Understanding overweight adolescents' beliefs using the theory of planned behaviour

Beliefs and Perceptions of Physical Activity Among Black Adolescents in South Florida: A Qualitative Study

INTRODUCTION

In the United States, non-Hispanic Black adolescents have a significantly higher prevalence of obesity than their peers. Though physical activity (PA) has many benefits, many adolescents fail to engage in adequate amounts of PA. Black adolescents are also more sedentary than those from other races and ethnicities. This study aimed to describe the perceptions, beliefs, and barriers to PA in South Florida Black adolescents.

METHODS

Five focus groups were conducted with self-identified non-Hispanic Black adolescents (n = 38) in South Florida. A semi-structured question guide based on the Theory of Planned Behavior was used for group discussions. The open-ended questions addressed adolescents' (1) attitudes and beliefs toward PA, (2) current PA-related behaviors, and (3) environmental, social, cultural, and racial influences on health behaviors.

RESULTS

The desire to be healthy, thoughts of the future, and self-image were among the reasons participants engaged in PA. Engagement in PA was associated with a positive social environment, including encouragement from family and friends. Race, culture, and social media were also cited as influences on PA. Perceived control beliefs, such as parental pressures and self-discipline, also impacted PA.

CONCLUSION

Adolescents recognize the importance of PA; however, their behaviors do not reflect this. Barriers and motivators for Black adolescents are multifaceted. It is critical for Public Health practitioners and local legislators to understand the complexities to serve this population. This study's findings can guide the development of tailored PA and education programs for Black adolescent populations.

The Impact of a Family-Based Assessment and Intervention Healthy Lifestyle Programme on Health Knowledge and Beliefs of Children with Obesity and Their Families

Objective: To determine the impact of a family-based assessment-and-intervention healthy lifestyle programme on health knowledge and beliefs of children and families affected by obesity. Second, to compare the health knowledge of the programme cohort to those of a national cohort in Aotearoa/New Zealand (NZ). Design: This mixed-methods study collected health knowledge and health belief data in a questionnaire at baseline and 12-, 24-, and 60-month follow-up assessments. Health knowledge over time was compared with baseline knowledge and with data from a nationally representative survey. A data-driven subsumption approach was used to analyse open-text responses to health belief questions across the study period. Setting: Taranaki region, a mixed urban−rural setting in NZ. Participants: Participants (caregiver/child dyads) from the Whānau Pakari randomised trial. Results: A greater proportion of the cohort correctly categorised foods and drinks as healthy or unhealthy at 12 months compared to baseline for most questionnaire items. Retention of this health knowledge was evident at 24- and 60-month follow-ups. More than twice as many participants correctly reported physical activity recommendations at follow-up compared to baseline (p < 0.001). Health knowledge of participants was similar to the national survey cohort at baseline, but surpassed it at 12 and 24 months. Participant beliefs around healthy lifestyles related to physical functioning, mental and emotional wellbeing, and enhancement of appearance, and gained greater depth and detail over time. Conclusions: This study demonstrates the important role that community-level healthy lifestyle programmes can have in knowledge-sharing and health promotion.

Intention to shift from short-acting to long-acting methods of contraceptives and its associated factors in Gondar city, northwest Ethiopia: Using the theory of planned behavior

Background

Despite its effectiveness, the intention, and utilization of long-acting contraceptive methods are very low in many developing countries, and the use of long-acting contraceptive methods has not kept pace with that of short-acting methods such as oral contraceptives and injectables. Therefore, this study aimed to assess the intention of using long-acting contraceptive methods and associated factors among women currently using short-acting contraceptive methods.

Methods

Institution-based cross-sectional study was conducted from March 19 to April 19, 2017. The study included 515 short-acting contraceptive users found in Gondar city who were selected from the study population using a systematic random sampling technique. A structured pre-tested questionnaire based on the theory of planned behavior was used to collect data. Both descriptive and analytical statistical procedures were used. Simple and multiple linear regression analyses were carried out. SPSS version 20 was used for the analysis of the data. Multiple linear regression was carried out to see the association between intention and sociodemographic variables, past contraception experience, attitude, subjective norm, and perceived behavioral control, and with 95% CI and a p-value of <0.05 was used to detect statistical significance.

