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Jurado-Gonzalez P, Xavier Medina F, Bach-Faig A. Barriers to home food preparation and healthy eating among university students in Catalonia. Appetite 2024; 194:107159. [PMID: 38103793 DOI: 10.1016/j.appet.2023.107159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
Despite college being a critical life stage for developing enduring healthy dietary behaviours, Spanish university students show poor adherence to a healthy diet. Since research has shown an association between home cooking and healthy eating, the aim of this study was to analyse the main barriers that influence home food preparation and healthy eating among students at three Catalan universities. Focus groups, the photovoice technique and a validated questionnaire were used. Six focus groups (10 female; 14 male; aged 18-22) were conducted. NVivo9, was used to analyse the transcripts using an inductive thematic analysis. In two focus groups, the photovoice technique was used to further explore their perceptions about a healthy diet and their barriers for home cooking and healthy eating. The validated questionnaire was sent out to obtain data on students' diet quality, food environment and cooking self-efficacy for the focus group's design. We found that lack of motivation was the main barrier to healthy eating and home cooking, which was further influenced by the lack of cooking self-efficacy. Young adults lacked the knowledge and skills to prepare quick, affordable, and nutritious meals. Hence, even lack of time was cited as a primary barrier, time constraints seemed to be related to personal priorities. Students did not feel motivated to eat healthy and adopt time-deepening behaviours that influence food-choices. Thus, further research is required to develop context-specific culinary interventions that enhance students' cooking self-efficacy and identify strategies for encouraging students to adopt healthier eating habits.
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Affiliation(s)
| | - F Xavier Medina
- FoodLab Research Group (2021SGR01357), Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018, Barcelona, Spain; Unesco Chair on Food, Culture and Development at Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018, Barcelona, Spain
| | - Anna Bach-Faig
- FoodLab Research Group (2021SGR01357), Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018, Barcelona, Spain.
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Ali SH, Cai J, Kamal F, Auer S, Yang K, Parikh RS, Parekh N, Islam NS, Merdjanoff AA, DiClemente RJ. A Multi-Stage Dyadic Qualitative Analysis to Disentangle How Dietary Behaviors of Asian American Young Adults are Influenced by Family. Behav Med 2024:1-13. [PMID: 38193280 DOI: 10.1080/08964289.2023.2298766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024]
Abstract
The dietary behaviors of Asian American (AA) young adults, who face a growing non-communicable disease burden, are impacted by complex socio-ecological forces. Family plays a crucial role in the lifestyle behaviors of AA young adults; however, little is known on the methods, contributors, and impact of familial dietary influence. This study aims to deconstruct the mechanisms of AA young adult familial dietary influence through a multi-perspective qualitative assessment. A five-phase method of dyadic analysis adapted from past research was employed to extract nuanced insights from dyadic interviews with AA young adults and family members, and ground findings in behavioral theory (the Social Cognitive Theory, SCT). 37 interviews were conducted: 18 young adults, comprising 10 different AA ethnic subgroups, and 19 family members (10 parents, 9 siblings). Participants described dietary influences that were both active (facilitating, shaping, and restricting) and passive (e.g., sharing foods or environment, mirroring food behaviors). Influences connected strongly with multiple SCT constructs (e.g., behavioral capacity, reinforcements for active influences, and expectations, observational learning for passive influences). Familial influence contributed to changes in the total amount, variety, and healthfulness of foods consumed. Intra-family dynamics were crucial; family members often leveraged each other's persuasiveness or food skills to collaboratively influence diet. AA family-based interventions should consider incorporating both passive and active forms of dietary influence within a family unit, involve multiple family members, and allow for individualization to the unique dynamics and dietary behaviors within each family unit.
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Affiliation(s)
- Shahmir H Ali
- New York University School of Global Public Health, New York, NY, USA
| | - Julia Cai
- New York University School of Global Public Health, New York, NY, USA
| | - Fatema Kamal
- New York University School of Global Public Health, New York, NY, USA
| | - Sian Auer
- New York University School of Global Public Health, New York, NY, USA
| | - Katherine Yang
- New York University School of Global Public Health, New York, NY, USA
| | - Roshan S Parikh
- New York University School of Global Public Health, New York, NY, USA
| | - Niyati Parekh
- New York University School of Global Public Health, New York, NY, USA
- New York University Grossman School of Medicine, New York, NY, USA
- New York University Rory College of Nursing, New York, NY, USA
| | - Nadia S Islam
- New York University Grossman School of Medicine, New York, NY, USA
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Livingstone KM, Olstad DL, McNaughton SA, Nejatinamini S, Dollman J, Crawford D, Timperio A. Do food-related capabilities, opportunities and motivations of adolescents mediate the association between socioeconomic position in adolescence and diet quality in early adulthood? Int J Behav Nutr Phys Act 2023; 20:70. [PMID: 37308957 DOI: 10.1186/s12966-023-01477-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Socio-economic position (SEP) in adolescence may influence diet quality over the life course. However, knowledge of whether individual and environmental determinants of diet quality mediate the longitudinal association between SEP and diet quality is limited. This study examined whether and to what extent food-related capabilities, opportunities and motivations of adolescents mediated the longitudinal association between SEP in adolescence and diet quality in early adulthood overall and by sex. METHODS Longitudinal data (annual surveys) from 774 adolescents (16.9 years at baseline; 76% female) from ProjectADAPT (T1 (baseline), T2, T3) were used. SEP in adolescence (T1) was operationalized as highest level of parental education and area-level disadvantage (based on postcode). The Capabilities, Opportunities and Motivations for Behaviour (COM-B) model was used as a framework to inform the analysis. Determinants in adolescence (T2) included food-related activities and skills (Capability), home availability of fruit and vegetables (Opportunity) and self-efficacy (Motivation). Diet quality in early adulthood (T3) was calculated using a modified version of the Australian Dietary Guidelines Index based on brief dietary questions on intake of foods from eight food groups. Structural equation modelling was used to estimate the mediating effects of adolescents' COM-B in associations between adolescent SEP and diet quality in early adulthood overall and by sex. Standardized beta coefficients (β) and robust 95% confidence intervals (CI) were generated, adjusted for confounders (T1 age, sex, diet quality, whether still at school, and living at home) and clustering by school. RESULTS There was evidence of an indirect effect of area-level disadvantage on diet quality via Opportunity (β: 0.021; 95% CI: 0.003 to 0.038), but limited evidence for parental education (β: 0.018; 95% CI: -0.003 to 0.039). Opportunity mediated 60.9% of the association between area-level disadvantage and diet quality. There was no evidence of an indirect effect via Capability or Motivation for either area-level disadvantage or parental education, or in males and females separately. CONCLUSIONS Using the COM-B model, the home availability of fruit and vegetables (Opportunity) of adolescents explained a large proportion of the association between area-level disadvantage in adolescence and diet quality in early adulthood. Interventions to address poor diet quality among adolescents with a lower SEP should prioritize environmental determinants of diet quality.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James Dollman
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, 5000, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
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Serasinghe N, Vepsäläinen H, Lehto R, Abdollahi AM, Erkkola M, Roos E, Ray C. Associations between socioeconomic status, home food availability, parental role-modeling, and children's fruit and vegetable consumption: a mediation analysis. BMC Public Health 2023; 23:1037. [PMID: 37259139 DOI: 10.1186/s12889-023-15879-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. METHODS Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. RESULTS The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51-4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10-1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35-1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 - -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06-1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40-1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. CONCLUSIONS Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
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Affiliation(s)
- Nithya Serasinghe
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Reetta Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, P.O. Box 63, Helsinki, FI-00014, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
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Zeinivanmoghadam L, Jalilian M, Mirzaei A. Predictors of Fruits and Vegetable Consumption in Adolescent Girls Based on Social Cognitive Theory. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.4.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Karimi N, Crawford D, Opie R, Maddison R, O'Connell S, Hamblin PS, Ng AH, Steele C, Rasmussen B, Ball K. EatSmart, a Web-Based and Mobile Healthy Eating Intervention for Disadvantaged People With Type 2 Diabetes: Protocol for a Pilot Mixed Methods Intervention Study. JMIR Res Protoc 2020; 9:e19488. [PMID: 33155571 PMCID: PMC7679211 DOI: 10.2196/19488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/10/2020] [Accepted: 09/16/2020] [Indexed: 12/30/2022] Open
Abstract
Background People of low socioeconomic position (SEP) are disproportionately affected by type 2 diabetes (T2D), partly due to unhealthy eating patterns that contribute to inadequate disease self-management and prognosis. Digital technologies have the potential to provide a suitable medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge or shopping or cooking skills, in this target group. Objective This study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded, fully automated web-based and mobile-delivered healthy eating behavior change program to help disadvantaged people living with T2D to eat healthily on a budget and improve diabetes self-management. Methods EatSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 18 to 75 years will be recruited. Participants will complete self-reported baseline assessments of their basic demographic and clinical data, dietary intake, dietary self-efficacy, and barriers to healthy eating. They will be provided with login access to the EatSmart web program, which includes six progressive skill-based modules covering healthy eating planning; smart food budgeting and shopping; time-saving meal strategies, healthy cooking methods, modifying recipes; and a final reinforcement and summary module. Over the 3-month intervention, participants will also receive 3 text messages weekly, encouraging them to review goals, continue to engage with different components of the EatSmart web program, and eat healthily. Participants will undertake follow-up assessments directly following the intervention 3 months post baseline and again after a 6-month postintervention follow-up period (9 months post baseline). Feasibility will be evaluated using the number of participants recruited and retained and objective indicators of engagement with the website. Program appeal and potential effects on primary and secondary outcomes will be assessed via the same surveys used at baseline, with additional questions asking about experience with and perceptions of the program. In-depth qualitative interviews will also be conducted 6 months post intervention to provide deeper insight into experiences with EatSmart and a more comprehensive description of the program’s appeal. Results The EatSmart website has been developed, and all participants have viewed the modules as of May 2020. Results are expected to be submitted for publication in December 2020. Conclusions This study will provide data to address the currently limited evidence regarding whether disadvantaged populations with T2D may benefit from digitally delivered behavior change programs that facilitate eating healthily on a budget. Trial Registration Australian New Zealand Clinical Trials Registry, ACTRN12619001111167; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001111167 International Registered Report Identifier (IRRID) DERR1-10.2196/19488
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Affiliation(s)
- Nazgol Karimi
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Rachelle Opie
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Stella O'Connell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Peter Shane Hamblin
- Diabetes & Endocrinology Centre, Sunshine Hospital, St Albans, Australia.,Department of Medicine-Western Precinct, University of Melbourne, St Albans, Australia
| | - Ashley Huixian Ng
- Department of Dietetics, Human Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - Cheryl Steele
- Diabetes Education Services, Sunshine Hospital, St Albans, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research, Western Health Partnership, Sunshine Hospital, St Albans, Australia.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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Mekonnen T, Havdal HH, Lien N, O'Halloran SA, Arah OA, Papadopoulou E, Gebremariam MK. Mediators of socioeconomic inequalities in dietary behaviours among youth: A systematic review. Obes Rev 2020; 21:e13016. [PMID: 32162413 DOI: 10.1111/obr.13016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 02/02/2023]
Abstract
Children and adolescents with a lower socioeconomic position have poorer dietary behaviours compared to their counterparts with a higher socioeconomic position. A better understanding of the mechanisms behind such socioeconomic inequalities is vital to identify targets for interventions aimed at tackling these inequalities. This systematic review aimed to summarize existing evidence regarding the mediators of socioeconomic differences in dietary behaviours among youth. A systematic literature search of MEDLINE, Embase, PsycINFO, and Web of Science databases yielded 20 eligible studies. The dietary behaviours included in the reviewed studies were the intake of fruit and vegetables, sugar-sweetened beverages, unhealthy snacks/fast food and breakfast. The consistent mediators of the effects of socioeconomic position on dietary behaviours among youth were: self-efficacy, food preferences and knowledge at the intrapersonal level; and availability and accessibility of food items at home, food rules and parental modelling at the interpersonal level. Few studies including mediators at the organisational, community or policy levels were found. Our review found several modifiable factors at the intrapersonal and interpersonal levels that could be targeted in interventions aimed at combating inequalities in dietary behaviours among youth. Rigorous studies exploring organisational, community and policy level mediators are warranted.
