International Journal of Food Sciences and Nutrition (1998) 49, 79-86

Identifying foods commonly consumed by the Jamaican population: the focus group approach

Pauline M. Samuda,' Richard A. Cook,' Cristanna M. Cook2 and Fitzroy Henry3

'Department of Food Science and Human Nutrition, 5749 Uern.11 Hall - Room 25, Orono, Maine 04469-5749, 'Uedical Care Development, I1 Parkwood Drive, Augusta, Maine 04330, USA and 'Caribbean Food and Nutrition Institute, PO Box 140, Mona, Kingston 7, Jamaica, West Indies

Focus group methodology was employed in a study conducted in the Caribbean island of Jamaica, aimed at providing critical information on priority foods to be included in a national food composition database. The specific objective of the study was to determine the single and prepared foods most commonly consumed within Jamaican households. Twenty focus groups were conducted nationwide comprising 130 households. Representativeness of sample was obtained by selecting the groups as a subset of the sample used by the Statistical Institute of Jamaica for national social and economic surveys. Groups consisted of 4-13 persons (responsible for household food purchase and preparation) recruited from each sampling region. Content analysis of transcripts was carried out by coding and tabulating mentions (food occurrence) for each question, by group. Code frequencies were collated in a matrix to arrive at foods commonly consumed by group and geographical area. Data generated by the study identified 70 foods as being the most commonly consumed on a weekly basis and 16 cooked dishes as the most commonly prepared. Oranges, ripe bananas, chicken, rice, yellow yam and green bananas were among the most commonly consumed foods, while rice and peas, brown stewed or fried chicken, porridges and soups were among the most commonly prepared dishes, overall. There were no significant differences, across geographical regions, in terms of the frequency with which groups reported household consumption of common foods or commonly prepared dishes. These results suggest a relative homogeneity in types of foods consumed within the Jamaican population and provide a list of 'core' foods and food products, in their forms most commonly consumed, for inclusion in an updated food composition database for Jamaica.

Introduction

The recognition of food intake as one factor in al., 1992). To satisfy this demand, an Inter- the long-term development of complex multi- national Network of Food Data Base Systems faceted diseases has stimulated the demand for (INFOODS) was established to create regional representative food composition data all over food composition centers with the major goals the world (Southgate, 1983; Stewart, 1983; of encouraging the generation of food composi- Rand & Young, 1984; EURORFWDS, 1985; tion data and developing an easy and accurate FA0 WHO, 1987; West et al., 1988; Hankin et interchange of food composition data among

Correspondence to Pauline M. Samuda.

0963-7486/98/010079-8 0 1998 Carfax Publishing Ltd

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80 I! M. Samuda et al.

countries and regions (Rand & Young, 1984). Jamaica. alone with the other Caribbean consumed by members of the population.

assess nutrient intakes from various foods

nations, 'has been incorporated into the regional body termed LATINFOODS (Bressani & Flores, 1992). However, to date, the process of generating current reliable food composition data has not commenced.

Food composition data are used by nutrition- ists, dietitians and epidemiologists to assess the adequacy of diets of population p u p s , sub- groups and individuals. The food industry uses food composition data for product development, food labeling and quality assurance. In addition, these data are used by governments to deter- mine policy regarding food and nutrition pro- grammes. The lack of valid data for foods commonly consumed impedes the assessment of diet-health relationships and impacts on the production, regulation and use of foods. In an effort to evaluate food consumption patterns and develop appropriate food and nutrition policies for the Jamaican population, the devel- opment of a valid national food composition database is critical. This is especially so in light of recent advances in nutrition knowledge and the changing health and disease patterns of the Jamaican population (Sinha, 1995).

Although some information is available on many of the food products that are widely traded, Jamaica lacks information required for the creation of a comprehensive food composi- tion database. Tables on food composition for use in the English-speaking Caribbean were developed in 1974 using data published between 1954 and 1963 by the Food and Agriculture Organization (FAO), the United States Department of Agriculture (USDA) and the Instituto de Centro America y Panama (INCAP) (CFNI, 1974). The data contained in these food tables are now inadequate for the following reasons:

- they were obtained over 20 years ago and do not reflect changes in new agronomic tech- nologies and processing methodologies, which can affect the nutritional value of both plant and animal products;

- the database lacks information on a number

The complexity of a national food supply makes the generation of accurate food composi- tion data a difficult and expensive task which, of necessity, must be carried out in prioritized stages. The first stage entails determining foods to be included in the database. Priorities for selecting food items for inclusion in a national food composition database should be based on considerations such as foods which are major contributors in the diet and for which reliable data are unavailable (Stewart, 1981) and foods as eaten - fully prepared commercial and home prepared (Beecher & Mathews, 1990). Sharma et al., (1996), in an effort to determine foods for inclusion on a Food Frequency Questionnaire (IT@, conducted a small food consumption study using 24-hour recalls on a sample of 109 persons in the Kingston Metropolitan Area and identified 69 food items. Apart from this study, no population studies have been conducted to determine the types of foods commonly con- sumed by the Jamaican population. It was, therefore, necessary to conduct this broader study prior to the generation of food composi- tion data for the island.

