Promoting fruit and vegetable consumption. Testing an intervention based on the theory of planned behaviour

From Information Seeking and Scanning to the Practice of Healthy Habits: A Longitudinal Test of the Integrative Model of Behavioral Prediction in the Context of Fruit and Vegetable Consumption

Fruit and vegetable intake is essential for health, but global adherence to recommended levels remains insufficient. Health information exposure positively influences consumption, yet the underlying mechanisms are not fully understood. This study aims to explore the relationships between information seeking and scanning, attitudes, norms, perceived behavioral control (PBC), intentions, and fruit and vegetable intake, following the main tenets of the Integrative Model of Behavioral Prediction (IM). Data were collected through face-to-face surveys in Santiago, Chile, with a representative sample of individuals aged 25 and older in two waves. Findings revealed that intentions in Wave 1 predicted fruit and vegetable consumption in Wave 2, with positive associations between attitudes, norms, PBC, and intentions. Information seeking was positively associated with attitudes, norms, and PBC, and it had indirect effects on fruit and vegetable consumption through attitudes, norms, PBC, and intentions. Information scanning did not show significant indirect effects on fruit and vegetable consumption, even though the path between scanning and attitudes was significant. The study provides support for the IM and highlights the importance of information seeking in promoting fruit and vegetable consumption through its influence on attitudes, norms, and PBC. The findings have practical implications for health campaigns, educational programs, healthcare interactions, and public policies targeting healthier dietary habits.

Factors associated with low fruit and vegetable consumption among people with severe mental ill health

Severe mental ill health (SMI) is associated with excess mortality, and poor diet is one associated modifiable risk factor. This study investigated factors associated with low consumption of fruit and vegetables among people with SMI (N = 9914). A total of 8.4% of participants ate no portions per day, while only 15% ate 5 + portions. Individuals who never consumed fruit and vegetables or ate < 5 portions per day were more likely to be male, younger than 65, unemployed, experience poorer general health, or perceive health as unimportant. Poor diet is common among people with SMI and tailored dietary improvement interventions are required.

Improving adolescents' dietary behavior through teacher-delivered cancer prevention education: a school-based cluster randomized intervention trial in urban Rajasthan

BACKGROUND

Dietary practices are one of the most common modifiable risk factors for cancers. Foods rich in dietary fibers are considered protective, meanwhile fast & junk foods are risk for common cancers. Adolescence period is marked by habit formation and is thus suited for delivering behavioral intervention. Schools offer an optimal setting for planning and executing these interventions to a large number of adolescents.

OBJECTIVE

To assess the effectiveness of a teacher-delivered cancer-prevention education in changing dietary behaviors of school going adolescents.

METHODS

A cluster randomized trial was conducted in government secondary and senior secondary schools with schools as clusters. A minimum required sample of 1032 students was estimated from 16 schools with 1:1 allocation in intervention and non-intervention groups. Dietary behaviors were recorded as dichotomous variable. The determinants were recorded as per theory of planned behavior framework using Likert-scale. Two teachers from each intervention school were trained to deliver cancer prevention education with focus on role of dietary behavior. Pre-post training assessment of teachers' knowledge towards common cancers was done using a self-administered questionnaire. Gender adjusted difference-in-difference analysis was done to assess intervention effect on both healthy and unhealthy behaviors.

RESULTS

In selected schools all students from classes 8 to 10 were approached and a total of 1224 students were enrolled, of whom 1096 completed the study. The study recorded significant improvement in scores of students from intervention group compared to non-intervention group for their attitude, subjective norms, perceived behavioral control and intention towards consuming healthy and avoiding unhealthy foods. The intervention was effective in significantly improving the proportion of students limiting fried/fast/packed food & sugar sweetened beverages (OR:1.51, 95%CI:1.08,2.12,p:0.017), and consuming fruits & vegetables daily (OR:1.55, 95%CI:1.08,2.22, p:0.017) while adjusting effect of gender.

CONCLUSION

Classroom-based cancer prevention education delivered through teachers during regular working hours is effective in improving dietary behaviors and its determinants among adolescent students. Thus, we recommend integrating a section focusing on the role of diet in cancer prevention and other lifestyle diseases in the existing school curriculum.

TRIAL REGISTRATION

The trial was registered under Clinical Trial Registry-India with registration number CTRI/2018/12/016586, dated-10/12/2018.

Effects of virtual interventions based on the theory of planned behavior to improve obesity-preventive lifestyle among girls, during COVID-19 pandemic

BACKGROUND

Adolescence is a critical period for the spread of obesity and overweight. This research was conducted with the aim of determining the effect of an educational intervention based on the theory of planned behavior on promoting obesity-related behaviors in overweight female students in Gachsaran.

METHODS

this quasi-experimental study was conducted on 90 female students of the first secondary school in the form of two intervention and control groups. Information related to nutritional status and the structures of the theory of planned behavior were collected using a researcher-made questionnaire whose validity and reliability have been confirmed. The educational intervention was carried out during five virtual training sessions. The data obtained three months after the intervention were analyzed using SPSS statistical software, version 20, using independent t-tests, paired t-tests, and equivalent non-parametric tests.

RESULTS

The present study showed that the scores of the constructs of awareness, perceived behavior control, subjective norms, intention, and nutritional behaviors were significantly improved after the intervention (p < 0.001). The results of the Mann-Whitney test showed that the two intervention and control groups did not have a significant difference in terms of the average overall physical activity score after the intervention (p = 0.078).

CONCLUSION

The results of the present study showed that training based on the theory of planned behavior in the conditions of COVID-19 disease and in a virtual form had an effect on nutritional behavior but could not increase physical activity behavior in adolescents with weight loss.

Long-term control of non-point source pollution by adjusting human environmental behavior in watershed-a new perspective

The control of non-point source pollution is a major scientific and technological problem faced by mankind. We proposed a new approach to eliminate non-point source pollution, focusing on adjusting human environmental behavior. The implementation procedures are as follows: (1) Investigate the intention of pollution discharge behavior through interviews and questionnaires. (2) Carry out targeted intervention within the framework of social psychology to transform it into an environmentally friendly mode. (3) Calculate the amounts of pollutants produced and discharged before and after the intervention, and then evaluate the effect of the intervention on reducing pollution. (4) Based on successful interventions, a scheme can be developed to curb non-point source pollution. Aiming to reduce fertilizer use, a case study was conducted in Hetao Irrigation District, one of the three major Irrigation districts in China. The results showed that the interventions indirectly affected intention through attitude, subjective norm, and perceived behavioral control. The structural equation model explained 76.0% of the total variance of farmers' intention to reduce fertilizer application (SMC = 0.760), indicating effective intervention. Subsequently, a program to curb non-point source pollution was developed. This study can provide a key scientific and applied reference for the long-term control of non-point source pollution in watershed.

