Parental Guidance and Children's Healthy Food Consumption: Integrating the Theory of Planned Behavior with Interpersonal Communication Antecedents

Predicting sugar intake using an extended theory of planned behavior in a sample of adolescents: The role of habit and self-control

INTRODUCTION

High levels of sugar intake are associated with multiple maladaptive health outcomes in adult and younger populations. Identifying the psychological determinants of sugar intake in adolescents, and the processes involved, may help identify potentially modifiable targets and inform intervention development. We tested the predictions of an extended theoretical model based on the theory of planned behavior (TPB), which specified social cognition constructs, habit, and self-control as correlates of sugar intake in an adolescent sample.

METHODS

Adolescents aged 12 to 14 years (N = 88) recruited via a survey panel company and consenting to participate in the study completed online self-report measures of constructs from the TPB alongside measures of habit and self-control. One month later, participants completed a follow-up measure of free-sugar intake. Hypothesized effects of our proposed extended model were tested using partial least squares structural equation modeling.

RESULTS

We found statistically significant effects of attitude, subjective norm, and perceived behavioral control on sugar intake intentions. We also found significant effects of habit and self-control on sugar intake measured at follow-up, but no effect for intention. Perceived behavioral control moderated the intention-behavior relationship such that intention effects on behavior were larger when perceived behavioral control was high. However, self-control did not moderate the intention-behavior relationship.

CONCLUSION

Results indicate that sugar intake in this sample was a function of habits and self-control, and the effect of sugar intake intentions was conditional on perceived behavioral control. Results contribute to an evidence base of determinants and associated processes that relate to sugar intake in adolescents and may signal potentially modifiable targets for intervention.

Challenges encountered by parents from urban, lower social economic class in changing lifestyle behaviors of their children who are overweight or obese

BACKGROUND

Parents from urban, lower social economic classes often encounter unique challenges in their lives, which shape how they work with their children who are overweight or obese to change their exercise and eating behaviors at home. The present study took an initial step to address a gap in the literature by describing the challenges that parents from lower social economic classes in an urban city encountered in changing exercise and eating behaviors of their children who are overweight or obese.

METHODS

A conversational style semi-structured interview with prompts and probes was conducted to 44 parents whose child is overweight or obese. Inductive content analysis and constant comparison was used to analyze the data. Data trustworthiness was established by using a variety of strategies.

RESULTS

Two major themes with eight sub-themes emerged from the data: Challenges to promote a healthy active lifestyle, and challenges from their child's development and lifestyle behavior. Eight sub-themes were: (1) Need for effective strategies for a lifestyle behavior change, (2) monitor and promote healthy choices, (3) money, time, and dangerous neighborhood, (4) scientific knowledge to promote a healthy active lifestyle, (5) developmental changes of adolescence, (6) unmotivated and lack of persistence, (7) sneaking eating, and (8) peer pressure.

CONCLUSION

The challenges, from economic to parenting, are certainly of importance, and understanding these challenges will be crucial to help school-based professionals develop interventions. Those identified challenges should be clearly placed within family-school collaboration practices.

Measuring Children's Stress via Saliva in Surgical and Endoscopic Procedures and Its Measurement Intention in the Community: Reality-Future Prospects

(1) Background: Children who undergo surgical or endoscopic procedures display high levels of stress, and various means are applied to reduce their anxiety. Salivary cortisol (S Cortisol) and salivary alpha-amylase (SAA) are often used as a valid biomarker of stress. The primary purpose of the study was the investigation of stress levels through S Cortisol and S amylase after intervention in surgical or endoscopic procedures (gastroscopy-colonoscopy). The secondary outcomes were the investigation of the intention to adopt new methods of saliva sampling. We collected saliva samples from children subjected to invasive medical procedures, with the aim of applying the Theory of Planned Behavior (TPB) as an intervention means to provide information and education to both parents and children undergoing stressful situations, and assess its efficacy in reducing stress levels. We also aimed at acquiring a better understanding of the acceptability of noninvasive biomarker collection in community settings. (2) Methods: The sample of this prospective study comprised 81 children who underwent surgical or endoscopic procedures at the Attikon General University Hospital, Athens, Greece and 90 parents. The sample was divided into two groups. The first, 'Group Unexplained', was not provided any information or education about the procedures, while the second, 'Group Explained', was informed and educated based on TPB. Thereafter, 8-10 weeks after intervention, the Theory of Planned Behavior questions were re-completed by the 'Group Explained'. (3) Results: Significant differences were detected in cortisol and amylase values between the two groups postoperatively after applying the TPB intervention. Saliva cortisol was reduced by 8.09 ng/mL in the 'Group Explained' while in the 'Group Unexplained' it was reduced by 4.45 ng/mL (p < 0.001). Salivary amylase values decreased by 9.69 ng/mL in the 'Group Explained' after the intervention phase of the study, while in the 'Group Unexplained' they increased by 35.04 ng/mL (p < 0.001). The regression explains 40.3% (baseline) and 28.5% (follow-up) of parental intention. The predictive factor of parental intention (baseline) is attitude (p < 0.001) and follow-up is behavioral control (p < 0.028) and attitude (p < 0.001). (4) Conclusions: Providing proper education and information for parents has a positive effect on reducing children's stress levels. Changing parental attitudes towards saliva collection plays the most important role, since a positive attitude can influence intention and ultimately participation in these procedures.

