor E, Mackenbach JP, Kunst AE: Educational inequalities in leisure-time physical activity in 15 European countries. Eur J Public Health. 2014, 24: 199-204. 10.1093/eurpub/ckt061.CrossRefPubMed

Lindström J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemiö K, Hämäläinen H, Härkönen P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J: Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish diabetes prevention study. Lancet. 2006, 368: 1673-1679. 10.1016/S0140-6736(06)69701-8.CrossRefPubMed

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002, 346: 393-403.CrossRefPubMed

10.

Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, Fowler S: The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005, 142: 611-619. 10.7326/0003-4819-142-8-200504190-00009.CrossRefPubMedPubMedCentral

11.

Roumen C, Feskens EJM, Corpeleijn E, Mensink M, Saris WHM, Blaak EE: Predictors of lifestyle intervention outcome and dropout: the SLIM study. Eur J Clin Nutr. 2011, 65: 1141-1147. 10.1038/ejcn.2011.74.CrossRefPubMed

12.

Salmela SM, Vähäsarja KA, Villberg JJ, Vanhala MJ, Saaristo TE, Lindström J, Oksa HH, Korpi-Hyövälti EA, Moilanen L, Keinänen-Kiukaanniemi S, Poskiparta ME: Perceiving need for lifestyle counselling: findings from Finnish individuals at high risk of type 2 diabetes. Diabetes Care. 2012, 35: 239-241. 10.2337/dc11-1116.CrossRefPubMedPubMedCentral

13.

Lakerveld J, IJzelenberg W, van Tulder MW, Hellemans IM, Rauwerda JA, van Rossum AC, Seidell JC: Motives for (not) participating in a lifestyle intervention trial. BMC Med Res Methodol. 2008, 8: 17-10.1186/1471-2288-8-17.CrossRefPubMedPubMedCentral

14.

Chinn DJ, White M, Howel D, Harland JOE, Drinkwater CK: Factors associated with non-participation in a physical activity promotion trial. Public Health. 2006, 120: 309-319. 10.1016/j.puhe.2005.11.003.CrossRefPubMed

15.

Moroshko I, Brennan L, O’Brien P: Predictors of dropout in weight loss interventions: a systematic review of the literature. Obes Rev. 2011, 12: 912-934. 10.1111/j.1467-789X.2011.00915.x.CrossRefPubMed

16.

Noar SM, Benac CN, Harris MS: Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull. 2007, 133: 673-693.CrossRefPubMed

17.

Hawkins RP, Kreuter M, Resnicow K, Fishbein M, Dijkstra A: Understanding tailoring in communicating about health. Health Educ Res. 2008, 23: 454-466. 10.1093/her/cyn004.CrossRefPubMedPubMedCentral

18.

Rimer BK, Kreuter MW: Advancing tailored health communication: a persuasion and message effects perspective. J Commun. 2006, 56: S184-S201. 10.1111/j.1460-2466.2006.00289.x.CrossRef

19.

Kreuter MW, Wray RJ: Tailored and targeted health communication: strategies for enhancing information relevance. Am J Health Behav. 2003, 27: S227-S232. 10.5993/AJHB.27.1.s3.6.CrossRefPubMed

20.

Cleland V, Granados A, Crawford D, Winzenberg T, Ball K: Effectiveness of interventions to promote physical activity among socioeconomically disadvantaged women: a systematic review and meta-analysis. Obes Rev. 2012, 14: 197-212.CrossRefPubMed

21.

Coveney J: A qualitative study exploring socio-economic differences in parental lay knowledge of food and health: implications for public health nutrition. Public Health Nutr. 2005, 8: 290-297.CrossRefPubMed

22.

Heikkinen H, Patja K, Jallinoja P: Smokers’ accounts on the health risks of smoking: why is smoking not dangerous for me?. Soc Sci Med. 2010, 71: 877-883. 10.1016/j.socscimed.2010.05.036.CrossRefPubMed

23.