[Psychosocial Influence Scale of Fruit and Vegetable Consumption among Adolescents: Adaptation and Factorial Validity]

Instruments to evaluate psychosocial determinants of fruit and vegetable (F&V) consumption among adolescents are scarce, and there appears to be only one instrument - unnamed and unvalidated - that investigates determinants derived from theories of social psychology targeting the frequency of F&V consumption among adolescents. The scope of this paper was to present the process of cultural adaptation and factor validation of this instrument al-lowing its use in studies with Brazilian adolescents. The cross-cultural adaptation process was accomplished and the final version - named Psychosocial Influence Scale for Fruit and Vegetable Consumption among Adolescents (PSI-FAVES) - was tested with 429 students (58% female) using McDonald's omega (ω) reliability and Confirmatory Factor Analysis (CFA) as analytical methods. The final version required refinement and the instrument showed adequate overall reliability (ω=0.86) and good fit of the data to the previously elaborated model (CFI=0.955; TLI=0.951 and RMSEA (90%CI) =0.043 (0.038-0.049)), being the first systematically validated instrument to investigate psychosocial determinants of F&V consumption among adolescents.

Behavior Change Training for Health Professionals: Evaluation of a 2-Hour Workshop

Background

Rates of noncommunicable diseases continue to rise worldwide. Many of these diseases are a result of engaging in risk behaviors. Without lifestyle and behavioral intervention, noncommunicable diseases can worsen and develop into more debilitating diseases. Behavioral interventions are an effective strategy to reduce the burden of disease. Behavior change techniques can be described as the “active ingredients” in behavior change and address the components that need to be altered in order for the target behavior to change. Health professionals, such as pharmacists and nurses, can engage in opportunistic behavior change with their patients, to encourage positive health behaviors.

Objective

We aimed to develop, implement, and evaluate a behavior change workshop targeted at health professionals in Australia, with the goal of increasing knowledge of behavior change techniques and psychological variables.

Methods

A prospective study design was used to develop and evaluate a 2-hour behavior change workshop targeted at health professionals. The workshop was developed based on the Capability, Opportunity, Motivation, and Behavior Model and had five core objectives: (1) to detail the role of health professionals in delivering optimal care, (2) to demonstrate opportunities to change behavior, (3) to describe principles of behavior change, (4) to explain behavior change techniques, and (5) to determine the most appropriate behavior change techniques to use and when to use them. A total of 10 workshops were conducted. To evaluate the workshops and identify any potential long-term changes in behavior, we collected pre- and postworkshop data on knowledge and psychological constructs from the attendees.

Results

A final sample of 41 health professionals comprising general practitioners, nurses, and pharmacists completed the pre- and postworkshop surveys. Following the workshops, there were significant improvements in knowledge of behavior change techniques (t40=–5.27, P<.001), subjective norms (t40=–3.49, P=.001), descriptive norms (t40=–3.65, P<.001), perceived behavioral control (t40=–3.30, P=.002), and intention (t36=–3.32, P=.002); each had a large effect size. There was no significant difference in postworkshop attitude (t40=0.78, P=.44). The participants also found the workshops to be highly acceptable.

Conclusions

A 2-hour, theoretically informed workshop designed to facilitate the use of behavior change techniques by health professionals was shown to be largely effective. The workshops resulted in increases in knowledge, descriptive and subjective norms, perceived behavioral control, and intention, but not in attitude. The intervention was also shown to be highly acceptable, with the large majority of participants deeming the intervention to be needed, useful, appropriate, and applicable, as well as interesting and worth their time. Future research should examine the lasting impacts of the workshop on health professionals’ practices.

Consumer Attitudes and Purchase Intentions in Relation to Animal Welfare-Friendly Products: Evidence from Taiwan

Animal welfare, environmental sustainability, and food safety have become topics of international concern. With the rise of friendly rearing and green consumption consciousness, consumers can use animal welfare certification labels as references to make purchase decisions. This study adopts the theory of planned behavior (TPB) as its core and incorporates variables, such as moral affection, health consciousness, and trust in certification, to discuss the thoughts of Taiwanese consumers on buying animal welfare-friendly products and the factors that affect their purchase decisions. This study will be conducive in clarifying the consumption behavioral pattern of animal welfare-friendly products, which previous literature has mentioned but not tested, thereby filling this literature gap. This study collects 653 valid questionnaires and uses the partial least square-structural equation modeling to analyze the correlations between various variables. The research findings indicate the following. (1) Consumers' attitudes, subjective norms, and perceived behavioral control have significant and positive influences on the behavioral intention of purchasing fresh milk with animal welfare labels. (2) Moral affection positively influences customers' behavioral intention toward fresh milk with an animal welfare label through attitudes, subjective norms, and perceived behavioral control. (3) Trust in certifications will enhance moral cognition and positive attitudes toward fresh milk with animal welfare labels. According to the research findings of this study, we recommend that businesses strengthen the promotion of dairy products in line with friendly rearing, environmental sustainability, and other ethical consumption concepts to generate market segregation elements.

The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011-2012

AIM

Periodontal disease is one of the most prevalent oral pathologies and a major chronic disease worldwide. Lifestyle habits such as poor nutrition and smoking have been established to contribute to the development of periodontal disease, but limited research has investigated whether physical activity and sedentary lifestyle play a role. The purpose of this study is to evaluate the association between physical activity, sedentary behaviour, and periodontal disease.

MATERIALS AND METHODS

We used a nationally representative data set from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. We examined the association between physical activity and sedentary behaviour and periodontal disease using multivariable logistic regression models and reported odds ratios (ORs).

RESULTS

Individuals with higher total physical activity, higher leisure time physical activity, and lower amount of total sedentary behaviour had lower periodontal disease prevalence. Adjusted multivariable regression models showed that higher sedentary behaviour (more than 7.5 h/day) was associated with higher odds of periodontal disease (OR = 1.17; 95% confidence interval = 1.00-1.36; p = .045).

CONCLUSIONS

The findings showed that higher sedentary behaviour is associated with higher odds of periodontal disease. Future prospective longitudinal studies and strategies are needed to investigate implications further and define the magnitude of the association between physical activity and periodontal disease.