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Affiliation(s)
- Teferi Mekonnen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Hanne Hennig Havdal
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Siobhan Anne O'Halloran
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Onyebuchi A Arah
- Department of Epidemiology and Department of Statistics, University of California, Los Angeles (UCLA), California, USA
| | - Eleni Papadopoulou
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Norway
| | - Mekdes Kebede Gebremariam
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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Gebremariam MK, Henjum S, Terragni L, Torheim LE. Correlates of screen time and mediators of differences by parental education among adolescents. BMC Pediatr 2020; 20:279. [PMID: 32503470 PMCID: PMC7273648 DOI: 10.1186/s12887-020-02181-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background Existing literature shows that there is an inverse association between socioeconomic position and screen time among adolescents. What is less known is the mechanism behind these differences. The study aimed to explore individual, interpersonal and neighborhood environmental correlates of total screen time (TST) among adolescents and to assess their mediating role in the association between parental education and TST. Methods A cross-sectional study including 706 adolescents (mean age of 13.6 (SD = 0.3)) was used to collect data at schools through an online questionnaire. Multiple regression analyses were used to explore factors associated with TST. Mediation analyses were conducted to assess whether these factors mediated the association between parental education and TST. Results Multiple linear regression analyses, adjusted for gender and age, showed that parental modelling of TV and movie streaming, TV/movie streaming during dinner and access to screens were positively related to TST. Self-efficacy towards limiting TV and movie streaming, self-efficacy towards limiting computer/electronic game use, and the perceived opportunities for physical activity in the neighborhood were inversely related to total screen time. All of these factors except self-efficacy towards limiting TV and movie streaming mediated the association between parental education and TST. Conclusions The study identified several modifiable factors at the individual, interpersonal and neighborhood environmental levels that can be targeted in interventions aimed at decreasing screen time among youth in general and among those with a low socioeconomic position in particular.
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Affiliation(s)
- Mekdes K Gebremariam
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O.Box 1046, Blindern, 0317, Oslo, Norway
| | - Sigrun Henjum
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, 0130, Oslo, Norway
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, 0130, Oslo, Norway
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, 0130, Oslo, Norway.
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Eng S, Donoghue C, Khun T, Szmodis W. Critical Consciousness of Food Systems as a Potential Lifestyle Intervention on Health Issues. Am J Lifestyle Med 2020; 14:258-263. [PMID: 32477023 PMCID: PMC7232891 DOI: 10.1177/1559827620907833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
When examining food systems in contemporary, industrialized, and globalized nations such as the United States, there is a quantity over quality cultural mind-set driven by capitalism. This creates an environment in which consumer desires for convenient lifestyles run high, mainly focused on the production of food and individual financial gain rather than the food systems as a whole. This approach neglects the overall outcomes in health, wellness, health disparities, and the sustainability footprint associated with consumption. Food is more than just food. It involves a network of different levels and elements that creates a multidimensional framework in which food systems, and the choices produced within those systems, can either positively or negatively affect consumers' lifestyles and health. This article discusses the importance of food systems and the ways in which they can be incorporated into a lifestyle intervention for general food consumers as well as those suffering from dietary-related diseases. With a critical understanding that structural barriers associated with current food systems are partly responsible for dietary-related diseases, individuals' self-blame and guilt can be alleviated and liberated, thus enhancing overall emotional and physical health. Drawing on social cognitive theory, food systems are conceptualized into triadic, dynamic interaction of environment (eg, food production, processing, packaging, transporting, marketing, disposing), cognition (eg, learned experience, and knowledge of food, nutrition, and wellness), and behavior (eg, food purchasing, preparation, and consumption).
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Affiliation(s)
- Sothy Eng
- Sothy Eng, PhD, University of Hawaii at Manoa, 2515 Campus Road, Honolulu, HI 96822; e-mail:
| | - Carli Donoghue
- University of Hawaii at Manoa, Honolulu, Hawaii (SE, CD, TK)
- Lehigh University, Bethlehem, Pennsylvania (WS)
| | - Tricia Khun
- University of Hawaii at Manoa, Honolulu, Hawaii (SE, CD, TK)
- Lehigh University, Bethlehem, Pennsylvania (WS)
| | - Whitney Szmodis
- University of Hawaii at Manoa, Honolulu, Hawaii (SE, CD, TK)
- Lehigh University, Bethlehem, Pennsylvania (WS)
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Factors associated with frequent consumption of fast food among Australian secondary school students. Public Health Nutr 2020; 23:1340-1349. [PMID: 32172726 DOI: 10.1017/s1368980019004208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine demographic and behavioural correlates of frequent consumption of fast food among Australian secondary school students and explore the associations between fast food consumption and social/environmental factors. DESIGN Cross-sectional survey using a web-based self-report questionnaire. SETTING Secondary schools across all Australian states and territories. PARTICIPANTS Students aged 12-17 years participating in the 2012-2013 National Secondary Students' Diet and Activity survey (n 8392). RESULTS Overall, 38 % of students surveyed reported consuming fast food at least weekly. Being male, residing in lower socio-economic areas and metropolitan locations, having more weekly spending money and working at a fast food outlet were all independently associated with consuming fast food once a week or more, as were several unhealthy eating (low vegetable intake and high sugary drink and snack food intake) and leisure (low physical activity and higher commercial television viewing) behaviours and short sleep duration. Frequent fast food consumption and measured weight status were unrelated. Students who agreed they go to fast food outlets with their family and friends were more likely to report consuming fast food at least weekly, as were those who usually 'upsize' their fast food meals and believe fast food is good value for money. CONCLUSIONS These results suggest that frequent fast food consumption clusters with other unhealthy behaviours. Policy and educational interventions that reach identified at-risk groups are needed to reduce adolescent fast food consumption at the population level. Policies placing restrictions on the portion sizes of fast food may also help adolescents limit their intake.
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The Effect of Nurse-Led Diet and Physical Activity Program for Health on Diet and Physical Activity Behavior of Children. J Phys Act Health 2019; 16:504-511. [PMID: 31154916 DOI: 10.1123/jpah.2018-0278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/17/2019] [Accepted: 03/02/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Many health problems encountered in childhood, adolescence, and adulthood periods arise from problematic eating behavior, an unhealthy dietary approach, and inactive lifestyles. The aim of this study was to determine the effect of the Diet and Physical Activity Program for Health, under the leadership of a nurse, on the dietary and physical activity behaviors of children. METHODS This study was planned in a quasi-experimental design with pretesting, posttesting, follow-up testing, and a control group. The study was conducted with 114 students in 2 schools. A total of 12 hours of training was given to the experimental group for 6 weeks. Institutional permission required for performing the study and an ethical consent from the commission for clinical trials of Marmara University institute of health sciences were received. RESULTS The results of the study reveal that Diet and Physical Activity Program for Health in posttest and follow-up periods was effective in improving dietary and physical activity behaviors of children within the program. However, the program's effect on dietary and physical activity self-efficacy was limited. CONCLUSION The results of the study indicate that this program was effective in development of children's behavior regarding diet and physical activity.
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12
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Understanding the effect of socio-economic characteristics and psychosocial factors on household water treatment practices in rural Nepal using Bayesian Belief Networks. Int J Hyg Environ Health 2019; 222:847-855. [PMID: 31047815 DOI: 10.1016/j.ijheh.2019.04.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/14/2019] [Accepted: 04/15/2019] [Indexed: 11/24/2022]
Abstract
About 20 Million (73%) people in Nepal still do not have access to safely managed drinking water service and 22 million (79%) do not treat their drinking water before consumption. Few studies have addressed the combination of socio-economic characteristics and psychosocial factors that explain such behaviour in a probabilistic manner. In this paper we present a novel approach to assess the usage of household water treatment (HWT), using data from 451 households in mid and far-western rural Nepal. We developed a Bayesian belief network model that integrates socio-economic characteristics and five psychosocial factors. The socio-economic characteristics of households included presence of young children, having been exposed to HWT promotion in the past, level of education, type of water source used, access to technology and wealth level. The five psychosocial factors capture households' perceptions of incidence and severity of water-borne infections, attitudes towards the impact of poor water quality on health, water treatment norms and the knowledge level for performing HWT. We found that the adoption of technology was influenced by the psychosocial factors norms, followed by the knowledge level for operating the technology. Education, wealth level, and being exposed to the promotion of HWT were the most influential socio-economic characteristics. Interestingly, households who were connected to a piped water scheme have a higher probability of HWT adoption compared to other types of water sources. The scenario analysis revealed that interventions that only target single socio-economic characteristics do not effectively boost the probability of HWT practice. However, interventions addressing several socio-economic characteristics increase the probability of HWT adoption among the target groups.
