Barriers and enablers to reduced meat intake and perceptions of sustainable diets, among Los Angeles County adults with low incomes: a qualitative interview study.

Introduction: Because of the environmental impacts of meat production, sustainable eating emphasizes eating less meat, and especially less red and processed meat. Here, barriers and enablers to reducing meat intake, and perceptions of sustainable diets, were examined among adults with low income, who often face barriers to food access and choice. The implementation science framework COM-B (Capability, Opportunity, Motivation, Behavior) model was used to contextualize the findings and inform behavior change strategies. Methods: 20 adults in Los Angeles County with low incomes (<300% FPL) participated in semi-structured qualitative interviews. Interviewees were asked about their meat intake behaviors and perceptions, barriers and enablers to reduce meat intake, including red and processed meat, and perceptions of sustainable diets. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Results: Five major themes emerged: (1) Interviewees expressed positive attitudes toward eating less red and processed meat, (2) Self-efficacy, knowledge, and skills related to selecting and preparing alternatives enabled meat reduction; (3) Health-related concerns related to reduced meat intake, and the high cost of meat alternatives, were barriers to reduction; (4) Interest in sustainable eating was high; However, (5) sustainable diets are not the current norm, and interviewees described competing priorities and perceptions that these diets are unattainable. Barriers and enablers to meat reduction spanned different COM-B components, and barriers to sustainable eating within the "opportunity" and "motivation" components emerged through interviews. Discussion: Interviewees were interested in consuming more sustainable diets, but faced barriers to reducing their meat intake and adopting sustainable diets. For example, interviewees perceived meat reduction as an important way to save money and benefit their health, yet also expressed concerns related to the unattainability of sustainable diets and had health concerns related to meat reduction. This suggests there is a need for clear communication and education, as well as interventions that strengthen enablers while addressing unique barriers faced by urban populations with low income, such as the high cost and accessibility of plant-based foods.