ABSTRACT

The health and well-being of adolescent students are significantly influenced by their food selection behaviors. This study investigates the health belief determinants affecting the automatic food selection behavior of adolescents in public secondary schools across rural and urban areas of Abia State. Employing a descriptive cross-sectional design, data was collected from 220 students aged 12-18 years using structured questionnaires. The findings reveal that family structure, educational status of parents, and socio-economic characteristics impact adolescents' food choices.

A notable 74.5% of respondents lived with both parents, suggesting a stable environment that may reinforce consistent dietary habits. The educational attainment of mothers, with 49.1% holding tertiary education, correlates with better nutritional knowledge, influencing family food choices. Urban students demonstrated a higher ability to control their food choices and recognize unhealthy options compared to their rural counterparts. Specifically, 55.9% of urban students identified popcorn and soft drinks as unhealthy, in contrast to 33.6% and 38.2% of rural students, respectively. Health belief determinants reveal that urban students struggle less with resisting unhealthy foods (mean: -0.80±1.42) compared to rural students (mean: 0.22±1.68). Urban students are also more likely to believe that healthy foods are more expensive (mean: 1.41±1.25) compared to rural students (mean: 1.33±1.26), and they report less confusion about which foods are healthy (mean: -1.07±0.27 for urban vs. 1.05±0.46 for rural). The perceived barriers, including the influence of advertisements and the presence of unhealthy foods at home, show differences between locations, with urban students reporting lower perceived barriers.  Further, urban students exhibit higher self-efficacy in controlling their food choices, with a mean score of -0.12±1.17 compared to 0.42±1.42 in rural areas. They are more confident in resisting unhealthy food temptations (mean: 0.85±1.47 for urban vs. 1.32±1.25 for rural), but they feel less control over their food choices compared to rural students. The study underscores the significant variations in health belief determinants between urban and rural settings. Socio-economic factors, such as parental education and occupation, play a crucial role in shaping adolescents' health beliefs and food choices. Notably, the highest educational level of the father showed a positive correlation with healthier food selection (r = .151, p < .05), suggesting that fathers with higher education levels may encourage better dietary choices.

Overall, the research highlights the need for targeted interventions that address specific health belief determinants and socio-economic factors influencing adolescent food selection behavior, aiming to promote healthier eating habits and improve health outcomes in diverse contexts.