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Psychosocial Mediators between Socioeconomic Status and Dietary Restrictions among Patients Receiving Hemodialysis in Japan. Int J Nephrol 2019; 2019:7647356. [PMID: 31139469 PMCID: PMC6500646 DOI: 10.1155/2019/7647356] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/31/2019] [Indexed: 11/24/2022] Open
Abstract
The generalizability of differences in dietary restrictions (DRs) as function of socioeconomic status (SES) and the pathways of the associations between SES and DRs remain unclear. Therefore, we aimed to explore SES differences in DRs and psychosocial mediators between SES and DRs in Japanese patients receiving hemodialysis. This study was a cross-sectional survey of 6,644 outpatients (average age = 66.5 years; 65% males) of hemodialysis facilities across Japan. DRs were assessed by self-reported and objective measures, and SES was assessed based on education and income. Three psychosocial mediators were used: self-efficacy, control expectancy, and social support. Indirect influences of SES through the mediators were evaluated with a multiple mediator model. Although higher education was significantly associated with higher self-reported DRs, higher income was significantly associated with lower self-reported DRs. Significant SES differences in objective DRs were not observed. The relationships between education and self-reported DRs and objective DRs were significantly mediated by self-efficacy and/or control expectancy. The influences of income were mediated by social support. It becomes possible to design interventions targeting modifiable psychosocial factors including self-efficacy, control expectancy, and social support in order to reduce SES inequalities in DRs.
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Wadolowska L, Hamulka J, Kowalkowska J, Kostecka M, Wadolowska K, Biezanowska-Kopec R, Czarniecka-Skubina E, Kozirok W, Piotrowska A. Prudent-Active and Fast-Food-Sedentary Dietary-Lifestyle Patterns: The Association with Adiposity, Nutrition Knowledge and Sociodemographic Factors in Polish Teenagers-The ABC of Healthy Eating Project. Nutrients 2018; 10:E1988. [PMID: 30558296 PMCID: PMC6315952 DOI: 10.3390/nu10121988] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 12/16/2022] Open
Abstract
A holistic approach to understanding the relationship between diet, lifestyle and obesity is a better approach than studying single factors. This study presents the clustering of dietary and lifestyle behaviours to determine the association of these dietary-lifestyle patterns (DLPs) with adiposity, nutrition knowledge, gender and sociodemographic factors in teenagers. The research was designed as a cross-sectional study with convenience sampling. The sample consisted of 1549 Polish students aged 11⁻13 years. DLPs were identified with cluster analysis. Logistic regression modelling with adjustment for confounders was applied. Three dietary-lifestyle patterns were identified: Prudent-Active (29.3% of the sample), Fast-food-Sedentary (13.8%) and notPrudent-notFast-food-lowActive (56.9%). Adherence to Prudent-Active pattern (reference: notPrudent-notFast-food-lowActive) was 29% or 49% lower in 12-year-old or 13-year-old teenagers than in 11-year-old teenagers, respectively, and higher by 57% or 2.4 times in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score. To the contrary, adherence to Fast-food-Sedentary (reference: notPrudent-notFast-food-lowActive) was lower by 41% or 58% in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score, respectively. In Prudent-Active, the chance of central obesity (waist-to-height ratio ≥0.5) was lower by 47% and overweight/obesity was lower by 38% or 33% (depending on which standard was used: International Obesity Task Force, 2012: BMI (body mass index)-for-age ≥ 25 kg/m² or Polish standards, 2010: BMI-for-age ≥ 85th percentile) when compared with the notPrudent-notFast-food-lowActive pattern. In Fast-food-Sedentary, the chance of central obesity was 2.22 times higher than the Prudent-Active pattern. The study identified a set of characteristics that decreased the risk of general and central adiposity in teenagers, which includes health-promoting behaviours related to food, meal consumption and lifestyle. Avoiding high-energy dense foods is insufficient to prevent obesity, if physical activity and the consumption frequency of health-promoting foods are low and breakfast and a school meal are frequently skipped. The results highlight the importance of the nutrition knowledge of teenagers in shaping their health-promoting dietary habits and active lifestyle to decrease adiposity risk and negative aspects of lower family affluence which promotes unhealthy behaviours, both related to diet and lifestyle.
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Affiliation(s)
- Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland.
| | - Jadwiga Hamulka
- Department of Human Nutrition, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Joanna Kowalkowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland.
| | - Malgorzata Kostecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, 15 Akademicka Street, 20-950 Lublin, Poland.
| | - Katarzyna Wadolowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland.
| | - Renata Biezanowska-Kopec
- Department of Human Nutrition, Faculty of Food Technology, University of Agriculture in Krakow, 122 Balicka Street, 30-149 Krakow, Poland.
| | - Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Witold Kozirok
- Department of Commodity and Quality Management, Faculty of Entrepreneurship and Quality Science, Gdynia Maritime University, 81-87 Morska Street, 81-225 Gdynia, Poland.
| | - Anna Piotrowska
- Department of Functional Food, Ecological Food and Commodities, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
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Lagerkvist CJ, Okello JJ, Adekambi S, Kwikiriza N, Abidin PE, Carey EE. Goal-setting and volitional behavioural change: Results from a school meals intervention with vitamin-A biofortified sweetpotato in Nigeria. Appetite 2018; 129:113-124. [PMID: 30008392 PMCID: PMC6102414 DOI: 10.1016/j.appet.2018.06.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 04/27/2018] [Accepted: 06/29/2018] [Indexed: 11/11/2022]
Abstract
Malnutrition, particularly vitamin A deficiency, is a major public health problem in many developing countries. This study investigated whether priming or self-generation of goals, or whether attention to instrumental or experiential goals together with use of a reminder condition or not, promotes dietary behaviour intentions and change. A set of 556 randomly selected children aged 7-12 in Osun state, Nigeria, participated in an four-week intervention and field experiment in which a meal based on orange-fleshed sweetpotato, rich in pro-vitamin A, was introduced on five occasions as a complement to the existing school meal. Baseline intentions, anticipated feelings and repeated measures of post-consumption and experience were assessed. The analyses included a generalised linear mixed model for consumption and a linear mixed model for feelings and experience. The results confirmed that attention to instrumental goals undermines goal pursuit, while a focus on experiential goals increases the persistence of pursuit. Priming of experiential goals should be recommended, especially because this approach evokes positive feelings after eating. There was no evidence of an effect from repeated pairing of goals with the school meal, but use of planning by stating intentions increased the amount eaten. These results have implications for how school meals programmes should be designed to better align personal motivation with behavioural change in relation to dietary health.
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Affiliation(s)
- C J Lagerkvist
- Swedish University of Agricultural Sciences, Box 7013, 75007, Uppsala, Sweden.
| | - J J Okello
- International Potato Center, P.O. 29053, Kampala, Uganda
| | - S Adekambi
- International Potato Center, P.O. Box 3785, Fumesua, Kumasi, Ghana
| | - N Kwikiriza
- International Potato Center, P.O. 29053, Kampala, Uganda
| | - P E Abidin
- International Potato Center, P.O. Box 3785, Fumesua, Kumasi, Ghana
| | - E E Carey
- International Potato Center, P.O. Box 3785, Fumesua, Kumasi, Ghana
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The Effect of Education on Increase Breakfast Consumption Among Female Students Based on Social Cognitive Theory (SCT). HEALTH SCOPE 2018. [DOI: 10.5812/jhealthscope.61758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Torkan N, Kazemi A, Paknahad Z, Bahadoran P. Relationship of Social Cognitive Theory Concepts to Dietary Habits of Pregnant Women. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:125-130. [PMID: 29628960 PMCID: PMC5881229 DOI: 10.4103/ijnmr.ijnmr_157_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Nutrition during pregnancy is undoubtedly one of the most important factors affecting maternal health. In this regard, considering the cognitive-behavioral factors associated with feeding, behaviors will play an important role in the effectiveness of interventions. Therefore, this study aimed to investigate the correlation between food habits and structures of social cognitive theory in pregnant women. Materials and Methods In this cross-sectional study, 192 pregnant women were randomly selected. Data were collected using a questionnaire based on the social cognitive theory structures and food habits questionnaire in the questioning manner and was also analyzed using Pearson correlation and multiple linear regression with the software Statistical Package for the Social Sciences, version 19. Results There was a significant correlation between nutritional behavior with self-regulation (p = 0.001), self-efficacy (p = 0.001), outcome expectations (p = 0.001), social support (p = 0.002), and access (p = 0.001). A significant correlation was observed between lack of consumption of unnecessary and unhelpful food with self-regulation (p = 0.02). In the multivariable regression analysis, only self-regulation revealed significant and direct contribution in relation to nutritional behavior (p < 0.001). Conclusions Results of this study showed that self-regulation is one of the important factors associated with feeding behavior in pregnant women so that it is suggested to be considered in nutritional interventions in order to improve nutritional behavior.
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Affiliation(s)
- Nasrin Torkan
- Student Research Center, Faculty of Nursing And Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, School of Nursing And Midwifery, Isfahan University of Medical Siences, Isfahan, Iran
| | - Zamzam Paknahad
- Professor of Nutrition, Isfahan University of Medical Sciences, Faculty of Nutrition And Food Sciences, Isfahan, Iran
| | - Parvin Bahadoran
- Nursing And Midwifery Research Center, School of Nursing And Midwifery, Isfahan University of Medical Science, Isfahan, Iran
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Michels N, Vynckier L, Moreno LA, Beghin L, de la O A, Forsner M, Gonzalez-Gross M, Huybrechts I, Iguacel I, Kafatos A, Kersting M, Leclercq C, Manios Y, Marcos A, Molnar D, Sjöström M, Widhalm K, De Henauw S. Mediation of psychosocial determinants in the relation between socio-economic status and adolescents' diet quality. Eur J Nutr 2018; 57:951-963. [PMID: 28160091 DOI: 10.1007/s00394-017-1380-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 01/10/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine the underlying reasons for the positive relation between socio-economic status (SES) and the diet quality of adolescents. METHODS In 2081 adolescents (12.5-17.5 years) of the European HELENA study, a continuous variable on diet quality via 2-day 24-h recalls was available. SES was reflected by parental education, parental occupation and family affluence. Mediation by several psychosocial determinants was tested: self-efficacy, availability at school and home, social support, barriers, benefits, awareness and some self-reported influencers (parents, school, taste, health, friends, food readily available, easy preparation, hunger, price and habits). Multiple mediation analyses were adjusted for age, sex and country. RESULTS The availability of soft drinks and fruit at home, social support, parental influence, barriers, price influence, taste influence, health influence and food being readily available were significant mediators. The multiple mediation indirect effect accounted for 23-64% of the total effect. Both occupation and education and both maternal and paternal factors could be explained by the mediation. The unavailability of soft drinks was the strongest mediator (17-44% of the total effect). CONCLUSION Up to 64% of the positive relation between SES and the diet quality in adolescence could be explained by several healthy eating determinants. Focusing on these factors in low-SES populations can minimize social inequalities in diet and health by improving the diet of these specific adolescents.