Results

The magnitude of intention to use long-acting contraceptive methods was 39.8%. Intention to use long-acting contraceptive methods was higher for women whose husbands were farmers when compared to women whose husbands were government employees (β =0.49, 95% CI: 0.41, 0.72). Number of children wanted (β = −0.19, 95% CI: −0.28, −0.1), attitude (β = 0.34, CI: 0.23, 0.46), subjective norm (β = 19, 95% CI: 0.12, 0.27) and perceived behavioral control (β = 0.18, 95% CI: 0.06, 0.3) were factors significantly associated with intention to use long-acting contraceptive methods.

Conclusions

Intention to use long-acting contraceptive methods was low. Interventions that focus on women's attitudes toward long-acting contraceptive methods and support groups, peer education, social mobilization, and persuasive communication could promote the intention to use long-acting contraceptive methods.

Health professionals' views and experiences of discussing weight with children and their families: A systematic review of qualitative research

BACKGROUND

Healthcare professionals are ideally placed to discuss weight management with children and families to treat and prevent childhood obesity. The aim of this review was to collect and synthesize primary research evidence relating to health professional's views and experiences of discussing weight with children and their families.

METHODS

Systematic searches were conducted using the following databases: MEDLINE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE (OVID), PsycINFO (OVID) and Healthcare Management Information Consortium (HMIC). Twenty-six full text qualitative studies published in English Language journals since inception to October 2019 were included. Papers were quality assessed and synthesized using an inductive thematic analysis approach.

RESULTS

Data analysis generated five themes: sensitivity of the issue, family-professional relationships, whole systems approach, professional competency and sociocultural context.

CONCLUSION

Supporting behaviour change through discussion of healthy weight with children and families is an important part of the health professional's role. Tailored information for professionals, including resources and training, facilitates them to confidently talk to children and families about weight prioritized within interventions. The success of such interventions requires commitment from a range of professionals to ensure healthy weight is tackled through a whole system approach.

Adolescents from low-income families in Hong Kong and unhealthy eating behaviours: Implications for health and social care practitioners

The development of dietary preferences of adolescents involves a complex interplay of individual behaviours and environmental factors. Interpersonal factors-such as peer influences and unpleasant school experiences-and institutional factors-such as school rules and policies-are closely associated with unhealthy eating of adolescents. Family support and guidance are also crucial in influencing adolescents' eating habits. However, the low social status, low educational levels, and low household incomes of disadvantaged parents can markedly prevent their children from establishing healthy eating habits. Therefore, adolescents from low-income families are more likely to engage in unhealthy dietary behaviours and hence to be more susceptible to diet-related health problems. However, few studies have addressed the difficulties associated with inculcating healthy eating habits among adolescents from low-income families. Therefore, to investigate the barriers to adopting healthy eating habits, this study adopted a qualitative research approach and conducted five focus-group semistructured interviews with 30 junior- and senior-form students of a secondary school in Hong Kong, all of whom were from low-income families. The results revealed skipping meals because of poverty, following irregular meal patterns on school holidays, receiving poor guidance from family and peers, perceiving healthy eating as expensive and unappealing, and geographical inaccessibility to healthy food all prevented these students from healthy eating. These mutually reinforcing factors were interlocking with the economic strain that was experienced by the participants and their families. In particular, the stereotype of "healthful food is expensive" was strong. Therefore, we suggest students from low-income families should be enabled to understand that healthy eating is not necessarily expensive. The participants' stereotypes about healthy food was handed down by their parents. Such stereotypes, together with the low health literacy, influence the food preparation habits of the parents. Therefore, parents should be made to aware that healthful food can also be affordable.

Alabama Children's Body Mass Index, Nutritional Attitudes, and Food Consumption: An Exploratory Analysis

OBJECTIVES

This study had three aims: assess the extent to which middle school children in southern Alabama were classified as overweight or obese; determine the magnitude of the relation between children's attitudes toward healthy eating and their actual dietary choices; and examine the role of race, sex, and ZIP codes on children's eating attitudes and behaviors.

