Healthy food purchasing among African American youth: associations with child gender, adult caregiver characteristics and the home food environment

Objective: To examine how factors related to the home food environment and individual characteristics are associated with healthy food purchasing among low-income African American (AA) youth. Subjects: A total of 206 AA youth (ninety-one boys and 115 girls), aged 10-14 years, and their primary adult caregivers. Setting: Fourteen Baltimore recreation centres in low-income neighbourhoods. Design: Cross-sectional study. We collected information about food purchasing, the home food environment, sociodemographic and psychosocial factors drawn from social cognitive theory. Multivariable logistic regression was used to examine the factors associated with the frequency and proportion of healthy food purchases in all youth and stratified by gender. Low-fat or low-sugar foods were defined as healthy. Results: Youth purchased an average of 1.5 healthy foods (range = 0-15) in the week before the interview, comprising an average of 11.6% (range = 0-80 %) of total food purchases. The most commonly purchased healthy foods included water and sunflower seeds/nuts. Healthier food-related behavioural intentions were associated with a higher frequency of healthy foods purchased (OR = 1.4, P < 0.05), which was stronger in girls (OR = 1.9, P < 0.01). Greater caregiver self-efficacy for healthy food purchasing/preparation was associated with increased frequency of healthy purchasing among girls (OR = 1.3, P < 0.05). Among girls, more frequent food preparation by a family member (OR = 6.6, P < 0.01) was associated with purchasing a higher proportion of healthy foods. No significant associations were observed for boys. Conclusions: Interventions focused on AA girls should emphasize increasing food-related behavioural intentions. For girls, associations between caregiver self-efficacy and home food preparation suggest the importance of the caregiver in healthy food purchasing.