What drives schoolchildren's food choices? Insights from a gamified stated-preference choice experiment in Tunisia

This paper models the drivers of schoolchildren's food choices in urban Tunisia using a gamified Stated-Preference Choice Experiment (SPSPCE), which includes scenario attributes (food placement, preparation, and price) and contextual factors (parental/peer modeling eating behaviors). A representative sample of 2465 schoolchildren aged 8 to 12 years in Greater Tunis participated in a SPCE, which simulates real-life food choice scenarios on a typical school day. The game includes six nodes (breakfast, recess, lunch, snack on the road to/from school, afternoon snack, dinner) in various locations (home, school, neighborhood). Each choice task includes nine items to choose from (3 beverages, 3 side-meals, and 3 meals) of different healthiness levels. Random-effects binary logit models estimated the drivers of food choices by location. We find that food placement and parental/peer modeling influence food choices to some degree, while preparation and price have negligible impact. Hard to reach items were significantly less likely to be selected at home. Presence of a peer eating unhealthy foods significantly increases the odds of choosing unhealthy items from food stores near schools. Results differ across locations, with children choosing healthier beverages/side meals at home than from food stores in school neighborhoods. A consistent and highly significant dependency between healthy and unhealthy meals is found across all nodes, highlighting some compensation behaviors whereby eating healthy foods would justify consuming unhealthy ones. This study offers insights into improving schoolchildren's diet by reducing availability of unhealthy choices, while offering accessible healthy options and encouraging the modeling of healthy eating behaviors by peers/parents. • Drivers of food choices in Tunisian schoolchildren was assessed using a gamified stated-preference choice experiment. • Food placement and parental/peer modeling influence children's food choices. • Children choose healthier food items at home than from food stores around schools. • Limiting unhealthy food options is crucial to promote healthy eating among schoolchildren.