Modeling fruit and vegetable consumption in Serbia

Although regular intake of fruits and vegetables has an essential role in a healthy diet and well-being, a majority of consumers in Serbia have a suboptimal intake of these groceries. To understand the main determinants of this unsatisfactory situation, the study tested an extended model of the theory of planned behavior intending to suggest necessary steps for improving fruits and vegetables daily intake. This theory, extended for the role of knowledge, was tested using structural equation modeling. Fit indices confirmed the utility of this extended model of the theory of planned behavior in explaining consumers' behavior as well as the mediating role of behavioral intentions. Serbia, as one of the central developing countries in the Balkans, was chosen to test the model with the possibility of applying it to other developing countries facing malnutrition. Data were collected in North Serbia, through an online survey (n=688). Despite consumers' high awareness of fruits and vegetables' beneficial health effects, the influence of consumers' knowledge only is not sufficient to trigger behavioral changes. Consumers' intentions and behavior should be influenced indirectly, by changing their attitudes and subjective norms. All custom-made activities promoting a higher fruit and vegetable intake should consider the present findings to achieve a bigger effect on behavioral changes among consumers.

Modeling fruit and vegetable consumption in Serbia

Although regular intake of fruits and vegetables has an essential role in a healthy diet and well-being, a majority of consumers in Serbia have a suboptimal intake of these groceries. To understand the main determinants of this unsatisfactory situation, the study tested an extended model of the theory of planned behavior intending to suggest necessary steps for improving fruits and vegetables daily intake. This theory, extended for the role of knowledge, was tested using structural equation modeling. Fit indices confirmed the utility of this extended model of the theory of planned behavior in explaining consumers' behavior as well as the mediating role of behavioral intentions. Serbia, as one of the central developing countries in the Balkans, was chosen to test the model with the possibility of applying it to other developing countries facing malnutrition. Data were collected in North Serbia, through an online survey (n=688). Despite consumers' high awareness of fruits and vegetables' beneficial health effects, the influence of consumers' knowledge only is not sufficient to trigger behavioral changes. Consumers' intentions and behavior should be influenced indirectly, by changing their attitudes and subjective norms. All custom-made activities promoting a higher fruit and vegetable intake should consider the present findings to achieve a bigger effect on behavioral changes among consumers.

Exploring Psychosocial Determinants of Eating Behavior: Fruit and Vegetable Intake Among Brazilian Adolescents

In most Western countries, children and adolescents do not eat the recommended amount of fruits and vegetables (FVs). Theoretical frameworks on social psychology of eating, such as the Reason Action Approach, Social Cognitive Theory, and Theory of Normal Conduct have been applied to understand how psychosocial variables can explain FV intake. However, considering those predictors is still rare on the understanding of FV intake among adolescents (particularly in Brazil) despite its importance within eating behavior. Therefore, this study explored important psychosocial determinants of weekly frequency of FV intake among Brazilian adolescents in a model testing socioeconomic status (SES) and body mass index (BMI). A cross-sectional design was performed with 429 students (58% female), mean age 14.45 (SD 1.86). Key variables of theoretical framework on social psychology of food were investigated by structural equation modeling. The model included self-efficacy, attitudes, and social norms (with its subcomponents descriptive and injunctive) as psychosocial predictors of weekly frequency of FV intake along with SES and BMI. An instrument developed for Brazilian Portuguese was used to collect psychosocial variables as well as to verify FV reported intake. The total model explained 45.5% of weekly frequency of FV intake, and self-efficacy was the only significant psychosocial determinant (λ = 0.51, p = 0.001). SES also showed an important effect on the model (λ = 0.21, p = 0.001), while for BMI no significance was observed. In conclusion, the model was adequate to understand psychosocial determinants of weekly frequency of FV intake for Brazilian adolescents, with self-efficacy and SES as the major determinants of this eating behavior.

Effect of educational program based on theory of planned behavior on promoting nutritional behaviors preventing Anemia in a sample of Iranian pregnant women

BACKGROUND

Iron deficiency anemia (IDA) is one of the most common problems during pregnancy. The aim of this research was to determine the effect of educational program based on Theory of Planned Behavior (TPB) on promoting nutritional behaviors preventing anemia in a pregnant woman in Shiraz city, Iran.

METHODS

This quasi-experimental study was done on 150 pregnant women (75 experimental and 75 control groups) who were selected using randomly sampling method in in Shiraz city, Iran, in 2020-2021. The educational intervention for the experimental group included six educational sessions for 50 or 55 min-based TPB model. A questionnaire consisted of items about demographic information, TPB constructs (attitude, perceived behavioral control, subjective norms and behavioral intention) was used to measure the nutritional behaviours preventing iron deficiency anemia in pregnancy women before and 3 months after the intervention.

RESULTS

The results showed that before the educational intervention, there was no significant difference between the two groups in terms of knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention and nutritional performance; however, three months after the educational intervention, the experimental group showed a significant increase in each of the mentioned variables. For example the mean and standard deviation score of behavioral intention after intervention in the experimental group was significantly increased (25.57 ± 1.66, P = 0.001),and the mean and standard deviation score of performance after intervention in the experimental group was significantly increased (31.03 ± 2.19, P = 0.001), (P < 0.05).

CONCLUSIONS

After the educational intervention, the experimental group showed a significant increase in of the knowledge, attitude, perceived behavioral control, subjective norms, behavioral intention and nutritional performance. Therefore the results of the study showed positive effect of nutrition educational intervention program base on TPB model on improvement of iron deficiency anemia preventive behaviours in the pregnancy women.

Trends in the Number of Behavioural Theory-Based Healthy Eating Interventions Inclusive of Dietitians/Nutritionists in 2000-2020

Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.

Mind the gap: Habit and self-determined motivation predict health behaviours in middle-aged and older adults

OBJECTIVES

Physical activity and fruit and vegetable consumption are two key health behaviours associated with the health and well-being of middle-aged and older adults. The present research investigated how habit and self-determined motivation interact with intention to prospectively predict physical activity and fruit and vegetable consumption in middle-aged and older adults.

DESIGN

A prospective correlational design (two data collection points) was used.

METHODS

A convenience sample of 195 adults completed online questionnaires measuring intention, habit, and self-determined motivation. One week later, 177 participants (67.2% female), aged 52-87 years (M = 61.50, SD = 5.90), completed self-report measures of physical activity and fruit and vegetable consumption over the previous week.

RESULTS

Separate hierarchical multiple regression analyses were conducted. For physical activity, the model explained 46% of the variance in behaviour, F(8, 168) = 17.88, p < .001 and a large effect size (ƒ2  = .85). Two-way interactions contributed an additional 3.70% of unique variance in physical activity, F(3, 165) = 4.07, p = .008, ƒ2  = .04. For fruit and vegetable consumption, the model explained 19.20% of the variance in behaviour, F(5, 171) = 8.13, p < .001 and a medium effect size (ƒ2  = .24). Two-way interactions did not significantly improve the model, F(3, 168) = 1.68, p = .174.