Bisogni CA, Jastran M, Seligson M, Thompson A: How people interpret healthy eating: contributions of qualitative research. J Nutr Educ Behav. 2012, 44: 282-301. 10.1016/j.jneb.2011.11.009.CrossRefPubMed

24.

Bouwman LI, te Molder H, Koelen MM, van Woerkum CMJ: I eat healthfully but I am not a freak. Consumers’ everyday life perspective on healthful eating. Appetite. 2009, 53: 390-398. 10.1016/j.appet.2009.08.005.CrossRefPubMed

25.

Nöhammer E, Stummer H, Schusterschitz C: Employee perceived barriers to participation in worksite health promotion. J Public Health. 2014, 22: 23-31. 10.1007/s10389-013-0586-3.CrossRef

26.

Ballering C, Schreurs H, Renders C, Kooiker S, van Ameijden E: Een inkijk in verhalen achter leefstijlgewoontes [A glimpse of stories behind lifestyle habits. In Dutch]. Tijdschrift voor Gezondheidswetenschappen. 2013, 91: 263-269. 10.1007/s12508-013-0094-4.CrossRef

27.

van Dillen SME, Hiddink GJ, Koelen MA, de Graaf C, van Woerkum CMJ: Perceived relevance and information needs regarding food topics and preferred information sources among Dutch adults: results of a quantitative consumer study. Eur J Clin Nutr. 2004, 58: 1306-1313. 10.1038/sj.ejcn.1601966.CrossRefPubMed

28.

Ball K, Salmon J, Giles-Corti B, Crawford D: How can socio-economic differences in physical activity among women be explained? A qualitative study. Women Health. 2006, 43: 93-113.CrossRefPubMed

29.

Morgan DL: Focus groups. Annu Rev Sociol. 1996, 22: 129-152. 10.1146/annurev.soc.22.1.129.CrossRef

30.

Dickson D: The focus group approach. Handbook of Communication Audits for Organizations. Edited by: Hargie O, Tourish D. 2000, London: Routledge, 85-103.

31.

Fishbein M, Triandis HC, Kanfer FH, Becker M, Middlestadt SE, Eichler A: Factors influencing behavior and behavior change. Handbook of Health Psychology. Edited by: Baum A, Revenson TA, Singer JE. 2001, Mahwah, NJ: Lawrence Erlbaum Associates, 3-17.

32.

Waterlander WE, de Mul A, Schuit AJ, Seidell JC, Steenhuis IHM: Perceptions on the use of pricing strategies to stimulate healthy eating among residents of deprived neighbourhoods: a focus group study. Int J Behav Nutr Phys Act. 2010, 7: 44-10.1186/1479-5868-7-44.CrossRefPubMedPubMedCentral

33.

Konttinen H, Sarlio-Lähteenkorva S, Silventoinen K, Männistö S, Haukkala A: Socio-economic disparities in the consumption of vegetables, fruit and energy-dense foods: the role of motive priorities. Public Health Nutr. 2013, 16: 873-882. 10.1017/S1368980012003540.CrossRefPubMed

34.

Kamphuis CBM, van Lenthe FJ, Giskes K, Brug J, Mackenbach JP: Perceived environmental determinants of physical activity and fruit and vegetable consumption among high and low socioeconomic groups in the Netherlands. Health Place. 2007, 13: 493-503. 10.1016/j.healthplace.2006.05.008.CrossRefPubMed

35.

Inglis V, Ball K, Crawford D: Why do women of low socioeconomic status have poorer dietary behaviours than women of higher socioeconomic status? A qualitative exploration. Appetite. 2005, 45: 334-343. 10.1016/j.appet.2005.05.003.CrossRefPubMed

36.

Schmidt M, Absalah S, Nierkens V, Stronks K: Which factors engage women in deprived neighbourhoods to participate in exercise referral schemes?. BMC Public Health. 2008, 8: 371-10.1186/1471-2458-8-371.CrossRefPubMedPubMedCentral

37.