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Affiliation(s)
- Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium.
| | - Lisa Vynckier
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, , Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain
| | - Laurent Beghin
- Centre d'Investigation Clinique CH&U Inserm, Bd Pr Leclercq, Hôpital Cardiologique, Lille Cedex, France
| | - Alex de la O
- Department of Physiology, Faculty of Medicine, Granada University, Granada, Spain
| | - Maria Forsner
- School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden
| | - Marcela Gonzalez-Gross
- Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Madrid, Spain
| | - Inge Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Isabel Iguacel
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
| | | | - Mathilde Kersting
- Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms-Universität Bonn, Dortmund, Germany
| | - Catherine Leclercq
- INRAN (National Research Institute on Food and Nutrition), Via Ardeatina, 546I00176, Roma, Italy
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Ascension Marcos
- Department of Metabolism and Nutrition, ICTAN Institute Frı´o Spanish National Research Council C/ Jose´ Antonio Novais, Madrid, 28000, Spain
| | - Denes Molnar
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Michael Sjöström
- Department of BioScience and Nutrition, Karolinska institutet, Stockholm, Sweden
| | - Kurt Widhalm
- Department of Pediatrics, Division of Clinical Nutrition, Medical University of Vienna, Vienna, Austria
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185-4K3, 9000, Ghent, Belgium
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Webb HJ, Zimmer-Gembeck MJ, Scuffham PA, Scott R, Barber B. Family stress predicts poorer dietary quality in children: Examining the role of the parent-child relationship. INFANT AND CHILD DEVELOPMENT 2018. [DOI: 10.1002/icd.2088] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Haley J. Webb
- School of Applied Psychology, Centre for Applied Health Economics, and Menzies Health Institute of Queensland; Griffith University; Gold Coast Queensland Australia
| | - Melanie J. Zimmer-Gembeck
- School of Applied Psychology, Centre for Applied Health Economics, and Menzies Health Institute of Queensland; Griffith University; Gold Coast Queensland Australia
| | - Paul A. Scuffham
- School of Applied Psychology, Centre for Applied Health Economics, and Menzies Health Institute of Queensland; Griffith University; Gold Coast Queensland Australia
| | - Rani Scott
- School of Applied Psychology, Centre for Applied Health Economics, and Menzies Health Institute of Queensland; Griffith University; Gold Coast Queensland Australia
| | - Bonnie Barber
- School of Applied Psychology, Centre for Applied Health Economics, and Menzies Health Institute of Queensland; Griffith University; Gold Coast Queensland Australia
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20
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Bagherniya M, Sharma M, Mostafavi Darani F, Maracy MR, Safarian M, Allipour Birgani R, Bitarafan V, Keshavarz SA. School-Based Nutrition Education Intervention Using Social Cognitive Theory for Overweight and Obese Iranian Adolescent Girls: A Cluster Randomized Controlled Trial. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 38:37-45. [PMID: 29298634 DOI: 10.1177/0272684x17749566] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Nowadays childhood obesity has become one the most challenging issue which is considered as a principle public health problem all around the world. This study was conducted with the aim of evaluating the impact of a 7-month school-based nutrition education intervention using social cognitive theory (SCT) to prevent obesity among overweight and obese adolescent girls. Method In this cluster randomized community trial after choosing schools, a total of 172 overweight and obese girl students participated in the study (87 in the intervention and 85 in the control group). A 7-month intervention based on SCT for students, their parents, and teachers was conducted. At baseline and end of the study, body mass index (BMI), waist circumstances (WCs), dietary intake, and psychological questionnaires regarding the SCT constructs were obtained. Results After 7 months, the mean of BMI and WCs reduced in the intervention group from 29.47 (4.05) to 28.5 (4.35) and from 89.65 (8.15) to 86.54 (9.76), respectively, but in comparison to the control group, they were not statistically significant ( p values .127 and .504, respectively). In the intervention group, nutritional behaviors and most of the psychological variables (self-efficacy, social support, intention, and situation) were improved in favor of the study and they were significant in comparison to the control group ( p < .05). Conclusion Although school-based nutrition education intervention using SCT did not change significantly BMI and WCs among the targeted population in this study, dietary habits as well as psychological factors improved significantly in the intervention group. This trial was registered in Iranian Registry of Clinical Trials, www.irct.ir (IRCT2013103115211N1).
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Affiliation(s)
- Mohammad Bagherniya
- 1 Student Research Committee, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Iran.,2 Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Iran
| | - Manoj Sharma
- 3 Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS, United States
| | - Firoozeh Mostafavi Darani
- 4 Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Iran
| | - Mohammad Reza Maracy
- 5 Department of Epidemiology & Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Safarian
- 6 Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Iran
| | - Ramesh Allipour Birgani
- 7 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Iran
| | - Vida Bitarafan
- 8 University of Adelaide Discipline of Medicine, Adelaide, Australia.,9 National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide, Australia
| | - Seyed Ali Keshavarz
- 2 Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Iran
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Food parenting and child snacking: a systematic review. Int J Behav Nutr Phys Act 2017; 14:146. [PMID: 29096640 PMCID: PMC5668962 DOI: 10.1186/s12966-017-0593-9] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/03/2017] [Indexed: 01/10/2023] Open
Abstract
Background While the role of parenting in children’s eating behaviors has been studied extensively, less attention has been given to its potential association with children’s snacking habits. To address this gap, we conducted a systematic review to describe associations between food parenting and child snacking, or consuming energy dense foods/foods in between meals. Methods Six electronic databases were searched using standardized language to identify quantitative studies describing associations of general and feeding-specific parenting styles as well as food parenting practices with snacking behaviors of children aged 2–18 years. Eligible peer-reviewed journal articles published between 1980 and 2017 were included. Data were extracted using a standard protocol by three coders; all items were double coded to ensure consistency. Results Forty-seven studies met inclusion criteria. Few studies focused on general feeding (n = 3) or parenting styles (n = 10). Most studies focused on controlling food parenting practices (n = 39) that were not specific to snacking. Parental restriction of food was positively associated with child snack intake in 13/23 studies, while pressure to eat and monitoring yielded inconsistent results. Home availability of unhealthy foods was positively associated with snack intake in 10/11 studies. Findings related to positive parent behaviors (e.g. role modeling) were limited and yielded mixed results (n = 9). Snacking was often assessed using food frequency items and defined post-hoc based on nutritional characteristics (e.g. energy-dense, sugary foods, unhealthy, etc.). Timing was rarely included in the definition of a snack (i.e. chips eaten between meals vs. with lunch). Conclusions Restrictive feeding and home access to unhealthy foods were most consistently associated with snacking among young children. Research is needed to identify positive parenting behaviors around child snacking that may be used as targets for health promotion. Detailed definitions of snacking that address food type, context, and purpose are needed to advance findings within the field. We provide suggested standardized terminology for future research. Electronic supplementary material The online version of this article (10.1186/s12966-017-0593-9) contains supplementary material, which is available to authorized users.
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Chansukree P, Rungjindarat N. Social Cognitive Determinants of Healthy Eating Behaviors in Late Adolescents: A Gender Perspective. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:204-210.e1. [PMID: 28284358 DOI: 10.1016/j.jneb.2016.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 10/23/2016] [Accepted: 10/30/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the impact of social cognitive determinants on healthy eating behaviors among adolescents, with a specific focus on gender differences. DESIGN Cross-sectional analysis of survey data. SETTING Bangkok, Thailand. PARTICIPANTS A total of 1,200 undergraduates from public and private universities. MAIN OUTCOME MEASURES Dependent variable: healthy eating behaviors measured by the total score of 11 items adapted from the Australian Dietary Guideline Index. INDEPENDENT VARIABLES self-efficacy, intentions, outcome expectations, perceived benefits, perceived barriers, situations, social support from parents and guardians, and social support from peers (measured by 54 Likert-type items). ANALYSIS Multiple linear regressions (α and P < .01). RESULTS Self-efficacy, intentions, perceived barriers, and situations had statistically significant relationships with healthy eating behaviors (ß = .17, .16, -.15, and .19, respectively). The predictor variables explained 18.1% of variance. Healthy eating in male adolescents was best predicted by perceived barriers, whereas that in female adolescents was best predicted by situations. CONCLUSIONS AND IMPLICATIONS These results indicate that relevant agencies should deliver gender-specific approaches to promote healthy eating in adolescents. The findings demonstrate the need for further studies to explore a broader range of factors influencing adolescent eating behaviors.
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Affiliation(s)
- Pananda Chansukree
- Research Center, National Institute of Development Administration, Bangkok, Thailand.
| | - Nitinai Rungjindarat
- Research Center, National Institute of Development Administration, Bangkok, Thailand
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Larson N, Miller JM, Eisenberg ME, Watts AW, Story M, Neumark-Sztainer D. Multicontextual correlates of energy-dense, nutrient-poor snack food consumption by adolescents. Appetite 2017; 112:23-34. [PMID: 28082196 DOI: 10.1016/j.appet.2017.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/07/2016] [Accepted: 01/08/2017] [Indexed: 11/24/2022]
Abstract
Frequent consumption of energy-dense, nutrient-poor snack foods is an eating behavior of public health concern. This study was designed to inform strategies for reducing adolescent intake of energy-dense snack foods by identifying individual and environmental influences. Surveys were completed in 2009-2010 by 2540 adolescents (54% females, mean age = 14.5 ± 2.0, 80% nonwhite) in Minneapolis-St. Paul, Minnesota schools. Daily servings of energy-dense snack food was assessed using a food frequency questionnaire that asked about consumption of 21 common snack food items, such as potato chips, cookies, and candy. Data representing characteristics of adolescents' environments were collected from parents/caregivers, friends, school personnel, Geographic Information System sources, and a content analysis of favorite television shows. Linear regression was used to examine relationships between each individual or environmental characteristic and snack food consumption in separate models and also to examine relationships in a model including all of the characteristics simultaneously. The factors found to be significantly associated with higher energy-dense snack food intake represented individual attitudes/behaviors (e.g., snacking while watching television) and characteristics of home/family (e.g., home unhealthy food availability), peer (friends' energy-dense snack food consumption), and school (e.g., student snack consumption norms) environments. In total, 25.5% of the variance in adolescents' energy-dense snack food consumption was explained when factors from within each context were examined together. The results suggest that the design of interventions targeting improvement in the dietary quality of adolescents' snack food choices should address relevant individual factors (e.g., eating while watching television) along with characteristics of their home/family (e.g., limiting the availability of unhealthy foods), peer (e.g., guiding the efforts of a peer leader in making healthy choices), and school environments (e.g., establishing student norms for selecting nutrient-dense snack foods).
