ArticleCurrent developments in nutrition2025
Drivers of Food Decision Making and Aspirations for the Future of the School Food Environment among Junior High School Students in Cape Coast, Ghana: a Photovoice Study.
Article in Current developments in nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Adolescent-Selected Food Intake and Engagement with the External Food Environment Contribute to Unhealthy Diets in Accra, Ghana.Current developments in nutrition · 2026Article
- Food vendors in the school foodscape: roles, challenges and opportunities for improving child nutrition.Journal of public health research · 2026Article
- Adapting Global Dietary Recommendation Indices to Assess Retail Food Environment Quality: Spatial Insights from Rural and Urban Kenya.Current developments in nutrition · 2026Article
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Authors and funding
6 authors.
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Abstract
Background: Food decision making is a complex and dynamic process that influences diet and ultimately health. Adolescents consider many different food environment-level factors when making decisions about food. These factors may vary by context. Adolescents attending junior high school (JHS) in Ghana frequently interact with their school food environments because they do not have access to a national school meal program. Objectives: The objective of this study was to understand the factors that influence adolescent food-related decisions and how adolescents interact with their school food environments from their own perspectives. Secondarily, we sought to elicit adolescent ideas for the future of their school food environment. Methods: Forty adolescents were purposively selected equally across 4 JHSs in Cape Coast, Ghana. We used Photovoice to elicit photographs and ideas across 5 workshops with each school. Adolescents were provided with digital cameras and weekly photography prompts followed by semistructured group discussions each week. We thematically analyzed photographs and discussions with input from the adolescents. Adolescents presented their findings to local stakeholders through a photograph exhibition at the end of the study. Results: Adolescents reported factors influencing their food decisions at the policy, environmental, interpersonal, and individual levels, mirroring the socioecological model. These factors included school policies (30 coded references), food hygiene and safety (374), food availability (83), relationships with vendors (62), peer influence (36), nutritional value (42), taste (41), satiety (25), appearance (30), and affordability (160), with hygiene, safety, and affordability being most frequently mentioned. Adolescents wanted to be involved in decisions around their school food environments. Conclusions: Adolescent food decision making in this context is often driven by food hygiene and safety and affordability. Supporting adolescent autonomy for food-related decisions and including them in decision making to change school food environments could empower adolescents in their food decisions and improve school food environments to match with adolescents' needs and desires.
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