The focus p u p methodology, a qualitative information-gathering technique, was the research method of choice for obtaining general information about foods commonly consumed in Jamaica, because it is quicker and less costly than individual interviews (Stewart & Shamda- sani, 1990). The methodology has been widely used as a research tool in social science, marketing, public policy, advertising and com- munications, and offers a means of obtaining in- depth information from a target audience in a non-threatening atmosphere (Bellenger et al., 1979; Calder, 1977; Krueger, 1988; Shepherd et al., 1989; Crockett et aL, 1990).

The si@icance of this research is related to the need to identify foods, in their foms most commonly consumed, which are the major contributors to the diet of the Jamaican popula- tion. Answers were sought to the following pertinent questions:

of foods used on the island as well as 1. Which foods (single and prepared) are most information on trace minerals and types of frequently consumed by the Jamaican lipids present in foods; population?

- values for prepared foods are almost non- 2. In which regions or population groups is the existent, making it extremely difficult to food most commonly consumed?

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Identifying foods commonly consumed by the Jamaican population 81

3. Is the food consumed more in urban or rural areas?

Methods Sampling and recruitment Twenty focus group discussions were conducted island-wide which were made up of 20 regrouped Enumeration Districts (EDs) of the 1991 Jamaican population census. Sample EDs were selected as a subset of the EDs adopted by the Statistical Institute of Jamaica (STATIN) for the 1995 Survey of Living Conditions (SLC) (STATINPIOJ, 1997). Taking into account pop- ulation proportions, 10 sampling regions were selected and distributed throughout the three divisions of the SLC as follows: two to the King- ston Metropolitan Area (KMA); three to Other Towns (OT) and five to Rural Areas (RA). Two EDs were selected from each sampling region, an ED comprising 16 dwellings (STATINPIOJ, 1997). The person responsible for food purchase and preparation in each of the 16 dwellings within the sample EDs was invited as a group participant. Focus group discussions were con- ducted in a venue which was considered cen- trally located in each enumeration district including schools, church halls and community centers. A small cash incentive and light refresh- ment were offered to each participant.

Discussion fonnat Group discussions were moderated by the Jamai- can researcher (senior author), aided by an assis- tant moderator who took notes of group dynam- ics and managed an audio recording of discussions. Each participant was requested to respond to each discussion question. Discussions were guided by a pre-tested Interview Guide (Appendix) consisting of 14 open-ended ques- tions under five broad areas, as follows:

1. Foods consumed dailylweekly 2. Fruits and vegetables consumed daily/

3. Foods consumed according to age and gender 4. Seasonal foods 5 . Dishes most commonly prepared within the

household.

weekly’

‘(Note: This question had to be asked separately since the pre-test revealed that, culturally, fruits and vegetables are not interpreted as ‘foods’.

Data management All discussion sessions were audio taped and transcribed verbatim. A code was designed for each food as the food was encountered within the transcripts, for example, RP (rice and peas) and BGB (boiled green bananas). Responses for each question in each group were coded in order to convert the data into a quantifiable form (Becker & Geer, 1960). Codes were then entered into a matrix (Miles & Huberman, 1994) and collated to arrive at ‘Food Occur- rence’ by group and geographical area. The most commonly consumed foods were deter- mined using the formula:

Food OccurrenceMo. of Households X 100

The food with the highest percentage occur- rence was designated the most commonly con- sumed. Percentages were ranked in descending order to arrive at a list of most commonly con- sumed foods. Chi-square tests were performed on the data, using the SPSS statistical package, to test the homogeneity of frequency of ‘men- tions’ regarding types of foods consumed across geographical regions. The Spearman’s rho statistic was used to test the rank order of the top 15 most commonly consumed foods by region.

Results Sample characteristics A total of 130 households participated in the group discussions (KMA - 18; OT - 35; RA - 77). Average number of households in each group was seven with a range of 4-13. The 130 focus group participants represented households totaling 623 persons within an age range of one month to 86 years.