Integrating the Theory of Planned Behavior and Bonding Social Capital to Examine Chinese Women's Tampon Use Intentions

This study integrates the theory of planned behavior with a structural approach to examining social capital to investigate how bonding social capital affected Chinese women's tampon use intentions. Bonding social capital was operationalized as network closure, which included two main dimensions: density and hierarchy. Results from an online survey (N = 766) showed that network density was positively associated with attitudes toward, social norms about, and perceived behavior control around tampon usage, while network hierarchy negatively predicted attitudes only. Moreover, the indirect effects of network density on tampon use intentions were mediated by descriptive norms and perceived behavior control. Examining women's intentions to adopt a rarely used product in China, this study extended the theory of planned behavior into the realm of social capital in an understudied context. The findings provide practical implications for health communication practitioners in public education concerning feminine hygiene products and gynecological health.

Understanding self-protective behaviors during COVID-19 Pandemic: Integrating the theory of planned behavior and O-S-O-R model

Adopting health preventive actions is one of the most effective ways to combat the COVID-19 pandemic. Based on the theory of planned behavior and the orientation-stimulus-orientation-response model, this study investigated the mechanisms by which health information exposure influenced individuals to adopt self-protective behaviors in the context of infectious disease. In this research, a convenience sampling was used and 2265 valid samples (Male = 843, 68.9% of participants aged range from 18 to 24) were collected in China. Structural equation modeling analysis was performed, and the analysis showed that health consciousness positively influenced the subsequent variables through interpersonal discussions and social media exposure to COVID-19-related information. The interaction between interpersonal discussion and social media exposure was found to be positively associated with the elements of the theory of planned behavior and risk perception. The findings also revealed that self-protective behavior was positively predicted by the components of the theory of planned behavior and risk perceptions, with subjective norms serving as the main predictor, followed by attitudes and self-efficacy.

Chinese International Students' Face Concerns, Self-Stigma, Linguistic Factors, and Help-Seeking Intentions for Mental Health

Chinese international students (CIS) in American universities encounter serious mental health issues, and they also underutilize campus mental health care services. The current study examined several factors which result in this phenomenon, such as Chinese face concerns, self-stigma of seeking help for mental health services, as well as English proficiency and language discrimination. A survey with 433 CIS in multiple U.S. universities was conducted to analyze the relationships between these factors above, help-seeking intentions, and mental health problems (depression and anxiety). The SEM results suggested that face concerns increased the risk of mental health problems such as depression and anxiety and also increased self-stigma toward seeking mental health services. However, face concerns positively influenced help-seeking intentions. The self-stigma had a negative effect on help-seeking intentions. Perceived English discrimination increased mental health problems while English proficiency increased help-seeking intentions. Meanwhile, both linguistic factors above were significantly associated with face concerns. The theoretical and practical implications are discussed to investigate how to address mental health problems among Chinese international students.

Parents Matter: A Descriptive Study of Parental Discussions With Teens About Violence Prevention and Related Topics

In the current article we examined the extent to which parents and caregivers engage in violence prevention and related discussions with their youth and the correlates (i.e., demographics, confidence, modeling of emotion regulation) of these experiences. We also examined the ways in which parents access prevention-related information to aid in these discussions with their youth. Participants were 142 parents/caregivers of a middle or high school-aged youth. Results suggested that adults reported speaking with youth about less sensitive prevention topics (e.g., bullying) more often than more sensitive topics (e.g., sexual violence). Whereas there were no demographic correlates for the level of confidence in discussing prevention topics with youth, emotion regulation modeling was positively correlated with confidence discussing prevention with youth. Also, parents who identified as White were less likely to discuss more sensitive topics with youth while parents who identified as American Indian were more likely to discuss more sensitive topics with youth and model emotion regulation. Having more confidence discussing prevention with youth positively correlated to discussing more sensitive and less sensitive topics with youth. These results underscore the need for engaging parents in prevention programming. More specifically, these data suggest that programs that builds parents' confidence and comfort in having prevention-related conversations with their youth, especially about more sensitive topics is needed in addition to programming that enhances parents' ability to model emotion regulation skills for their children.

