Purpose: This study provides insight into decision making about food choices in the family and its relationship with (un)healthy eating, by including the responses of four members of the family as a sampling unit.
Setting: The study was conducted through four medical centers, visited by 69 classes from 19 different schools in Belgium.
Subjects: Ninety-two family quartets, including both parents and two adolescents between 12 and 18 years old, completed questionnaires independently.
Measures: Four previously investigated measures of decision-making power (30 items on a seven-point scale) were administered, along with a short food choice questionnaire and demographic variables.
Results: Results indicate that the influence of fathers but more especially that of children is important in food decisions. Moreover, the relative influence of each family member is dependent on the kind of product or product group considered. Differences in perceptions between the four family members show the importance of considering the responses of all the people involved in family decision making. Finally, it is clear that in families where adolescents have more power, food choices are less healthy.
Conclusions: Our main conclusion is the rejection of the "gatekeeper hypothesis" as an artifact of biased measurement. A multidimensional approach to the issue of influence in food decision making in the family is potentially richer and leads to different conclusions. The necessity of the involvement of the entire family for the introduction and adoption of healthy eating is emphasized.