Commonly consumed foods and dishes - general Table 1 presents the 70 food items which were mentioned by participants as being the most commonly consumed in their households. The top 15 of these foods are ranked, by geograph- ical division, and presented in Table 2. All rank order comparisons were significant at P = 0.05 except for that between Rural Areas and Other Towns (P = 0.15). Dishes most commonly pre- pared in households, as mentioned by partici- pants, included chicken and chicken back (fried, brown stewed, cumed); rice and peas; plain

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82 I! M. Samuda et al.

a b l e 1. Foods most commonly consumed by the Jamaican population

Cereal and cereal prodvcts Brown bread Sliced white bread Hard dough white bread watcr crackers Spiced bun Bulla Biscuits Oats Macaroni Corn flakes Rice

Green leafy and yellow vegetables Cabbage Callaloo Lettuce carrot Chocho (christophene) Sweet pepper

Pak choi pumpkin

stringed beans

Other vegetables Ackee Cucumber Okra Tomato

Meat and meat products Beef Pork Goat’s flesh Corned beef Ox liver Cow’s head Franwlrter

Poultry Chicken Chicken back

Fish Fish (fresh) Mackerel (salted) Mackerel (tinned) Cod fish (salted) Sardines

E m Eggs (hen’s)

Mixed dishes Rice and peas

Peas. soups (beef, chicken foot.

Dumpiings @oiled fried) patty Cornmeal ponidge Banana porridge Oats porridge Rice porridge

Fnrits Orange Ripe banana Mango Gqefmit Papaya Otaheiti apple Garden chu-ries Orange juice Guava Water melon

Starchy mots and tubers Yellow yam Renta yam St Vicent yam sweet yam Tau yam sweet potato lrish potato coco Green banana Plantain

Dairy Cheddar cheese Condensed milk

Nuts Peanuts

Table 2. Rank order of top 15 most commonly consumed foods, by geographical regions’ ,

Rank order by geographical region

Food Jamaka KMAb Other Towns Rural Areas

orange Cabbage Ripe banana carmt Chicken Rice and peas callaloo Sardine Tinned mackerel Plain rice Yellow yam corned beef Tomato Green banana Lettuce

1 1 1 2 2 3 3 3 5 4 1 2 5 5 9 6 1 I 7 3 5 8 4 4 9 6 6 10 5 10 11 9 10 12 8 8 13 11 12 14 11 12 15 12 13

1 4 3 8 2 3 9 10 I 6 5 11 13 12 14

‘All rank order comparisom significant at P = 0.05 except for Rural ARAB and other Towns (P = 0.15). bKingston Metropolitan Area

rice; beef (roast, stewed); fish (brown stewed); pork (stewed); stewed peas (kidney beans); boiled yellow or sweet yam, dumplings, green bananas; soups and porridges (cornmeal, oats, rice, banana).

Frequency of occurrence of common foods and dishes were cross-tabulated with geograph- ical regions to test the homogeneity of items mentioned across regions. Table 3 shows that there were no si@icant differences by region (P = 0.98).

Table 3. Comparison of patterns of consumption of common foods and dishes by geographical regions’

Frequenq by geographical regions

Category KMAb Other Towns Rural Areas

Common foods 34.2’ 32.1 33.3 (25)* (35) (60)

Common dishes 65.8 61.3 66.1 (48) (72) (120)

“chi-square = 0.046. df = 2; P = 0.98. b a g s t o n Metropolitan Area. ‘Percentage. dNumber of mentions.

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Identihing foods commonly consumed by the Jamaican population 83

Table 4. Foods consumed by children, 1-3 years of age

Type of fooddish Type of f o d d i s h

Porridges Cornmeal porridge Oats porridge Rice porridge Banana porridge Plantain pomdge Arrowroot pomdge Carrot porridge

Meaumeat products Tinned mackerel Chicken

Egg and dairy Boiled egg ‘Lasco’ milk ‘Ready’ milk ‘Cremo’ milk Cheddar cheese

Fruits Orange Orange juice Ripe banana Papaya Grapefruit Vegetables Callaloo Chocho (christophene)

Staples Boiled rice Boiled yellow yam Boiled green banana Boiled dumpling

Other soups ‘Mint tea’

Foods consumed by children, 1-3 years Pomdge made from cornmeal, rice, oats, banana, plantain, arrowroot or carrot was the most common ‘child’ food mentioned by partic- ipants. Table 4 presents the foods identified as being consumed by children, 1-3 years. Chi- square statistics revealed that there were no dif- ferences, by geographical region, in the types of foods reported to be consumed by young chil- dren (P = 0.95).