CONCLUSIONS

Habit and self-determined motivation were both important in narrowing the intention-behaviour gap for two key health behaviours, and combining these processes may better inform strategies to support people's intentions to improve these health behaviours.

Behavioural change box? Applying the COM-B model to understand behavioural triggers that support consumption of fruits and vegetable among subscribers of a fruit and vegetable box scheme

OBJECTIVE

To understand the key mechanisms that support healthy dietary habits promoted by fruit and vegetable (F&V) box schemes, testing relevant behaviour change triggers identified under the COM-B model in an evaluation research study of a Portuguese F&V box scheme (PROVE).

DESIGN

Correlation study with a post-test-only non-equivalent group design based on survey data. The mechanisms underpinning the differences between subscribers and non-subscribers are operationalised as mediation effects. Data availability, theoretical relevance and empirical validation supported the selection and testing of four potential mediators for the effects of subscribing to the box scheme on F&V consumption. These estimations derive from the coefficients of a structural equation model combined with the product coefficient approach and Sobel test.

SETTING

The study is part of a wider evaluation study on the impact of the PROVE box scheme on sustainability, health and equity.

PARTICIPANTS

A sample of PROVE box subscribers (n 294) was compared with a matched subsample of non-subscribers (n 571) in a nationally representative survey.

RESULTS

Subscribing to the PROVE box correlates with an increased probability of eating at least five portions of F&V, irrespective of differences in age, education and perceived economic difficulties. Diet quality perceptions, and more robustly, the strength of meal habits and household availability were identified as relevant mediators.

CONCLUSIONS

The subscription to an F&V box scheme is connected with proximal context that enables the consumption of F&V by ensuring more readily available F&V and better situational conditions associated with healthier meal habits.

Perceived Onset Time of Medical Conditions: The Interplay Between Subjective Fear and Risk in Four Lifestyle Domains

Engaging in unhealthy behaviors (e.g., smoking, drinking) and not engaging in healthy ones (e.g., exercising, consuming fruit and vegetables) are both relatively prevalent among individuals despite the available information about their risks for health. People's perception of an event's time course can be used to gauge their risk perception for that event thus casting light on any possible misperception and suggesting directions for health-promoting interventions. This study investigates people's perception of the time of onset of 5 noncommunicable diseases (e.g., "having high blood pressure") associated with 4 health-related behaviors: Smoking, drinking, exercising, and eating fruit and vegetable. Participants from Italy (N = 214) and the UK (N = 151) gave onset time estimates of how long they thought it would take for 5 noncommunicable diseases to occur in the life of an 18-year-old person who starts or stops adopting those health-related behaviors. Results showed that participants who rated the noncommunicable diseases as more likely to themselves perceived the onset time of these diseases as more temporally proximal. Participants who were more afraid of developing the noncommunicable diseases estimated their onset time as delayed.

Assessing the impact of an educational intervention program based on the theory of planned behavior on the nutritional behaviors of adolescents and young adults with PCOS in Iran: a field trial study

BACKGROUND

Polycystic ovary syndrome is the most common endocrine disorder among adolescents and adults. Given the importance of healthy nutritional behaviors in management of this disease, the present study was conducted to determine the impact of an educational intervention program based on the theory of planned behavior on the nutritional behaviors of adolescents and young adults with polycystic ovary syndrome.

METHODS

In this field trial study, 72 participants aged between 15 and 21 years old from four gynecology clinics in Shiraz, Iran, were assigned into the intervention and control groups. Educational intervention program was implemented based on the theory of planned behavior over 4 sessions during two weeks. The data collection tools were researcher-made questionnaires of demographic information, knowledge assessment, and assessment of theory of planned behavior constructs, as well as a questionnaire for assessing consumption of food groups, fast food, and snacks. The data were collected at two stages (once at baseline and once three months after the intervention), and then the changes in knowledge, attitude, subjective norms, the perceived behavioral control, behavioral intention, and nutritional behavior were analyzed using descriptive and inferential statistical methods (t-test, Chi-square, Mann- Whitney U, and Wilcoxon tests; as well as one- way ANOVA, repeated measures ANOVA, and ANCOVA, respectively).

RESULTS

Statistically significant increases were observed in the mean scores of knowledge, attitude, subjective norms, the perceived behavioral control, behavioral intention, and nutritional behavior in the intervention group by passing three months from the intervention compared to the scores before the intervention (P < 0.001). However, these differences were not statistically significant in the control group (P > 0.05). Moreover, the mean scores of knowledge, attitude, subjective norms, perceived behavioral control, behavioral intention, and nutritional behavior had no statistically significant difference before the intervention between the two groups; however, this was statistically significant by passing three months from the intervention (P < 0.001).

CONCLUSION

Considering the effect of an educational intervention program based on the theory of planned behavior on creating healthy nutritional behaviors in adolescents and young adults with polycystic ovary syndrome, it is recommended to use it in order to improve the nutritional health of them.

TRIAL REGISTRATION

IRCT, IRCT20160224026756N6. Registered 18 Aug 2018, https://en.irct.ir/user/trial/32693/view.

Habit is the Bridge between Intention and Behavior: A Look at Fruit and Vegetable Consumption among Low-Income Older Adults

OBJECTIVE

To examine the influence of habit and theory of planned behavior (TPB) variables in predicting low-income older adults' fruit and vegetable (F&V) consumption.

DESIGN

Cross-sectional study.

SETTING

A city in the southeast United States.

PARTICIPANTS

A total of 372 low-income older adults participated in this study.

RESULTS

Participants completed a validated survey measuring TPB variables (attitude, subjective norm, perceived behavioral control, and intention), F&V intake using the Block Dietary Fruit-Vegetable Screener, and self-reported habit index to measure F&V consumption. Perceived behavioral control was the largest factor influencing intention to consume F&V, followed by attitude and subjective norm. In addition, there was a significant interaction between habit strength and intention, such that intention influenced F&V consumption only among individuals with average or higher habit strength.

CONCLUSIONS

Findings from this study suggest health promotion programs aimed at increasing F&V intake among low-income older adults should focus on establishing F&V intake as a habit so that an individual's intentions to consume F&V can be transformed into actual F&V intake. Also, emphasizing how to overcome potential barriers would improve low-income older adults' actual F&V intake by increasing their sense of control over consuming F&V.

