(P17-045-23) Factors That Influence Diet and Physical Activity Among Adolescents Living in an Informal Settlement in Kenya: A Qualitative Exploration

Objectives: Optimal nutrition during adolescence is important for adolescents’ short- and long-term health. In low- and middle-income countries, adolescents face increased risks for all forms of malnutrition. In Kenya, rates of overweight, obesity, and nutrition-related noncommunicable diseases are rising while undernutrition and micronutrient deficiencies remain. In Nairobi, 70% of the population lives in informal settlements; Kibera is the largest. Understanding diets and physical activity (PA) among adolescents in informal settlements is essential for designing effective interventions. This qualitative study aimed to explore factors that influence diet and PA among adolescents living in Kibera.

Methods: We conducted focus group discussions (FGDs) with adolescent girls (8 FGDs, n=63) and boys (6 FGDs, n=46) 10-19 years of age, parents and guardians (4 FGDs, n=31), and teachers (3 FGDs, n=21), and key informant interviews with school administrators (n=5) and health care workers (n=7) in Kibera. All FGDs and interviews were transcribed, translated, and analyzed thematically.

Results: Participants identified individual, social, school, and environmental factors that influence adolescents’ diets and PA. Adolescents and their parents described food insecurity and high costs of healthy foods as key barriers to healthy diets. They also expressed concerns about the food safety and hygiene of school meals and food vendors near schools. Adolescents enjoyed learning about balanced diets in school and wanted their parents to receive the same information. Participants described several barriers to PA including lack of space at schools and in the community, lack of equipment, concerns about safety, and lack of time because of household chores (for girls) and schoolwork. Adolescents want to learn more about healthy foods, preparing healthy meals on a budget, and gardening, and want safe opportunities for PA at school and in the community.

Conclusions: While adolescents in Kibera discussed wanting to eat a balanced diet and participate in PA, they experience considerable environmental, social, and economic barriers. Tailored, contextually appropriate interventions are needed to address these barriers.

Funding Sources: UNC Nutrition Obesity Research Center; the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health