Drivers of food choice in three urban communities in South Africa

Background: With South Africa's high burden of disease, increasing attention has been given to improving food environments to facilitate healthier food access. An understanding of the main drivers of food choice and barriers in consuming healthier foods can assist in the formulation of nudge strategies to improve the quality of diets consumed.Objectives: To explore the drivers of food choice among adults in three urban communities in South Africa.Design: Qualitative descriptive phenomenological study using focus-group discussions.Setting: Three urban sites in the Eastern Cape, KwaZulu Natal, and Western Cape provinces in South Africa.Subjects: Adults (male and female, 21 to 59 years of age).Outcome measures: Self-administered sociodemographic questionnaire and focus-group discussions.Findings: Nine focus groups with 68 participants were completed. Financial considerations, household/family factors, and shop/food retail factors were the key drivers of food choice identified. Health considerations were present, but not prevalent. Enablers of healthy food consumption included: cost, recognised health/nutrition benefits, and good taste. Barriers were unavailability, unknown preparation, beliefs, and disliked taste.Conclusions: This study found that financial considerations, household/family factors, and the retail food environment were key influences on food choice in three urban South African communities. The research contributes to qualitative evidence on consumer perspectives in urban contexts. Recommendations include exploring retail interventions and pricing strategies to improve access to healthy foods. The study limitations include limited transferability beyond the study sites, but findings remain valuable for guiding future research and public health nutrition policy.