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Jonathan M Miller
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, United States.
| | - Allison W Watts
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Mary Story
- Global Health and Community and Family Medicine, Duke Global Health Institute, Duke University, 112 Trent Hall, 310 Trent Drive, Box 90519, Durham, NC 27708, United States.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
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Davison J, Share M, Hennessy M, Bunting B, Markovina J, Stewart-Knox B. Correlates of food choice in unemployed young people: The role of demographic factors, self-efficacy, food involvement, food poverty and physical activity. Food Qual Prefer 2015. [DOI: 10.1016/j.foodqual.2015.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hall E, Chai W, Albrecht JA. Relationships between nutrition-related knowledge, self-efficacy, and behavior for fifth grade students attending Title I and non-Title I schools. Appetite 2015; 96:245-253. [PMID: 26431680 DOI: 10.1016/j.appet.2015.09.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/22/2015] [Accepted: 09/26/2015] [Indexed: 10/23/2022]
Abstract
The Social Cognitive Theory (SCT) is a widely used theory for nutrition education programming. Better understanding the relationships between knowledge, self-efficacy, and behavior among children of various income levels can help to form and improve nutrition programs, particularly for socioeconomically disadvantaged youth. The purpose of this study was to determine the relationships between knowledge, self-efficacy, and behavior among fifth grade students attending Title I (≥40% of students receiving free or reduced school meals) and non-Title I schools (<40% of students receiving free or reduced school meals). A validated survey was completed by 55 fifth grade students from Title I and 122 from non-Title I schools. Differences in knowledge, self-efficacy, and behavior scores between groups were assessed using t test and adjusted for variations between participating schools. Regression analysis was used to determine the relationships between knowledge, self-efficacy, and behavior. In adjusted models, the Title I group had significantly lower scores on several knowledge items and summary knowledge (P = 0.04). The Title I group had significantly lower scores on several behavior variables including intakes of fruits (P = 0.02), vegetables (P = 0.0005), whole grains (P = 0.0003), and lean protein (P = 0.047), physical activity (P = 0.002) and summary behavior (P = 0.001). However the Title I group scored higher on self-efficacy for meal planning (P = 0.04) and choosing healthy snacks (P = 0.036). Both self-efficacy (β = 0.70, P < 0.0001) and knowledge (β = 0.35, P = 0.002) strongly predicted behavior; however, only self-efficacy remained significant in the Title I group (self-efficacy, β = 0.82, P = 0.0003; knowledge, β = 0.11, P = 0.59). Results demonstrate disparities in nutrition knowledge and behavior outcomes between students surveyed from Title I and non-Title I schools, suggesting more resources may be necessary for lower income populations. Findings suggest that future nutrition interventions should focus on facilitating the improvement of children's self-efficacy.
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Affiliation(s)
- Elisha Hall
- University of Nebraska-Lincoln, Department of Nutrition and Health Sciences, 110 Leverton Hall, Lincoln, NE 68583, USA.
| | - Weiwen Chai
- University of Nebraska-Lincoln, Department of Nutrition and Health Sciences, 104B Leverton Hall, Lincoln, NE 68583, USA.
| | - Julie A Albrecht
- University of Nebraska-Lincoln, Department of Nutrition and Health Sciences, 119E Leverton Hall, Lincoln, NE 68583, USA.
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Vasiljevic M, Ng YL, Griffin SJ, Sutton S, Marteau TM. Is the intention-behaviour gap greater amongst the more deprived? A meta-analysis of five studies on physical activity, diet, and medication adherence in smoking cessation. Br J Health Psychol 2015; 21:11-30. [PMID: 26264673 PMCID: PMC5014219 DOI: 10.1111/bjhp.12152] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/03/2015] [Indexed: 11/29/2022]
Abstract
Objectives Unhealthy behaviour is more common amongst the deprived, thereby contributing to health inequalities. The evidence that the gap between intention and behaviour is greater amongst the more deprived is limited and inconsistent. We tested this hypothesis using objective and self‐report measures of three behaviours, both individual‐ and area‐level indices of socio‐economic status, and pooling data from five studies. Design Secondary data analysis. Methods Multiple linear regressions and meta‐analyses of data on physical activity, diet, and medication adherence in smoking cessation from 2,511 participants. Results Across five studies, we found no evidence for an interaction between deprivation and intention in predicting objective or self‐report measures of behaviour. Using objectively measured behaviour and area‐level deprivation, meta‐analyses suggested that the gap between self‐efficacy and behaviour was greater amongst the more deprived (B = .17 [95% CI = 0.02, 0.31]). Conclusions We find no compelling evidence to support the hypothesis that the intention–behaviour gap is greater amongst the more deprived. Statement of contribution What is already known on this subject? Unhealthy behaviour is more common in those who are more deprived. This may reflect a larger gap between intentions and behaviour amongst the more deprived. The limited evidence to date testing this hypothesis is mixed.
What does this study add? In the most robust study to date, combining results from five trials, we found no evidence for this explanation. The gap between intentions and behaviour did not vary with deprivation for the following: diet, physical activity, or medication adherence in smoking cessation. We did, however, find a larger gap between perceived control over behaviour (self‐efficacy) and behaviour in those more deprived. These findings add to existing evidence to suggest that higher rates of unhealthier behaviour in more deprived groups may be reduced by the following:
Strengthening behavioural control mechanisms (such as executive function and non‐conscious processes) or Behaviour change interventions that bypass behavioural control mechanisms.
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Affiliation(s)
| | - Yin-Lam Ng
- Behaviour and Health Research Unit, University of Cambridge, UK
| | - Simon J Griffin
- Behaviour and Health Research Unit, University of Cambridge, UK.,Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Stephen Sutton
- Behaviour and Health Research Unit, University of Cambridge, UK.,Behavioural Science Group, University of Cambridge, UK
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Leme ACB, Philippi ST. The “Healthy Habits, Healthy Girls” randomized controlled trial for girls: study design, protocol, and baseline results. CAD SAUDE PUBLICA 2015; 31:1381-94. [DOI: 10.1590/0102-311x00136014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 03/16/2015] [Indexed: 11/22/2022] Open
Abstract
The purpose of this article is to describe the study design, protocol, and baseline results of the “Healthy Habits, Healthy Girls” program. The intervention is being evaluated through a randomized controlled trial in 10 public schools in the city of São Paulo, Brazil. Data on the following variables were collected and assessed at baseline and will be reevaluated at 7 and 12 months: body mass index, waist circumference, dietary intake, nutrition, physical activity, social cognitive mediators, physical activity level, sedentary behaviors, self-rated physical status, and overall self-esteem. According to the baseline results, 32.4% and 23.4% of girls were overweight in the intervention and control groups, respectively, and in both groups a higher percentage failed to meet daily recommendations for moderate and vigorous physical activity and maximum screen time (TV, computer, mobile devices). There were no significant differences between the groups for most of the variables, except age (p = 0.000) and waist circumference (p = 0.014). The study showed a gap in the Brazilian literature on protocols for randomized controlled trials to prevent obesity among youth. The current study may thus be an important initial contribution to the field.
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Stephens LD, McNaughton SA, Crawford D, Ball K. Nutrition promotion approaches preferred by Australian adolescents attending schools in disadvantaged neighbourhoods: a qualitative study. BMC Pediatr 2015; 15:61. [PMID: 25986466 PMCID: PMC4448298 DOI: 10.1186/s12887-015-0379-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 05/15/2015] [Indexed: 11/17/2022] Open
Abstract
Background Links between socioeconomic disadvantage and unhealthy eating behaviours among adolescents are well established. Little is known about strategies that might support healthy eating among this target group. This study aimed to identify potential strategies and preferred dissemination methods that could be employed in nutrition promotion initiatives focussed on improving eating behaviours among socioeconomically disadvantaged adolescents. Methods Semi-structured interviews were conducted in 2011 among 22 adolescents (12–15 years) recruited from secondary schools in disadvantaged neighbourhoods in Victoria, Australia. Results Strategies suggested by adolescents to support healthy eating included increasing awareness about healthy eating; greater cooking involvement; greater parental and peer support; frequent family meal participation; greater parental and peer role-modelling of healthy eating; increased availability of healthy foods and decreased availability of unhealthy foods in homes and schools. Adolescents preferred electronic media, adolescent-specific recipe books, and school-based methods for distributing nutrition promotion messages and strategies. Conclusions A number of suggested strategies and methods identified in the present investigation have been employed with success in previous nutrition promotion interventions targeting socioeconomically disadvantaged adolescents. The present study also contributes novel insights into potential strategies and methods that could be employed in initiatives aiming to improve eating behaviours in this vulnerable group, and particularly highlights the importance of incorporating strategies involving parents and modifying the home food environment.
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Affiliation(s)
- Lena D Stephens
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Sarah A McNaughton
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - David Crawford
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Kylie Ball
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
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Mirzaei A, Ghofranipour F, Ghazanfari Z. Social Cognitive Predictors of Breakfast Consumption in Primary School's Male Students. Glob J Health Sci 2015; 8:124-32. [PMID: 26234965 PMCID: PMC4804056 DOI: 10.5539/gjhs.v8n1p124] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/04/2015] [Indexed: 02/05/2023] Open
Abstract
PURPOSE This study aimed to test the usefulness of social cognitive theory (SCT) in explaining breakfast consumption in a sample of primary male students. METHODS Participants in this cross-sectional study were 358 male students (3rd, 4th and 5th grades) from eight public primary schools of Ilam city. Data were collected by a self-administered questionnaire based on components of SCT. Bivariate correlations and multiple logistic regression analysis using an Enter method were used to identify social cognitive correlates and determinants of breakfast consumption. RESULTS A total of 358 participants ranging in age from 8-12 years (M=10.06) were studied. The result of the study showed that the SCT significantly predicted breakfast consumption. SCT variables explained 41.4% of the variance in breakfast consumption behaviors, though, self-regulation was found to be the strongest predictor of breakfast consumption behaviors. There was the strongest correlation between behaviors and self-regulation, (r=0.561; P<0.001). CONCLUSION The findings support the usefulness of SCT in explaining breakfast consumption behaviors. These results suggest an essential role for self-regulation, self-efficacy and social support in the breakfast consumption behaviors of primary male students.