Explaining inequalities in fruit and vegetable intake in Europe: The role of capabilities, opportunities and motivations

People who do not eat enough fruit and vegetables (F&V) have incremental health risks. Most Europeans do not comply with health recommendations relating to F&V consumption and this is especially true for those with lower-level education, which reinforces structural inequalities in health and wellbeing among Europeans. This study investigated the role of key behavioural triggers - capabilities, opportunities and motivation (in the COM-B model) - as pathways for educational differentials in F&V intake in Europe. A cross-sectional survey-based study was conducted in five European countries differing widely in their consumption habits, wealth, and climatic conditions. A structural equation model was designed to study how capabilities (diet perceived knowledge, health purchase criteria), opportunities (financial availability, social norms), and motivations (health value, habits strength) affect educational inequalities in the intake of F&V (5 portions a day) as mediators. Multi-group comparisons assessed country differences. People with higher levels of education were more likely to eat the recommended diet, i.e., at least 5 portions of F&V a day. Countries in the sample vary significantly in the percentage of people complying with the recommendation, but not significantly in terms of relative education differentials. The educational gap in the intake of F&V is mainly explained by education differentials in financial availability, diet knowledge, and habits in inserting F&V in main meals. Policies targeting dietary inequalities should address behavioural triggers affecting dietary intake, for example by subsidising F&V, developing targeted dietary awareness campaigns, or by intervening in mass catering contexts to facilitate the implementation of healthy habits.

Recruiting and retaining young adults: what can we learn from behavioural interventions targeting nutrition, physical activity and/or obesity? A systematic review of the literature

OBJECTIVE

To describe strategies used to recruit and retain young adults in nutrition, physical activity and/or obesity intervention studies, and quantify the success and efficiency of these strategies.

DESIGN

A systematic review was conducted. The search included six electronic databases to identify randomised controlled trials (RCT) published up to 6 December 2019 that evaluated nutrition, physical activity and/or obesity interventions in young adults (17-35 years). Recruitment was considered successful if the pre-determined sample size goal was met. Retention was considered acceptable if ≥80 % retained for ≤6-month follow-up or ≥70 % for >6-month follow-up.

RESULTS

From 21 582 manuscripts identified, 107 RCT were included. Universities were the most common recruitment setting used in eighty-four studies (79 %). Less than half (46 %) of the studies provided sufficient information to evaluate whether individual recruitment strategies met sample size goals, with 77 % successfully achieving recruitment targets. Reporting for retention was slightly better with 69 % of studies providing sufficient information to determine whether individual retention strategies achieved adequate retention rates. Of these, 65 % had adequate retention.

CONCLUSIONS

This review highlights poor reporting of recruitment and retention information across trials. Findings may not be applicable outside a university setting. Guidance on how to improve reporting practices to optimise recruitment and retention strategies within young adults could assist researchers in improving outcomes.

Association between food availability and young people's fruits and vegetables consumption: understanding the mediation role of the theory of planned behaviour

OBJECTIVE

To evaluate the relationship between fruits and vegetables (F&V) availability at home and young people's F&V consumption behaviour, and how the theory of planned behaviour (TPB) constructs could potentially mediate the relationship.

DESIGN

Cross-sectional face-to-face survey questionnaire to assess the TPB constructs and home food availability assessed using open inventories method. F&V availability was categorised into low and high levels based on median split.

SETTING

Singapore.

PARTICIPANTS

Two hundred and ten households (each consisting one parent-child pair) recruited via stratified cluster sampling with child participants ranging from 9 to 16 years of age.

RESULTS

Mediation analyses were conducted using structural equation modelling. The relationship between home F&V availability and F&V consumption behaviour did not have a significant direct association, but there were significant indirect effects through the routes of perceived behavioural control (PBC) and intention as well as attitude and intention. Specifically, higher level of F&V availability at home was related to more positive PBC and attitude towards F&V, and subsequently greater intention to consume F&V and higher consumption of F&V.

CONCLUSIONS

Parents should make F&V more readily available at home as increased exposure to F&V could be related to enhanced liking, sense of control and intention to consume F&V and facilitate children's healthy diet.

A psychometric investigation of Brazilian Portuguese versions of the Caregiver Eating Messages Scale and Intuitive Eating Scale-2

The Caregiver Eating Messages Scale (CEMS) was developed to assess perceived restrictive or critical caregiver messages in relation to food intake and pressure to eat, whereas the Intuitive Eating Scale-2 (IES-2) measures one's tendency to follow internal cues of hunger and satiety when making eating-related decisions. Both scales are useful in the arsenal of eating behaviour scholars. Here, we developed Brazilian Portuguese translations of both scales and assessed their psychometric properties in Brazilian adults. A total of 288 participants (men = 52.8%) completed the CEMS, IES-2, Body Appreciation Scale (BAS), and a demographic questionnaire. The results of confirmatory factor analysis indicated that the factor structure of both scales had adequate fit following the elimination of items and addition of covariances. Evidence of adequate factorial, convergent and discriminant validity, as well as reliability was identified. Furthermore, correlations of CEMS and IES-2 with BAS scores and body mass index were obtained. Both instruments' models were found to be invariant across sex, with men having significantly higher scores on three subscales of the IES-2 only. These results provide evidence for the psychometric properties of the CEMS and IES-2 in Brazilian Portuguese-speaking adults.Level of Evidence: V, cross-sectional descriptive study.

Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status

A healthy lifestyle with sufficient physical activity (PA) can contribute to weight management. Yet, many people do not maintain a healthy lifestyle. To explain PA, we propose a model that incorporates the Theory of Planned Behavior (TPB) with weight-related self-stigma. We recruited 325 young adults to complete questionnaires regarding their physical activities, weight-related self-stigma, and TPB factors. We used structural equation modeling to examine the model fit and the path invariance across weight groups. The model showed excellent model fit, but path invariance was not supported. Weight-related self-stigma significantly explained the perceived behavioral control, behavioral intention, and engagement of PA. People without overweight and people with overweight have different considerations for PA. Weight-related self-stigma is important for PA as well. To promote a healthy lifestyle, healthcare providers should provide different suggestions or interventions that suit their patients' weight-related concerns.

Dietary Intake Among Church-Affiliated African Americans: The Role of Intentions and Beliefs

Diabetes and heart disease disproportionately burden African Americans, who tend to have worse nutritional intake than Whites. Many Black churches are influential institutions in the Black community, with potential to assist with promotion of healthy eating behaviors. The purpose of the current study was to use the Theory of Planned Behavior (TPB) to examine intention to eat a healthy diet and dietary behaviors among church-affiliated African Americans. It was hypothesized that TPB constructs would positively predict intention to eat a healthy diet and that intention to eat a healthy diet would be a predictor of fat and fruit and vegetable intake. It was also hypothesized that control beliefs would predict reduced fat intake and increased fruit and vegetable intake. Path analyses indicated behavioral, normative, and control beliefs were predictive of intention to eat a healthy diet. Intention to eat healthy was a significant predictor of dietary intake behaviors. These findings provide support for the use of the TPB in examining diet among church-affiliated African Americans. This study represents an opportunity to inform dietary interventions for the African American faith community.