Promoting Healthier Eating via Parental Communication: Development and Validation of the Active and Restrictive Parental Guidance Questionnaire (PARQ)

Parents are important sources of influence in the development of healthy eating among children and adolescents. Besides gatekeeping and modeling, parents serve as health educators and promoters, using intentional and persuasive communication to encourage healthier eating preferences and behaviors in children. Despite this, a lack of reliable and valid measures has limited the research on how parent-driven interpersonal communication about foods influence child food consumption outcomes. Building on the research in parental mediation of media consumption, and parenting practices in public health nutrition, this study details the development and validation of the active and restrictive parental guidance questionnaire with a sample of 246 children and adolescents at the scale development phase and another sample of 1,113 children and adolescents at the scale validation phase. Findings show that parents employ four communicative strategies to encourage a healthier diet: active guidance, general discussion, preventive restrictive guidance, and promotive restrictive guidance. The new measure was shown to have good validity and measurement model fit. Implications for future research are discussed.

Examining the Moderating Effect of Parenting Style and Parental Guidance on Children's Beliefs about Food: A Test of the Parenting Style-as-Context Model

Research examining the effect of parenting practices on child food consumption has often neglected the role in which global aspects of parenting - such as parenting style - play in shaping children's dietary behaviors. To address this gap, the parenting style-as-context model was used to examine the moderating effects of parenting style - defined as the perceived emotional climate communicated to children by their parents - on the association between parental guidance of food consumption and children's beliefs surrounding food. A cross-sectional survey of 1,113 child/adolescent participants between the ages of 9 and 18 was conducted to test the theoretical propositions derived from the parenting style-as-context model. Results suggest desirable relationships between different dimensions of parental guidance of food consumption on children's beliefs surrounding foods were stronger among children who were under an authoritative parenting style compared to other parenting styles. The results offer some support for the parenting style-as-context model and has theoretical and practical implications for research targeted at understanding the role parents play in inculcating healthy dietary habits among children.

Applying the socio-ecological model to understand factors associated with sugar-sweetened beverage behaviours among rural Appalachian adolescents

OBJECTIVE

The objective of the current study was to identify factors across the socio-ecological model (SEM) associated with adolescents' sugar-sweetened beverage (SSB) intake.

DESIGN

This cross-sectional study surveyed adolescents using previously validated instruments. Analyses included descriptive statistics, ANOVA tests and stepwise nonlinear regression models (i.e., two-part models) adjusted to be cluster robust. Guided by SEM, a four-step model was used to identify factors associated with adolescent SSB intake - step 1: demographics (i.e., age, gender), step 2: intrapersonal (i.e., theory of planned behaviour (attitudes, subjective norms, perceived behavioural control, behavioural intentions), health literacy, media literacy, public health literacy), step 3: interpersonal (i.e., caregiver's SSB behaviours, caregiver's SSB rules) and step 4: environmental (i.e., home SSB availability) level variables.

SETTING

Eight middle schools across four rural southwest Virginia counties in Appalachia.

PARTICIPANTS

Seven hundred ninety seventh grade students (55·4 % female, 44·6 % males, mean age 12 (sd 0·5) years).

RESULTS

Mean SSB intake was 36·3 (sd 42·5) fluid ounces or 433·4 (sd 493·6) calories per day. In the final step of the regression model, seven variables significantly explained adolescent's SSB consumption: behavioural intention (P < 0·05), affective attitude (P < 0·05), perceived behavioural control (P < 0·05), health literacy (P < 0·001), caregiver behaviours (P < 0·05), caregiver rules (P < 0·05) and home availability (P < 0·001).

CONCLUSIONS

SSB intake among adolescents in rural Appalachia was nearly three times above national mean. Home environment was the strongest predictor of adolescent SSB intake, followed by caregiver rules, caregiver behaviours and health literacy. Future interventions targeting these factors may provide the greatest opportunity to improve adolescent SSB intake.