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Affiliation(s)
- Amin Mirzaei
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Socio-economic position as a moderator of 9–13-year-old children’s non-core food intake. Public Health Nutr 2015; 19:55-70. [DOI: 10.1017/s1368980015001081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveThere is limited understanding as to why children of low socio-economic position (SEP) consume poorer diets than children of high SEP. Evidence suggests that determinants of dietary intake may differ between SEP groups. The present study aimed to determine if SEP moderated associations of personal and environmental predictors with children’s non-core food and sweetened drink intakes and unhealthy dietary behaviours.DesignChildren completed online questionnaires and parents completed computer-assisted telephone interviews to assess intrapersonal and environmental dietary predictors. Dietary intake was measured using an FFQ. Parents reported demographic information for maternal education, occupation and employment, and household income.SettingTwenty-six primary schools in South Australia, Australia.SubjectsChildren aged 9–13 years and their parents (n 395).ResultsMultiple personal and home environment factors predicted non-core food and sweetened drink intakes, and these associations were moderated by SEP. Maternal education moderated associations of girls’ sweetened drink intake with self-efficacy, cooking skills and pressure to eat, and boys’ non-core food intake with monitoring, parent’s self-efficacy and home environment. Maternal occupation and employment moderated associations of sweetened drink intake with attitudes, self-efficacy, pressure to eat and food availability, and non-core food intake with parents’ self-efficacy and monitoring. Income moderated associations with pressure to eat and home environment.ConclusionsIdentifying differences in dietary predictors between socio-economic groups informs understanding of why socio-economic gradients in dietary intake may occur. Tailoring interventions and health promotion to the particular needs of socio-economically disadvantaged children may produce more successful outcomes and reduce socio-economic disparities in dietary intake.
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Socio-economic and lifestyle parameters associated with diet quality of children and adolescents using classification and regression tree analysis: the DIATROFI study. Public Health Nutr 2015; 19:339-47. [DOI: 10.1017/s136898001500110x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo explore factors affecting children’s and adolescents’ diet quality, in the framework of a food aid and promotion of healthy nutrition programme implemented in areas of low socio-economic status of Greece, during the current financial crisis.DesignFrom a total of 162 schools participating in the programme during 2012–2013, we gathered 15 897 questionnaires recording sociodemographic characteristics, lifestyle parameters and dietary habits of children and their families. As a measure of socio-economic status, the Family Affluence Scale (FAS) was used; whereas for the assessment of diet quality, the KIDMED score was computed. Associations between KIDMED and FAS, physical activity and socio-economic parameters were examined using regression and classification–regression tree analysis (CART).ResultsThe higher the FAS score, the greater the percentage of children and adolescents who reported to consume, on a daily basis, fruits and vegetables, dairy products and breakfast (P<0·001). Results from CART showed that children and adolescents in the medium or high FAS groups had higher KIDMED score, compared with those in the low FAS group. For those in the low FAS group, KIDMED score is expected to increase by 12·4 % when they spend more than 0·25 h/week in sports activities. The respective threshold for the medium and high FAS groups is 1·75 h/week, while education of the mother and father affected KIDMED score significantly as well.ConclusionsDiet quality is strongly influenced by socio-economic parameters in children and adolescents living in economically disadvantaged areas of Greece, so that lower family affluence is associated with worse diet quality.
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Young MD, Plotnikoff RC, Collins CE, Callister R, Morgan PJ. Impact of a male-only weight loss maintenance programme on social-cognitive determinants of physical activity and healthy eating: A randomized controlled trial. Br J Health Psychol 2015; 20:724-44. [PMID: 25777588 DOI: 10.1111/bjhp.12137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 02/18/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To examine the effect of a gender-tailored, Social Cognitive Theory (SCT)-based weight loss maintenance (WLM) intervention on men's physical activity and healthy eating cognitions and behaviours in the 12 months after completing a weight loss programme. DESIGN A two-phase, assessor-blinded, randomized controlled trial. METHODS Ninety-two overweight/obese men (mean [SD] age: 49.2 years [10.1], BMI: 30.7 [3.3] kg/m(2) ) who lost at least 4 kg after completing the 3-month SCT-based SHED-IT Weight Loss Program were randomly allocated to receive (1) the SCT-based SHED-IT WLM Program; or (2) no additional resources (self-help control group). The 6-month gender-tailored SHED-IT WLM Program was completely self-administered and operationalized SCT behaviour change principles to assist men to increase moderate-to-vigorous physical activity (MVPA) and decrease energy-dense, nutrient-poor (discretionary) food consumption after initial weight loss. After randomization (WLM baseline), men were reassessed at 6 months (WLM post-test) and 12 months (6-month WLM follow-up). SCT cognitions (e.g., self-efficacy, goal setting), MVPA, and discretionary food consumption were assessed with validated measures. RESULTS Following significant improvements in cognitions, MVPA and discretionary food consumption during the weight loss phase, intention-to-treat, linear mixed models revealed no significant group-by-time differences in cognitions or behaviours during the WLM phase. Initial improvements in MVPA and some cognitions (e.g., goal setting, planning, and social support) were largely maintained by both groups at the end of the study. Dietary effects were not as strongly maintained, with the intervention and control groups maintaining 57% and 75% of the Phase I improvements in discretionary food intake, respectively. CONCLUSIONS An additional SCT-based WLM programme did not elicit further improvements over a self-help control in the cognitions or behaviours for MVPA or discretionary food intake of men who had lost weight with a SCT-based weight loss programme. Statement of contribution What is already known on this subject?Weight regain after weight loss (WL) is common. As successful weight loss maintenance (WLM) requires sustained improvements in cognitions and behaviours, health psychology can contribute to intervention development. However, little research has examined the utility of psychological theory in the context of a WLM randomised controlled trial. What does this study add? A theory-based WL program improved men's physical activity and dietary behaviours and cognitions. Men who also received a theory-based WLM program did not show further improvements in physical activity or dietary cognitions and behaviours compared to those that did not.
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Affiliation(s)
- Myles D Young
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robin Callister
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
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Sugisawa H, Nomura T, Tomonaga M. Psychosocial mediators between socioeconomic status and dietary habits among Japanese older adults. J Nutr Health Aging 2015; 19:130-6. [PMID: 25651437 DOI: 10.1007/s12603-014-0521-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION OBJECTIVES The purpose of this study was to examine psychosocial mediators between socioeconomic status (SES) and eating habits in older Japanese adults. SUBJECTS AND METHODS A questionnaire was mailed to a representative sample of people who were 60 years and older (N=1,000) living in a suburban area within the Tokyo city metropolitan limits, in Japan. There were 552 effective participants in the study. DESIGN Dietary habits were evaluated by assessing the diversity of food that was consumed. SES was evaluated by educational attainment and household income. Four dimensions of psychosocial mediators were assessed: control expectancy, self-efficacy, social influence, and social support. Indirect effects of SES through the mediators were evaluated by using a multiple mediator model. RESULTS The relationship between education and dietary habits was mediated by three variables excluding social support. Especially, social influence had the strongest mediating effect. These three significant variables explained the majority of differences in dietary habits resulting from education. The effects of household income were also similarly mediated by the identical variables. CONCLUSIONS Control expectancy, self-efficacy, and social influence mediate the relationship between SES and dietary habits.
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Affiliation(s)
- H Sugisawa
- Hidehiro Sugisawa, Graduate School of Gerontology, J. F. Oberlin University, 3758 Tokiwa-machi, Machida-shi, Tokyo, Japan, TEL: +81 (0) 42-797-9847,FAX: +81 (0) 42-797-9847, E-mail:
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Caught in a ‘spiral’. Barriers to healthy eating and dietary health promotion needs from the perspective of unemployed young people and their service providers. Appetite 2015; 85:146-54. [DOI: 10.1016/j.appet.2014.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 10/16/2014] [Accepted: 11/08/2014] [Indexed: 11/21/2022]
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Springvloet L, Lechner L, Oenema A. Can individual cognitions, self-regulation and environmental variables explain educational differences in vegetable consumption?: a cross-sectional study among Dutch adults. Int J Behav Nutr Phys Act 2014; 11:149. [PMID: 25480542 PMCID: PMC4275939 DOI: 10.1186/s12966-014-0149-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 11/24/2014] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Educational differences in health-related behaviors, where low- and moderate-educated individuals have poorer outcomes than high-educated individuals, are persistent. The reasons for these differences remain poorly understood. This study explored whether individual cognitions, self-regulation and environmental-level factors may explain educational differences in vegetable consumption. METHODS A cross-sectional study was conducted among 1,342 Dutch adults, of whom 54.5% were low/moderate-educated. Individuals completed an online questionnaire, assessing education, vegetable consumption, demographics, individual cognitions (attitude towards consuming 200 grams of vegetables a day, self-efficacy, subjective norm, intention, perception of vegetables as being expensive), self-regulation (general self-regulation, vegetable-specific action- and coping planning) and environmental-level factors (perception of availability of vegetables in the supermarket and availability of vegetables at home). The joint-significance test was used to determine significant mediation effects. RESULTS Low/moderate-educated individuals consumed less vegetables (M = 151.2) than high-educated individuals (M = 168.1, β = -0.15, P < .001). Attitude and availability of vegetables at home were found to partially mediate the association between education and vegetable consumption (percentage mediated effect: 24.46%). DISCUSSION Since attitude and availability of vegetables at home partially explain the difference in vegetable consumption between low/moderate- and high-educated individuals, these variables may be good target points for interventions to promote vegetable consumption among low/moderate-educated individuals.
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Affiliation(s)
- Linda Springvloet
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Anke Oenema
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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What factors are associated with frequent unhealthy snack-food consumption among Australian secondary-school students? Public Health Nutr 2014; 18:2153-60. [PMID: 25439182 DOI: 10.1017/s1368980014002675] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine demographic and behavioural correlates of unhealthy snack-food consumption among Australian secondary-school students and the association between their perceptions of availability, convenience and intake with consumption. DESIGN Cross-sectional survey of students' eating, physical activity and sedentary behaviours using validated instruments administered via an online questionnaire. SETTING Australian secondary schools across all states/territories. SUBJECTS Secondary-school students aged 12-17 years participating in the 2009-10 National Secondary Students' Diet and Activity (NaSSDA) survey (n 12 188). RESULTS Approximately one in five students (21 %) reported consuming unhealthy snack foods ≥14 times/week ('frequent snackers'). After adjusting for all covariates, older students and those with a BMI of ≥25 kg/m² were less likely to be frequent snackers, while students who reported high fast-food and high sugar-sweetened beverage consumption and those who watched television for >2 h/d were more likely to snack frequently. Furthermore, after adjusting for all covariates and demographic factors, students who agreed that snack foods are usually available at home, convenient to buy and that they eat too many snack foods were more likely to be snacking frequently. Conversely, students who agreed that fruit is a convenient snack were less likely to be frequent snackers. CONCLUSIONS Frequent unhealthy snack-food consumption appears to cluster with other poor health behaviours. Perceptions of availability and convenience are factors most readily amenable to change, and findings suggest interventions should focus on decreasing the availability of unhealthy snack foods in the home and promoting healthier options such as fruit as convenient snacks.