Effects of interventions based on the theory of planned behavior on sugar-sweetened beverage consumption intentions and behavior

There is increasing concern about the health risks of added dietary sugar, perhaps particularly when consumed in beverages that contain no essential nutrients (e.g., sodas). The purpose of this experiment was to examine the relative and combined efficacy of three interventions based on the theory of planned behavior (TPB) for motivating reductions in sugar sweetened beverage (SSB) consumption. Four-hundred-thirty undergraduates were randomised in a 2*2*2 factorial design. Participants received either information designed to increase awareness of the risks of SSB consumption or control information, and received either information about SSB consumption norms or no norms information, and either made plans to reduce their SSB consumption or engaged in a control planning task. Results demonstrated that the interventions, separately and in conjunction, resulted in greater intentions to reduce SSB consumption in the future, and there was evidence that these effects were mediated by the effects the interventions had on the TPB constructs. Further, the risks information resulted in more behaviors indicative of preparations to alter SSB consumption and those who engaged in the SSB planning task reported significantly lower SSB consumption at follow-up compared to controls. The three interventions utilized showed promise for altering SSB consumption intentions and behavior and, given their brevity and low cost, have potential to be developed into large scale community-based interventions that may lead to meaningful public health benefits.

Effectiveness of Interventions and Behaviour Change Techniques for Improving Dietary Intake in Young Adults: A Systematic Review and Meta-Analysis of RCTs

Poor eating habits are common during young adulthood and influence chronic disease morbidity. This systematic review evaluates the effectiveness of interventions aiming to improve dietary intake among young adults and, identifies which behaviour change techniques (BCTs) are most effective. Six electronic databases were searched for RCTs published until October 2018, and evaluating behavioural interventions assessing change in dietary intake in young adults (17–35 years). Of the 18,779 articles identified, 54 were included. Forty studies focused on fruit and/or vegetable intake, of which 63% showed a significant between-group difference in favour of the intervention group. Meta-analysis (n = 17) demonstrated a significant increase in fruit and vegetable intake of +68.6 g/day after three months of intervention and +65.8 g/day for interventions >3 months when compared to control. A meta-analysis (n = 5) on total energy intake found no significant differences between groups. The BCTs with the highest effectiveness ratio were habit formation (100%), salience of consequences (83%) and adding objects to the environment (70%). The review highlights the potential of behavioural interventions to improve young adults’ fruit and vegetable intake but was less convincing for other dietary outcomes. Due to the lack of studies including each BCT, the BCTs imperative to success could not be identified.

The impact of a theory-based web-intervention on the intention to use prescription drugs for non-medical purposes among college students: a randomized controlled trial

The non-medical use of prescription drugs (NMUPD) among college students is escalating at an alarming rate. A limited number of studies have utilized a theoretical framework to influence this behavior. To utilize the reasoned-action approach theory to design and evaluate a web-based intervention to influence students' attitudes, perceived norms (PNs), perceived behavioral control (PBC) and intentions toward NMUPD. Using a two-group post-test only controlled trial, students were randomized to view either a general health website or a web-based intervention focused on NMUPD. The intervention was presented in multiple sections to address each component of the reasoned-action approach. Subsequently, respondents completed a web-survey. Independent t-tests were used to compare responses between the two groups. Of 391 respondents, 112 (28.9%) students indicated previous NMUPD. The intervention group had significantly (P = 0.04) more negative attitudes toward NMUPD. No significant differences were found in PNs (P = 0.11), PBC (P = 0.68) or intentions to NMUPD (P = 0.97). The intervention was successful in changing attitudes toward NMUPD. Targeting the intervention toward college students regardless of previous experiences of NMUPD might have led to insufficiency of the intervention to influence intentions. Additional research is needed to improve the intervention dissemination and utilization.

The Effect of Education Based on the Theory of Planned Behavior on Iron Supplementation among Pregnant Women

Background

Iron is an essential element for women of reproductive age, especially in the period before and during the pregnancy. This study investigates the consumption of iron to prevent iron deficiency anemia among pregnant women visiting Neyshabur healthcare centers based on the theory of planned behavior.

Methods

In this experimental study, data were collected through a questionnaire survey. It included 160 pregnant women who were receiving maternity services at twelve healthcare centers in the city of Neyshabur in Iran between 2015 and 2017. The participants’ demographic and anthropometric characteristics, Using the theory of planned behavior, and blood lab examination results, including ferritin levels were measured and the data were analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA).

Results

The average scores of knowledge, attitude, perceived behavioral control, subjective norms, and intention categories for the intervention group were meaningfully increased after the participants received education on iron supplementation (P<0.05). However, these changes were not found to be significant in the control group (P>0.05). No statistically significant difference was obtained in the subjective norms category between the two groups after the education intervention (P=0.92).

Conclusion

Based on the experimental effects of education encouraging iron supplementation in pregnant women, it is suggested that workshops promoting iron supplementation should be conducted in health centers with the aim of preventing widespread iron deficiency anemia.

A randomised controlled trial of a program based on the theory of planned behavior to promote fruit and vegetable intake among schoolchildren: PROFRUVE study protocol

BACKGROUND

The PROFRUVE study is a controlled intervention based on the Theory of Planned Behavior (TPB), which follows those behavioral theories that have proved to be the most effective at changing infant fruit and vegetable (FV) intake pattern. The main purpose of the study is to evaluate the effectiveness of an intervention program in increasing FV consumption in schoolchildren aged 8 to 10 and based on TPB.

METHODS

Eligible classrooms within schools from Vitoria-Gasteiz (Basque Country, Spain) will be randomly assigned to the intervention (classrooms n = 4; children n = 86) or control (classrooms n = 4; children n = 86) group. The intervention group will receive 14 sessions of 60 min during an academic year (October to June). These sessions, designed by a multidisciplinary team, are based on TPB and are directed at modifying determinants of behavior (attitudes, subjective norms, perceived behavioral control and intention of consumption), and intake of FV itself. Both the process and the evolution of consumption and determinants of behavior will be evaluated (before, during, shortly after and a year after) using validated surveys, 7 day food records, 24 h reminders and questionnaires.