Table 5. Frequency of mentions of category of meals consumed on weekends, by geographical area’

Geographical area

Category KMAb Other Towns Rural Areas

‘No cooking’ 2.9‘ 3.0 (4)d (6)

soups 26.3 27.3 (36) (54)

Main dishes 35.8 33.3 (49) (66)

Light meals 35.0 36.4 (48) (72)

Bchi-squa = 0.407; df = 6; P = 0.99. bKingston Metropolitan Area. “Percentage. dNumber of mentions.

Foods consumed by the elderly Foods consumed by the elderly resembled those reported to be consumed by children I-3 years old. These included porridges; soups; veget- ables; chicken; fish; chocho (christophene); sweet yam and bread - all of medium to soft consistency.

Weekend food consumption There were no significant differences, across geographical regions, in the reported frequency of category of meals mentioned as being con- sumed on weekends (P = 0.99), as shown in Table 5. The frequency of mentions of ‘no cooking’ in the household on Fridays was sim- ilar in all three areas (KMA - 2.9%; OT - 3.0%; RA - 3.1%). Foods consumed on Fri- days were often described by participants as ‘light’ and consisted of sandwiches; bread and tea; crackers and tea; fried or ‘jerk’ chicken with bread. Soups, ‘light meals’ and main meals were consumed in similar proportions across regions.

A significant difference was observed in the pattern of food consumption by weekend day (P = 0.00) as shown in Table 6. On Fridays there was a mix of ‘no cooking’ (7.2%); soups (7.5%) and ‘light meals’ (85.3%), while soup was the most commonly consumed dish on Saturdays (99.4%). The most commonly consumed soups were those made with beef, chicken foot, peas/ beans, tripe, chicken back and green vegetables.

Table 6. Frequency of pattern of food consumption on weekend daysa

Weekend day

Category Friday Saturday Sunday

‘No cooking’ 7.2b (20)c

soups 7.5 (21)

Main dishes 0 (0)

(138) Light meals 85.3

“chi-square = 1197.16; df = 9; P = 0.00. ”Percentage. ‘%umber of mentions.

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84 f? M. b w d a et al.

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60 - E- 50

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0

Common foods

Figure 1. Common foods CoIlSumed by households on Sundays.

All mentions of items consumed on Sundays were main foods/dishes. Food items on the Sun- day dinner menu were almost identical in all areas and consisted mainly of chicken, rice and peas, cooked and raw vegetables and a fruit drink (Figure 1). Participants repeatedly repor- ted that vegetables were consumed in their households always on Sundays, and in larger quantities than on weekdays. Sixty-five percent of participants reported consuming a dessert on Sundays - a practice which is not common to any other day of the week. Common Sunday desserts were potato or cornmeal puddings, and ice cream and ‘Jell-0’. Worthy of note is that desserts were not consumed as part of the main meal but were usually consumed ‘later in the evening’.

Discussion The purpose of this research was to identify the single and prepared foods most commonly con- sumed within the Jamaican population and to ascertain whether or not there were regional dif- ferences in the consumption patterns of these foods. Three conclusions may be drawn from the results of the study. First, the research was able to identify a list of single and prepared foods and food products commonly consumed by the Jamaican population. Second, the homo- geneity of responses displayed in the results strongly suggest that there are no real differen- ces in the types of foods consumed across geo-

graphical regions. In this regard, one may ques- tion the effect of factors such as food availability, food distribution and purchasing power on these food patterns. Further studies are necessary. Third, in similar situations where resources are scarce and the objective is to gen- erate a list of commonly consumed foods by a given population, the focus group methodology provides a rapid and cost-efficient means of obtaining this information.

The synergistic effect of a focus group setting often results in the production of data and/or ideas that might not have been uncovered with other methodologies. The issues of the ‘prob- lematic’ eating patterns of the elderly, vegetable consumption mostly on Sundays and the unique weekend food consumption patterns are cases in point.

The ‘problematic’ eating patterns of the eld- erly referred to by most respondents were related to restricted food patterns due to chronic diseases of aging. Many ‘favourite’ foods appear to be limited in therapeutic diets and compliance is difficult to maintain. These findings suggest the need for more detailed investigations into the eating patterns of the elderly in Jamaica.

The likelihood of vegetables not being con- sumed in the household on weekdays was expressed by a large proportion (64%) of res- pondents. In addition, this study found signifi- cant differences among weekend days in the types of foods consumed in households. These issues are worthy of note, especially to inves- tigators embarking on food consumption studies in Jamaica.

