Figure 1: Integrated conceptual framework to study youth perceptions associated to an eventual School Nutrition Policy (SNP) development in Lebanon

Schools profilearrow
Urban
Rural

Total (N)
From 8 schools)

Sample characteristics
down
2 private
2 public
2 private
2 public
Boys (n)
6
6
4
4
20

Age (years)

10 y
0
0
1
1
2
11 y
1
2
0
3
6
12 y
3
1
2
0
6
13 y
1
2
0
0
3
14 y
1
1
1
0
3
BMI
Underweight
1
1
2
1
5
Normal weight
4
4
2
2
12
Overweight
0
1
0
1
2
Obese
1
0
0
0
1
Girls (n)
6
6
8
8
28

Age (years)

10y
0
1
0
1
2
11y
1
0
3
0
4
12y
1
2
0
1
4
13y
3
1
4
3
11
14y
1
2
1
3
7
BMI
Underweight
1
1
3
1
6
Normal weight
4
5
5
7
21
Overweight
1
0
0
0
1
Obese
0
0
0
0
0
Total (N)
12
12
12
12
48

Table 1: Characteristics of Youth Participants from Different Schools Profile (N=48)

Variables arrow
Individual Variables
Community Variables
Organizational Variables
Other Variables (Motivation, mobilization, social conflict, knowledge…)
Schools
down
Private (n= 24 youth)
Facilitating factors
- Convince youth with arguments   on the physical, mental & biological well-being
-Tailored messages with respect to age "children like innovation & originality"1
- Recognize adolescents needs& idols "Justin Bieper is one of our idols"1
- Respect youth autonomy - Getting youth to feel responsible & reproductive
-Sharing responsibilities between parents & youth1
- Emphasize on the physical activity part of the SNP
- Adapt the SNP to the Lebanese culture & youth needs
- Presence of reinforcing communities2
- Parental role modeling "father and/or mother role modeling"1
- Peer pressure
- Ameliorate school food services (quality, taste, variety)1
- Increase time & varieties of physical activities
- Gain the school personnel support
- Interactive communication between young people1 "I prefer to participate in school activities given by other peers"
- Banishing unhealthy food from all environments " availability of sugar & salty snacks is attempting"
-Establishment of legislations
- Ensure youth motivation & mobilization (positive effect of parents & popular persons)1
- Regular follow-up
- Role of health professionals, experts & parents in increasing youth knowledge
Barriers
-Absence of youth perception of health risk susceptibility & severity2
- Heterogeneity in youth perceptions with respect to age & gender1
- Girls obsession with body image
 - Youth resistance to comply with the nutrition content of the SNP more than the physical activity part1
- Discrepancies in youth mentalities
- Peer pressure
-Difficulty to change acquired patterns from familial environment2
- Religion restrictions2
- Lack of health education
- Lack of physical education in public school      
- Inappropriate scholar physical environment
- Accessibility & availability of unhealthy food
-  Lack of interest in health information2
- Difficulty to motivate & to mobilize adolescents
Public (n= 24 youth)
Facilitating factors
- Increase youth perceptions of SNP advantages on the physical, mental & biological well-being2
- Using body image & social acceptance arguments   

-Ensure broad participation among young people
- Parental & social role modeling
- Peer pressure (for girls)2
- Presence of reinforcing environments

- Communicate SNP by using conferences2 and "talk shows & reportages" 1
- Active school health advisors2
- Intra scholar collaboration1
- Use of strict regulations2
- Increasing youth knowledge (role of schools & parents)1
- Social segmentation
- National mobilization
Barriers

- Absence of perception of risk susceptibility
- Polluted environment1 "the Lebanese environment is polluted & not helpful for the SNP development".
- Food insecurity1

-Difference between youth perceptions with respect to regional belonging
- Lack of youth enthusiasm & willingness to participate in the SSH1
- Peer pressure (for boys)2
- Lack of scholar health services1
 - Irresponsible school personnel1
- Inappropriate school physical environment

- Diversity in social & regional structure
- Gender discrimination in physical activity classes "we let boys play more than girls"1

1= Urban schools; 2= Rural schools.   Italic statements are youth extracts.
Table 2: Perceptions of Youth Associated With an Eventual Development of School Nutrition Policy (SNP) in Lebanon. (n=48)