DISCUSSION

This study will provide a valid and useful tool to achieve changes in the consumption of FV at school level. A negative result will be helpful in redefining new strategies in the framework of changing habits in the consumption of FV.

TRIAL REGISTRATION

This study has been retrospectively registered at ClinicalTrials.gov. Identifier: NCT03400891 . Data registered: 17/01/2018.

Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses

AIM

Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia.

METHODS

An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses.

RESULTS

Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence.

CONCLUSION

The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting.

Intention of Older Women to Consume 100% Watermelon Juice for Vascular Health: An Application of Theory of Planned Behavior

To strengthen randomized controlled trials (RCT) evaluating the efficacy of 100% watermelon juice on vascular function of older women, theory-driven behavioral analysis as well as comparative sensory analysis of the intervention and placebo were conducted. The Theory of Planned Behavior was adopted to assess psychosocial determinants of intention to consume watermelon juice. Sensory attributes were assessed utilizing hedonic scales. Analysis included Structural Equation Modeling with maximum likelihood. The measurement model provided a good fit (x² = 70.22, df = 38; RMSEA = 0.07, CFI = 0.98; NFI = 0.95). Attitude (γ = 0.36), subjective norm (γ = 0.43), and perceived behavioral control (γ = 0.21,) were significant predictors (p < 0.001) of intention. Participants identified no significant differences in sensorial attributes between beverages, thereby minimizing sensory bias and discrimination. Similar approaches may help other RCT investigating novel foods and bioactive compounds bridge gaps between efficacy and effectiveness.

Preventing tobacco in vocational high schools: study protocol for a randomized controlled trial of P2P, a peer to peer and theory planned behavior-based program

BACKGROUND

In France, the issue of youth smoking remains a major challenge for public health. School failure, socio-economic and socio-cultural backgrounds influence the initiation and maintenance of smoking behavior in adolescents. Vocational students are at particularly high risk of using psychoactive substances, including tobacco. One of the most important factors is the environment, whether family, friends or peers. Therefore, peer education has a positive potential to change smoking behavior of adolescents. It has also been demonstrated that the Theory of Planned Behavior (TPB) has yielded the best prediction of intentions and behavior, in several health domains, including on tobacco. However, it is usually confined to the measurement of processes by which interventions change behavior, rather than to the development of these interventions. The objective of this paper is to describe the protocol for a randomized controlled trial of a peer intervention based on the TPB on a highly exposed young population.

METHODS/DESIGNS

This is a cluster randomized controlled trial comparing an intervention group to a control group, randomized into clusters (professional schools and classes) and stratified in three departments (Hérault, Aude and Gard) in the Languedoc-Roussillon region. The primary issue is the prevalence of daily smoking at 24 months, defined by a daily tobacco use of at least 1 cigarette, validated by CO levels in exhaled air. The primary hypothesis is that intervention will lead to decrease the daily smoking prevalence of 10% between the intervention group and the control group during a 2-year follow-up.

DISCUSSION

The results from this trial will provide evidence on the effectiveness of an innovative peer-to-peer intervention based on the TPB.

TRIAL REGISTRATION

ISRCTN: 37336035 , Retrospectively registered 11/12/2015.

Reduction in Vegetable Intake Disparities With a Web-Based Nutrition Education Intervention Among Lower-Income Adults in Japan: Randomized Controlled Trial

BACKGROUND

No existing Web-based nutrition education interventions have been evaluated in light of socioeconomic status just in Japan.

OBJECTIVE

The aim was to investigate the effect of a Web-based intervention program on reducing vegetable intake disparities between low- and middle-income Japanese adults.

METHODS

In this randomized controlled trial, participants were assessed at three time points-baseline, postintervention (5 weeks later), and a follow-up after 3 months-from October 2015 to March 2016. We collected data via a Japanese online research service company from 8564 adults aged 30 to 59 years. Participants were stratified according to national population statistics for gender and age, and randomly selected. They were then randomly allocated into intervention (n=900) and control (n=600) groups such that both groups contained an equal number of individuals with low and middle income. The intervention program encouraged behavior change using behavioral theories and techniques tailored to their assumed stage of change. The outcome was vegetable intake servings per day (1 serving being approximately 70 g).

RESULTS

Out of 900 participants who started, 450 were from the middle income group (of which 386 or 85.7% completed the intervention), and 450 were from the low income group (of which 371 or 82.4% completed). In the intervention group, vegetable intake increased in the low-income participants from baseline to postintervention (0.42 servings, 95% CI 0.11-0.72). A two-way analysis of variance showed that low-income participants had significant main effects of group (η2=0.04, P=.01) and time (η2=0.01, P<.001), and a significant interaction (η2=0.01, P=.009). Middle-income participants also had a significant main effect of time (η2=0.01, P=.006) and a significant interaction (η2=0.01, P=.046).

CONCLUSIONS

This Web-based nutritional education intervention could fill the vegetable intake gap between low- and middle-income adults in Japan, and is expected to prevent noncommunicable and lifestyle-related diseases. Further intervention program improvements are necessary to maintain and increase vegetable intake for other groups.

TRIAL REGISTRATION

Current Controlled Trials (UMIN-ICDR): UMIN000019376; https://upload.umin.ac.jp/cgi-open-bin/ icdr_e/ctr_view.cgi?recptno=R000022404 (Archived by WebCite at http://www.webcitation.org/6u9wihBZU).

Evaluation of an Intimate Partner Violence Training for Home Visitors Using the Theory of Planned Behavior

INTRODUCTION

Intimate partner violence (IPV) is a public health issue with recent intervention focus by home visiting programs with at-risk families in the United States. Home visitors are typically required to assess IPV but feel unprepared to do so and desire training. Our aim was to evaluate the impact of a daylong IPV training on the intention to enact three key IPV behaviors (screening, making referrals, and safety planning) using the theory of planned behavior.

METHOD

Survey of 125 home visitors in West Virginia was conducted before and after a daylong IPV training.

RESULTS

The IPV training had a positive impact on intention to perform the three behaviors of interest, with the greatest impact on the intention to conduct IPV screenings.

DISCUSSION

Results provide important preliminary evidence supporting the effectiveness of professional development as a means of increasing intentions to conduct activities related to IPV. The impact on IPV screening intention is promising because screening is the first step in addressing IPV.

CONCLUSION

The IPV training proved beneficial in increasing intentions and such trainings should be expanded, but further study is needed to link intentions to subsequent behaviors to address IPV with at-risk families.