Withall J, Jago R, Fox KR: Why some do but most don’t. Barriers and enablers to engaging low-income groups in physical activity programmes: a mixed methods study. BMC Public Health. 2011, 11: 507-10.1186/1471-2458-11-507.CrossRefPubMedPubMedCentral

38.

Siu J, Giskes K, Turrell G: Socio-economic differences in weight-control behaviours and barriers to weight control. Public Health Nutr. 2011, 14: 1768-1778. 10.1017/S1368980011000644.CrossRefPubMed

39.

Wardle J, Steptoe A: Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J Epidemiol Community Health. 2003, 57: 440-443. 10.1136/jech.57.6.440.CrossRefPubMedPubMedCentral

40.

Damiani G, Federico B, Bianchi CBNA, Ronconi A, Basso D, Fiorenza S, Sassi F: Socio-economic status and prevention of cardiovascular disease in Italy: evidence from a national health survey. Eur J Public Health. 2011, 21: 591-596. 10.1093/eurpub/ckq075.CrossRefPubMed

41.

Sambamoorthi U, McAlpine DD: Racial, ethnic, socioeconomic, and access disparities in the use of preventive services among women. Prev Med. 2003, 37: 475-484. 10.1016/S0091-7435(03)00172-5.CrossRefPubMed

42.

McCaffery K, Wardle J, Nadel M, Atkin W: Socioeconomic variation in participation in colorectal cancer screening. J Med Screen. 2002, 9: 104-108. 10.1136/jms.9.3.104.CrossRefPubMed

43.

Orton E, Forbes-Haley A, Tunbridge L, Cohen S: Equity of uptake of a diabetic retinopathy screening programme in a geographically and socio-economically diverse population. Public Health. 2013, 127: 814-821. 10.1016/j.puhe.2013.04.015.CrossRefPubMed

44.

van der Waerden JEB, Hoefnagels C, Jansen MWJ, Hosman CMH: Exploring recruitment, willingness to participate, and retention of low-SES women in stress and depression prevention. BMC Public Health. 2010, 10: 588-10.1186/1471-2458-10-588.CrossRefPubMedPubMedCentral

45.

Ball K, Crawford D, Mishra G: Socio-economic inequalities in women’s fruit and vegetable intakes: a multilevel study of individual, social and environmental mediators. Public Health Nutr. 2006, 9: 623-630.CrossRefPubMed

46.

Wiig Dammann K, Smith C: Factors affecting low-income women’s food choices and the perceived impact of dietary intake and socioeconomic status on their health and weight. J Nutr Educ Behav. 2009, 41: 242-253. 10.1016/j.jneb.2008.07.003.CrossRef

47.

Cleland V, Ball K: What might work? Exploring the perceived feasibility of strategies to promote physical activity among women living in socioeconomically disadvantaged neighbourhoods. Health Educ Res. 2013, 28: 205-219. 10.1093/her/cys097.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/14/1036/prepub

Title: Perceptions on healthy eating, physical activity and lifestyle advice: opportunities for adapting lifestyle interventions to individuals with low socioeconomic status
Authors: Andrea J Bukman
Dorit Teuscher
Edith J M Feskens
Marleen A van Baak
Agnes Meershoek
Reint Jan Renes
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/1471-2458-14-1036

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Perceptions on healthy eating, physical activity and lifestyle advice: opportunities for adapting lifestyle interventions to individuals with low socioeconomic status

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2014

Identifying associations between sedentary time and cardio-metabolic risk factors in working adults using objective and subjective measures: a cross-sectional analysis

Quality of life and social engagement of alcohol abstainers and users among older adults in South Africa

Informing the development of an online self-management program for men living with HIV: a needs assessment

The changing food outlet distributions and local contextual factors in the United States

Stable time patterns of railway suicides in Germany: comparative analysis of 7,187 cases across two observation periods (1995–1998; 2005–2008)

Socioeconomic and demographic predictors of selected cardiovascular risk factors among adults living in Pohnpei, Federated States of Micronesia