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Muzaffar H, Castelli DM, Scherer J, Chapman-Novakofski K. The impact of web-based HOT (Healthy Outcomes for Teens) Project on risk for type 2 diabetes: a randomized controlled trial. Diabetes Technol Ther 2014; 16:846-52. [PMID: 25127372 DOI: 10.1089/dia.2014.0073] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The HOT (Healthy Outcome for Teens) Project is an innovative online educational intervention for middle school children for prevention of diabetes and obesity by balancing food intake with physical activity. The objective was to improve knowledge, outcome expectations, self-efficacy, and self-reported food intake and skills and to compare a passive online learning (POL) control group with an active online learning (AOL) treatment group by implementing a social cognitive theory (SCT)-grounded online intervention. SUBJECTS AND METHODS In total, 214 participants were recruited from three middle schools. Full data were secured for 181 students. Six valid, reliable questionnaires were administered online, pre/post, to both the AOL and POL groups to assess knowledge gain, self-reported intake, and meal planning skills, as well as change in SCT constructs. RESULTS Subjects in the AOL group improved significantly for all five categories of planning a meal questionnaire (P=0.001) and also for outcome expectations for exercise (P=0.001). At postintervention, no significant differences were found for composite scores of exercise self-efficacy, weight efficacy lifestyle, and rapid eating assessment plan questionnaires between AOL versus POL (by Mann-Whitney test). CONCLUSIONS We conclude that teens participating in the AOL version of the HOT Project intervention acquired skills for planning a meal and improved outcome expectations for exercise.
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Affiliation(s)
- Henna Muzaffar
- 1 Human and Community Development, University of Illinois at Urbana-Champaign , Urbana, Illinois
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Niven P, Scully M, Morley B, Crawford D, Baur LA, Wakefield M. Socio-economic disparities in Australian adolescents' eating behaviours. Public Health Nutr 2014; 17:2753-8. [PMID: 24152543 PMCID: PMC10282261 DOI: 10.1017/s1368980013002784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 09/02/2013] [Accepted: 09/04/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the association between socio-economic position (SEP) and poor eating behaviours in a large representative sample of Australian secondary-school students. DESIGN Cross-sectional survey of students' vegetable, fruit, sugar-sweetened beverage and fast-food consumption assessed using validated instruments and collected via a web-based self-report format. SETTING Secondary schools across all Australian states and territories. SUBJECTS Secondary-school students (n 12 188; response rate: 54 %) aged 12-17 years participating in the 2009-10 National Secondary Students' Diet and Activity (NaSSDA) survey. RESULTS Overall, 25 % of students reported consuming ≤1 serving of vegetables/d and 29 % reported eating ≤1 serving of fruit/d. Fourteen per cent of students reported drinking at least 1-2 cups of sugar-sweetened beverages/d while 9 % reported eating fast food ≥3 times/week. After adjusting for other demographic factors, students of lower-SEP areas were more likely to report low intake of vegetables (F(4, 231) = 3·61, P = 0·007) and high frequency of consumption of sugar-sweetened beverages (F(4, 231) = 8·41, P < 0·001) and fast food (F(4, 231) = 4·59, P = 0·001) compared with students of high-SEP neighbourhoods. A positive SEP association was found for fruit consumption among female students only (F(4, 231) = 4·20, P = 0·003). Those from lower-SEP areas were also more likely to engage in multiple poor eating behaviours (F(4, 231)=5·80, P < 0·001). CONCLUSIONS Results suggest that socio-economic disparities in Australian adolescents' eating behaviours do exist, with students residing in lower-SEP neighbourhoods faring less well than those from high-SEP neighbourhoods. Reducing social inequalities in eating behaviours among young people should be a key consideration of future preventive strategies.
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Affiliation(s)
- Philippa Niven
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - David Crawford
- Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Victoria, Australia
| | - Louise A Baur
- Discipline of Paediatrics & Child Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
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Kedem LE, Evans EM, Chapman-Novakofski K. Psychometric Evaluation of Dietary Self-Efficacy and Outcome Expectation Scales in Female College Freshmen. Behav Modif 2014; 38:852-77. [DOI: 10.1177/0145445514543467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Lifestyle interventions commonly measure psychosocial beliefs as precursors to positive behavior change, but often overlook questionnaire validation. This can affect measurement accuracy if the survey has been developed for a different population, as differing behavioral influences may affect instrument validity. The present study aimed to explore psychometric properties of self-efficacy and outcome expectation scales—originally developed for younger children—in a population of female college freshmen ( N = 268). Exploratory principal component analysis was used to investigate underlying data patterns and assess validity of previously published subscales. Composite scores for reliable subscales (Cronbach’s α ≥ .70) were calculated to help characterize self-efficacy and outcome expectation beliefs in this population. The outcome expectation factor structure clearly comprised of positive (α = .81-.90) and negative outcomes (α = .63-.67). The self-efficacy factor structure included themes of motivation and effort (α = .75-.94), but items pertaining to hunger and availability cross-loaded often. Based on cross-loading patterns and low Cronbach’s alpha values, respectively, self-efficacy items regarding barriers to healthy eating and negative outcome expectation items should be refined to improve reliability. Composite scores suggested that eating healthfully was associated with positive outcomes, but self-efficacy to do so was lower. Thus, dietary interventions for college students may be more successful by including skill-building activities to enhance self-efficacy and increase the likelihood of behavior change.
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40
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Longitudinal predictors of frequent vegetable and fruit consumption among socio-economically disadvantaged Australian adolescents. Appetite 2014; 78:165-71. [DOI: 10.1016/j.appet.2014.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 03/16/2014] [Accepted: 03/21/2014] [Indexed: 11/18/2022]
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Abstract
Children of low socio-economic position (SEP) consume poorer diets than those of high SEP; however, there is limited understanding of why socio-economic gradients in diet occur. Some evidence suggests that determinants of dietary intake may differ between SEP groups. The aim of the present study was to determine whether the associations between personal and environmental variables and children's fruit and vegetable intake, and healthy dietary behaviours are moderated by SEP. A total of 395 children aged 9 to 13 years and their parents were recruited in Adelaide, South Australia. Personal and environmental dietary predictors were measured using child-completed online questionnaires and telephone interviews with parents. Dietary intake was measured using an online FFQ. First, dietary predictors were identified using correlated component regression, and subsequently tested for moderation by four SEP indicators using partial least-squares structural equation modelling. Fruit and vegetable intake and healthy behaviours were predicted by self-efficacy, attitudes and a supportive home environment. For girls, only the associations of self-efficacy with healthy behaviours were moderated by occupation. For boys, income moderated the associations of fruit and vegetable intake with attitudes, and healthy behaviours with supportive home environments. Occupation and employment moderated the associations of boys' family environments and fruit intake, and attitudes with healthy behaviours. Reducing socio-economic disparities in children's healthy dietary intake may be more successfully achieved by tailoring health promotion policies and interventions according to variables that moderate the relationships between dietary intake and SEP.
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Zarnowiecki DM, Dollman J, Parletta N. Associations between predictors of children's dietary intake and socioeconomic position: a systematic review of the literature. Obes Rev 2014; 15:375-91. [PMID: 24433310 DOI: 10.1111/obr.12139] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 11/05/2013] [Accepted: 12/02/2013] [Indexed: 12/16/2022]
Abstract
Socioeconomically disadvantaged children are at higher risk of consuming poor diets, in particular less fruits and vegetables and more non-core foods and sweetened beverages. Currently the drivers of socioeconomically related differences in children's dietary intake are not well understood. This systematic review explored whether dietary predictors vary for children of different socioeconomic circumstances. Seven databases and reference lists of included material were searched for studies investigating predictors of 9-13-year-old children's diet in relation to socioeconomic position. Individual- and population-based cross-sectional, cohort and epidemiological studies published in English and conducted in developed countries were included. Twenty-eight studies were included in this review; most were conducted in Europe (n = 12) or North America (n = 10). The most frequently used indicators of socioeconomic position were parent education and occupation. Predictors of children's dietary intake varied among children of different socioeconomic circumstances. Socioeconomic position was consistently associated with children's nutrition knowledge, parent modelling, home food availability and accessibility. Indeterminate associations with socioeconomic position were observed for parent feeding practices and food environment near school. Differences in the determinants of eating between socioeconomic groups provide a better understanding of the drivers of socioeconomic disparities in dietary intake, and how to develop targeted intervention strategies.
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Affiliation(s)
- D M Zarnowiecki
- Exercise for Health and Human Performance Group, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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43
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Factors Affecting the Consumption of Fast Foods Among Women Based on the Social Cognitive Theory. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2014. [DOI: 10.20286/jech-010119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Zarnowiecki D, Ball K, Parletta N, Dollman J. Describing socioeconomic gradients in children's diets - does the socioeconomic indicator used matter? Int J Behav Nutr Phys Act 2014; 11:44. [PMID: 24674231 PMCID: PMC3986827 DOI: 10.1186/1479-5868-11-44] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 03/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children of low socioeconomic position (SEP) generally have poorer diets than children of high SEP. However there is no consensus on which SEP variable is most indicative of SEP differences in children's diets. This study investigated associations between diet and various SEP indicators among children aged 9-13 years. METHOD Families (n=625) were recruited from 27 Adelaide primary schools in 2010. Children completed semi-quantitative food frequency questionnaires providing intake scores for fruit, vegetables, non-core foods, sweetened drinks, and healthy and unhealthy eating behaviours. Parents reported demographic information by telephone interview. Differences in dietary intake scores were compared across parental education, income, occupation, employment status and home postcode. RESULTS Across most SEP indicators, lower SEP was associated with poorer dietary outcomes, including higher intake of non-core foods and sweetened drinks, and more unhealthy behaviours; and lower intake of fruit and vegetables, and fewer healthy behaviours. The number and type of significant SEP-diet associations differed across SEP indicators and dietary outcomes. Mother's education appeared most frequently as a predictor of children's dietary intake, and postcode was the least frequent predictor of children's dietary intake. CONCLUSION Socioeconomic gradients in children's dietary intake varied according to the SEP indicator used, suggesting indicator-specific pathways of influence on children's dietary intake. Researchers should consider multiple indicators when defining SEP in relation to children's eating.