Of the 70 most frequently consumed foods identified in this study, 48 (68%) were similarly identified in the Kingston sample studied by Sharma et al. (1996). The results of this study coupled with those of Sharma et al. are, to date, the only information available identifying types of foods consumed by the Jamaican population.

A number of caveats concerning the study findings beg for discussion. Included among these are the issues of identifying a single list of commonly consumed foods from a country’s total food system, the effect of group interaction on results obtained, and the generalization of results from focus group findings.

While a country’s food system may contain hundreds or thousands of foods, studies conduc- ted in the United States have demonstrated that

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Identifying fooh commonly consumed by the Jamaican population 85

a small percentage of the total food items avail- able make up a large percentage of the total food consumed (Wolf, 1981; Pennington, 1983; Greenfield 8c Southgate, 1992). Stewart (1983) postulates that these and other findings suggest that there is a small ‘core’ of food items con- sumed by population groups which account for the bulk of the food consumed by that group. If it is assumed that this is so for all populations, then the establishment of the existence of this ‘core’ food list and their identification could be very useful, especially in developing countries where resources for analytical work are very limited.

The list of foods and dishes identified by this study could be considered a ‘core foods’ list for Jamaica and does provide valuable information for establishing the priorities for which foods in the country should be assayed for inclusion in an updated national nutrient database. Beecher and Vanderslice (1984) argue that although core food lists identified with specific socio-eco- nomic or cultural groups may vary, notwith- standing, a great deal of information on nutrient intake can be provided by using the nutrient composition of core foods. Similar studies con- ducted in the other English-speaking Caribbean islands would be useful in providing a core of information from which a larger database, rele- vant to the entire region, could be developed.

The interaction of respondents with one another and with the researcher, in a group dis- cussion, could result in responses from mem-

bers of the group not being independent of one another and thus affect the data obtained in any one group. The effect of this problem may be reduced by conducting several focus groups on the same topic, as was the case in this study. It is the authors’ view that results of this study are not affected by intergroup influences, since groups were selected nationwide and partici- pants from one group had no way of identifying and interacting with those of other groups.

A noted disadvantage of the use of the focus group methodology is that generalization to a larger population are limited due to the small numbers of respondents and the convenience nature of the sample. As pointed out by Stewart and Shamdasani (1990), however, ‘if there is reason to believe that the population of interest is relatively homogeneous, at least with respect to the issue at hand [then] a small number of respondents is all that is needed to generalize to the larger population’. The results of this study strongly support the hypothesis of homogeneity in the common types of foods and dishes con- sumed by households across geographical regions represented in the study sample and, as such, the findings may safely be generalized to the larger Jamaican population. Acknowledgments-This research was supported, in part, by funds from the Caribbean Food and Nutrition Institute, Jamaica, and the Maine Agricultural and Forestry Experi- mental Station as part of Regional Research Project NE- 172, MAFES Publication # 2154. Special thanks to the Sta- tistical Institute of Jamaica and all focus group participants.

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Appendix Focus Group Interview Guide Icebreakzrs: ‘If you had a chance, the food that you would eat NOW is. . .?’ ‘What foods do you enjoy eating? How often do you get to eat these foods?’

Discussion questions 1. Which foods do you and family members eat

every week? Which foods are eaten at least once per week?

2. Is there a food which is eaten in your household every day? More than once for the day?

3. Think about fruits. Which ones are eaten every day? Which are eaten every week?

4. What about vegetables, are they eaten in your household? Which ones are eaten in your house- hold every day? Which ones are eaten every Week?

5. What about tinned or processed foods? Which ones do members of your household eat regu- larly? How often?

6. Think for a while about young children, 1-3

years old in your households. What foods do they eat every day? What do they drink?

7. Do the teenage boys in your household eat dif- ferent kinds of foods than the teenage girls? What do boys eat? What do girls eat?

8. Tell me about the kinds of foods that men eat compared with those that women eat?

9. Do older people in your household eat different kinds of foods than the younger adults?

10. Let us talk about the foods that are only available some seasons of the year. Name some of them. How often are they eaten in your households, when they are in season?

11. Do you prepare and eat different kinds of foods on weekends than during the week? Tell me about them, starting from Friday evening.

12. Which foods do you and your household mem- bers NEVER eat?

13. If you were asked to name the dish that is pre- pared most often in your household, what would it be?

14. The dish that you prepare most often, how is it cooked?

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