Health psychology: It's not what you do, it's the way that you do it

Despite the growth in theoretical understandings of health behaviour and standardised approaches to health interventions (e.g. behaviour change taxonomies), health psychology has paid comparatively less attention to the importance of the implementation processes - 'how to' rather than 'what to' of such interventions. The clinical and interpersonal skills that often reflect these implementation processes are poorly defined within the health psychology literature. The level of proficiency in such skills expected of Health and Care Professions Council registered practitioner health psychologists is unclear and poorly documented within the UK training requirements. This article explores the potential impact of this and offers some pragmatic solutions.

Effect of theory-based intervention to promote physical activity among adolescent girls: a randomized control trial

BACKGROUND

Physical activity (PA) rates decline among most high school female students, and due to cultural restrictions, the reduction of physical activity might be exacerbated in female Iranian adolescents.

OBJECTIVE

To determine the effects of the physical activity education theory-based intervention to promote activity among adolescent girls.

METHODS

This randomized clinical trial was conducted at public high schools in Tehran, Iran, from September 2015 to July 2016 on 578 girls. The subjects were assigned randomly to two groups of experiment and control (n=289 per group). All participants in the experimental group received an educational program based on a modified TPB. Measures were assessed before and 6 months after the experiment. The data were analyzed using SPSS version 23. We used descriptive statistics, multilevel analysis, Likelihood Ratio (LR) test, P-value less than 0.05 were considered statistically significant.

RESULTS

Five hundred and seventy-eight participants with a mean age of 14.26±0.96 years were studied in two groups of experiment (n=289) and control (n=289). Moreover, adjusted for the baseline values, the mean of the scores of the knowledge (84.1±13.6), attitude (31.2±13.6), subjective norm (40.4±11.1), behavioral intention (34.3±14.7), perceived behavioral control (38.4±11.6), perceived parental control (42.9±14.2), behavioral (42.6±17.1) was significantly higher in the experiment group compared with the control group (p<0.001).

CONCLUSIONS

The results of this study implicate that theory based educational intervention is considered to be more effective in improving physical activity in adolescents. This result can be used to increase adolescent's health promotion.

TRIAL REGISTRATION

The trial was registered at the Iranian Registry of Clinical Trials (IRST) with the identification number: IRCT2015070623089N2.

FUNDING

The authors received no financial support for the research from Kermanshah University of Medical Sciences.

Does Economic Crisis Force to Consumption Changes Regarding Fruits and Vegetables?

This study focuses on consumers' behaviour towards Fruits and Vegetables (FVs) under economic crisis. The implementation of both factor analysis and logistic regression reveals discrete consumer groups, affected and not affected by the ongoing economic crisis. Interviewees were selected randomly. In total, 250 questionnaires were completed and 238 of them were used for computations. There are two consumer groups, one affected by the crisis and one which did not. For the former, the price criterion prevails, while for the latter parameters like locality of production and heath concerns lead them to purchasing decisions. The economic crisis has reduced the quantities of FVs being consumed, and the retail chain stores fail to meet the criteria of locality and secure traceability procedures about the origin of the products. Nevertheless, educated consumers with higher incomes prefer to visit super markets, while elderly people with low incomes prefer grocery stores and open markets.

Is a Nutrition Education Intervention Associated with a Higher Intake of Fruit and Vegetables and Improved Nutritional Knowledge among Housewives in Mauritius?

The purpose of the study was to assess the determinants of nutrition behaviors and body mass index and determine the impact of a nutrition education intervention (NEI) among Mauritian housewives. A pretest-posttest design was used assessing Nutrition Knowledge (NK), Nutrition Attitudes, Fruit and Vegetable Intake (FVI), body mass index (BMI). Two hundred Mauritian housewives were recruited. The NEI was in the form of a lecture and lasted for twenty minutes. Statistical tests performed revealed that the mean NK score at baseline was 65.8 ± 6.92 and a significant increase of +17.1 at post-test and +16.1 at follow-up was observed. Determinants of NK were age, presence of elderly people, and BMI. Mean nutrition attitude score at baseline was 2.37 ± 0.22 with significant increase of +0.2 (post-test) and +0.17 at follow-up. Age, level of education, presence of elders, and NK were linked to a positive attitude. FVI was predicted by age, income, presence of elders, NK, and nutrition attitudes. Baseline FVI was 4.77 ± 1.11 which increased significantly (p < 0.001) to 4.98 ± 1.13 at post-test and 5.03 ± 1.20 at follow up. NEI had a positive impact suggesting the benefits of such intervention in the promotion of healthy nutrition behaviors.

Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth

BACKGROUND

Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD.

METHODS

Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10-14 y) dyads participating in the baseline evaluation of the B'More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income.

RESULTS

On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth's healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06-1.41, ORvegetable 1.31; 1.15-1.51 and ORfiber 1.46; 1.23-1.74, Self-efficacy: ORfruit 1.07; 1.03-1.12, ORvegetable 1.04; 1.01-1.09, ORfiber 1.10; 1.04-1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable and fiber intake (OR 1.26; 1.06-1.50; OR 1.28; 1.03-1.58, respectively). Also, youth with parents who shopped more frequently at fast-food stores had 7 % lower odds for higher vegetable intake (95 % CI: 0.88-0.99).

CONCLUSION

In this study, both, youth and household factors were associated with youth FV and fiber intake, underscoring the need for a multi-level approach to increasing youths' diet quality. These results will inform and shape an effective intervention program for improving youth dietary intakes.

The impact of parameters of store illumination on food shopper response

Customer behavior in sales areas is strongly influenced by the perception of surroundings and feelings of well-being. By using dynamic retail solutions of basic, accent and dramatic lighting it is possible to attract attention, create a unique in-store environment and give customers a reason to stay and return to the store. The simplest and also the most successful method to reach customer attention in food selection (buying) process is through eye-catchingly illuminated visuals of products. Visual senses has evolved to top ranks in the sensory hierarchy, therefore visual stimuli have a tendency to overcome all other senses. The paper deals with a comprehensive interdisciplinary research of the influence of light and color on the emotional state of consumers (valence) on the food market. It integrates the measurement of light intensity, color temperature or emitted color spectrum in grocery stores, recognition of emotional response and the time of its occurrence among respondents due to different lighting types and color in simulated laboratory conditions. The research is focused on accent lighting in the segment of fresh unpackaged food. Using a mobile 16-channel electroencephalograph (EEG equipment) from EPOC company and a mini camera we observed the response time and the emotional status (valence), in order to reveal true consumer preferences in different lighting conditions (color temperature and color rendering index) and their non-traditional color (yellow, purple, red, blue and green) for the selected food type. The paper suggests possibilities for rational combination of the effective, efficient and energy-saving accent lighting, by which the retailer can achieve not only an eye-catching and attractive presentation of merchandised products, but also significant savings within operating their stores.