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Affiliation(s)
- Dorota Zarnowiecki
- School of Population Health, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
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45
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The SHED-IT weight loss maintenance trial protocol: A randomised controlled trial of a weight loss maintenance program for overweight and obese men. Contemp Clin Trials 2013; 37:84-97. [PMID: 24246820 DOI: 10.1016/j.cct.2013.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/05/2013] [Accepted: 11/08/2013] [Indexed: 12/21/2022]
Abstract
UNLABELLED Despite short-term efficacy, many weight loss studies demonstrate poor long-term results and have difficulty recruiting men. Cost-effective treatments that help men achieve long-term weight loss are required. Using a two-phase, assessor-blinded, parallel-group randomised controlled trial design this study will test the effectiveness and cost-effectiveness of a male-only weight loss maintenance intervention. In Phase I (3 months) 209 men received the SHED-IT Weight Loss Program. In Phase II (12 months) 92 men who lost 4 kg or more were randomised to either (i) a maintenance group who received the 6-month, gender-tailored SHED-IT Weight Loss Maintenance Program, which included no face-to-face contact (n = 47), or (ii) a self-help control group (n = 45). Randomisation was stratified by weight loss (4 kg-7.4 kg, ≥7.5 kg) and BMI (<30 kg/m(2), ≥30 kg/m(2)). Assessments occurred at 'study entry' (start of Phase I), 'baseline' (start of Phase II), '6 months' (post-test) and will occur at '12 months' (follow-up; primary endpoint). The primary outcome is weight change in Phase II (i.e. from 'baseline' at 12 months after randomization). Secondary outcomes include waist circumference (umbilicus and narrowest), blood pressure, body composition, objectively measured physical activity, sedentary time, portion size, dietary intake, quality of life, depressive symptoms, and behavioural cognitions. Costing data will be collected for cost-effectiveness analysis. Generalised linear mixed models (intention-to-treat) will assess outcomes for treatment (maintenance vs. control), time (baseline, 6-month and 12-month) and the treatment-by-time interaction. This will be the first study to evaluate a male-only, gender-targeted weight loss maintenance program. Results will provide evidence regarding feasible and theoretically-driven obesity treatments for men with potential for long-term impact and widespread dissemination. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12612000749808).
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Nansel TR, Haynie DL, Lipsky LM, Wang J, Mehta SN, Laffel LMB. Relationships among parent and youth healthful eating attitudes and youth dietary intake in a cross-sectional study of youth with type 1 diabetes. Int J Behav Nutr Phys Act 2013; 10:125. [PMID: 24195642 PMCID: PMC3827889 DOI: 10.1186/1479-5868-10-125] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 09/18/2013] [Indexed: 01/01/2023] Open
Abstract
Background Constructs based on Social Cognitive Theory have shown utility in understanding dietary behavior; however, little research has examined these relations in youth and parents concurrently. Unique demands of dietary management among families of youth with type 1 diabetes (T1D) suggest the importance of investigation in this population. The purpose of this study was to develop and evaluate youth and parent measures of self-efficacy, outcome expectations, and barriers for healthful eating, and parent modeling of healthful eating, in a sample of youth with type 1 diabetes and their parents. Methods Youth (n=252) ages 8–18 years with diabetes duration ≥1 year and parents completed self-report measures of healthful eating attitudes including self-efficacy, perceived barriers, positive and negative outcome expectations; youth reported parent modeling of healthful eating. Youth dietary intake from 3-day diet records was used to calculate the Healthy Eating Index 2005 and the Nutrient Rich Foods 9.3 index, measures of overall diet quality. The relations among parent and youth healthful eating attitudes, parent modeling, and youth diet quality were examined using structural equation modeling. Results Internal consistency and test-retest reliability of the measures were acceptable. The structural equation model demonstrated acceptable fit (CFI/TLI=0.94/0.94; RMSEA=0.03), and items loaded the hypothesized factors. Parent modeling β^=.27,p=.02 and attitudes toward healthful eating (latent variable comprised of self-efficacy, barriers, outcome expectations) β^=.16,p=.04 had direct effects on youth diet quality. Parent modeling had a direct effect on youth attitudes β^=.49,p<.001; parent attitudes had an indirect effect on youth attitudes through parent modeling β^=.12,p,<.001. Youth attitudes were not associated with youth diet quality. Overall, the model accounted for 20% of the variance in child diet quality. Conclusions Parent diet-related behaviors demonstrated an impact on youth attitudes and diet quality, suggesting the importance of family-based clinical and public health efforts to improve diet.
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Affiliation(s)
- Tonja R Nansel
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Health Behavior Branch, Division of Intramural Population Health Research, NIH, DHHS, 6100 Executive Blvd,, Rm, 7B13, MSC 7510, Bethesda, MD 20892-7510, USA.
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Nutrition knowledge in relation to the eating behaviour and attitudes of Slovenian schoolchildren. ACTA ACUST UNITED AC 2013. [DOI: 10.1108/nfs-10-2012-0108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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48
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Franko DL, Cousineau TM, Rodgers RF, Roehrig JP, Hoffman JA. Social-cognitive correlates of fruit and vegetable consumption in minority and non-minority youth. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2013; 45:96-101. [PMID: 22929007 PMCID: PMC3731768 DOI: 10.1016/j.jneb.2011.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 11/04/2011] [Accepted: 11/07/2011] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Inadequate fruit and vegetable (FV) consumption signals a need for identifying predictors and correlates of intake, particularly in diverse adolescents. DESIGN Participants completed an on-line assessment in early 2010. SETTING Computer classrooms in 4 high schools. PARTICIPANTS One hundred twenty-two Caucasian and 125 minority (African American and Hispanic) high school students (mean age = 15.3 years, SD = 1.0) with parental consent. Response rate was 89%. VARIABLES MEASURED Self-efficacy as measured by confidence in goal setting and decision making about healthful eating; perceived benefits and barriers to eating FVs; healthful eating-related social support; body esteem; and FV intake. ANALYSIS t tests were used to examine group differences, and binary logistic regression analyses were conducted to explore the predictors of 5-A-Day FV consumption. RESULTS Thirty-four percent of the non-minority group and 28% of the minority group reported eating 5 or more portions of FVs a day (P = .34). Self-efficacy and perceived benefits predicted consumption in minority participants, whereas barriers and social support were significant predictors in the non-minority group. CONCLUSIONS AND IMPLICATIONS These findings suggest different variables predict consumption for minority and non-minority groups and that self-efficacy is an important variable to consider in dietary change programs for minority adolescents.
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Affiliation(s)
- Debra L Franko
- Department of Counseling and Applied Educational Psychology, Northeastern University, Boston, MA, USA.
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Fismen AS, Samdal O, Torsheim T. Family affluence and cultural capital as indicators of social inequalities in adolescent's eating behaviours: a population-based survey. BMC Public Health 2012. [PMID: 23190697 PMCID: PMC3533876 DOI: 10.1186/1471-2458-12-1036] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dietary inequality, via socio-economic inequality, may involve several mechanisms. Different aspects of adolescents' socio-economic circumstances should therefore be considered in order to make effective interventions to promote healthy eating in the young population. Indicators designed to tap socio-economic status among adolescents in particular will facilitate a better understanding of the concept of socio-economic status and how it influences health behaviour among young people. The purpose of this study was to evaluate if material capital and cultural capital individually and independently contribute to the prediction of eating habits in the Norwegian adolescent population. METHODS The analysis is based on survey data from the Health Behaviour in School-Aged Children study. The Family Affluence Scale (number of cars, holidays, PC and bedrooms) and number of books in the household were used as indicators of socio-economic status, respectively measuring material capital and cultural capital. Their influence on adolescent's consumption of fruit, vegetables, sweets, soft drinks, and consumption of breakfast and dinner was evaluated. Pearson's correlation, logistic regression and ridit transformation analysis were used to analyse the data. RESULTS Higher family affluence was shown to predict consumption of more fruit (OR 1.52) and vegetables (OR 1.39) and consumption of breakfast (OR 1.61) and dinner (1.35). Cultural capital was significantly associated to consumption of fruit (OR 1.85), vegetables (OR 2.38) sweets (OR .45), sugary soft drinks (OR .26), breakfast (OR 2.13) and dinner (OR 1.54). Cultural capital was the strongest predictor to healthy eating among adolescents in Norway. CONCLUSIONS Material capital and cultural capital individually and independently contributed to the prediction of healthy eating patterns among adolescents in Norway. Cultural capital is an understudied dimension of the socio-economic status concept and the influence on health behaviour needs to be explored in future studies. Initiatives to promote healthy eating should focus on education, habits and consciousness of a healthy diet, but also at reducing the high cost of fruit and vegetables. There is further a need for developing appropriate indicators for adolescent socio-economic status.
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Affiliation(s)
- Anne-Siri Fismen
- Department of health promotion and development, University of Bergen, Christiesgate 13, Bergen, 5015, Norway.
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50
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De Cocker K, Artero EG, De Henauw S, Dietrich S, Gottrand F, Béghin L, Hagströmer M, Sjöström M, Plada M, Manios Y, Mauro B, Molnár D, Moreno LA, Ottevaere C, Valtueña J, Maes L, De Bourdeaudhuij I. Can differences in physical activity by socio-economic status in European adolescents be explained by differences in psychosocial correlates? A mediation analysis within the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Public Health Nutr 2012; 15:2100-9. [PMID: 22717373 PMCID: PMC10271304 DOI: 10.1017/s1368980012001036] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 02/29/2012] [Accepted: 03/06/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Socio-economic status (SES) has been positively associated with physical activity (PA) levels in adolescents. In order to tackle these social inequalities, information is needed about the underlying mechanisms of this association. The present study aimed to investigate the potential mediating role of psychosocial correlates of PA on the relationship between SES and PA in European adolescents. DESIGN Cross-sectional study testing the mediating role of psychosocial correlates in the SES-PA association using the product-of-coefficients test of MacKinnon. SETTING Ten European cities in nine different countries, the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. SUBJECTS Adolescents (n 2780) aged 12·5-17·49 years self-reported on PA (moderate-to-vigorous intensity PA and total PA), SES indicators (education of the mother and Family Affluence Scale) and psychosocial correlates of PA (stage of change, attitudes, awareness, modelling, social support, self-efficacy, benefits, barriers and environmental correlates). RESULTS SES (Family Affluence Scale) was significantly associated with moderate-to-vigorous intensity PA. According to single-mediator models, this association was significantly mediated by stage of change (t = 3·6, P ≤ 0·001), awareness (t = 2·7, 0·001 < P ≤ 0·01), modelling (t = 4·8, P ≤ 0·001), self-efficacy (t = 2·5, 0·01 CONCLUSIONS Adolescents with low family wealth scored lower on stage of change, awareness, modelling, self-efficacy and environmental correlates of PA, and higher on PA barriers, which in turn resulted in lower levels of moderate-to-vigorous PA. Future interventions should target these individual and environmental constructs in order to tackle and intervene on social inequalities in PA among adolescents.
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Affiliation(s)
- Katrien De Cocker
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, Ghent, Belgium.
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