METHODS

Registered dietitians took height and weight measurements of middle school children in southern Alabama to establish body mass index (BMI). Children were given a Likert-type survey with multiple-choice items to assess the study's objectives. Descriptive statistics were generated, and structural equation modeling was used to examine potential moderating effects on the associations between a latent variable of healthy eating attitudes and a latent variable of healthy eating behaviors across race and ethnicity. A series of analyses of variance was used to determine any significant differences in the children's attitudes across schools. The χ² tests were used to examine potential race differences in BMI.

RESULTS

A total of 630 children participated in the study. Their average age was 12 years. More than half (53%) of the children were girls, and more than half (61%) were White. Approximately one-third (29%) identified as Black/African America. A large proportion of children across the sample (42.3%) were classified as overweight or obese. The multigroup structural equation modeling yielded a significant direct path between healthy attitudes and healthy eating behaviors. Healthy eating attitudes strongly predicted intentions toward healthy eating behaviors for children classified as normal weight and for those children classified as overweight or obese. Children's BMI classifications did not differ significantly across schools, race, or sex.

CONCLUSIONS

A large percentage of children in south Alabama were classified as overweight or obese, conditions that are preventable. Moreover, evidence suggests a lack of nutritious food in their diets. Children overall endorsed healthy eating attitudes, and those attitudes were strongly related to healthy food choices; however, their level of healthy food consumption was not related to their BMI classification. Although children in this study were from three schools and represented a variety of racial, sex, and socioeconomic systems, there were more similarities than differences in their healthy eating attitudes or behavior. These similarities highlight the need for research to examine other factors, such as southern culture, as a potential contributor to childhood obesity.

Growing as a Human Being--Obese Adolescents' Experiences of the Changing Body

The aim of the presented study was to describe how obese adolescents experience themselves and their bodies and how their views changed as a result of participation in a weight loss program. A total of five adolescents were interviewed in this qualitative study. Data were analyzed by means of content analysis. One main theme emerged, "Growing as a human being", which comprised four themes based on 13 sub-themes. Being part of a weight loss program was a time of transition that led not only to weight reduction but also to a higher level of well-being and a feeling of dignity.

Time perspective and the theory of planned behavior: moderate predictors of physical activity among central Appalachian adolescents

INTRODUCTION

The purpose of this study was to determine how well time perspective and the Theory of Planned Behavior (TPB) predicted physical activity among adolescents residing in the central Appalachian region of the United States.

METHOD

A descriptive, correlational design was used. The setting was a rural high school in central Appalachia. The sample included 185 students in grades 9 through 12. Data were collected in school. Variables included components of the TPB, time perspective, and various levels of exercise. Data were analyzed using Pearson's correlation coefficients and multiple regression analysis.

RESULTS

The TPB was a moderate predictor of exercise frequency among central Appalachian adolescents, accounting for 42% of the variance. Time perspective did not add to the predictive ability of the TPB to predict exercise frequency in this sample.

DISCUSSION

This study provides support for the TPB for predicting frequency of exercise among central Appalachian adolescents. By understanding the role of the TPB in predicting physical activity among adolescents, nurse practitioners will be able to adapt intervention strategies to improve the physical activity behaviors of this population.

Influence of friends on children's physical activity: a review

We examined evidence for friendship influences on children's physical activity (PA) through systematic searches of online databases in May 2012. We identified 106 studies (25 qualitative) published in English since 2000 that analyzed indicators of friendship influences (e.g., communication about PA, friends' PA, and PA with friends) among persons younger than 19 years. Children's PA was positively associated with encouragement from friends (43 of 55 studies indicating a positive relationship), friends' own PA (30/35), and engagement with friends in PA (9/10). These findings are consistent with friends influencing PA, but most studies did not isolate influence from other factors that could explain similarity. Understanding friendship influences in childhood can facilitate the promotion of lifelong healthy habits. PA with friends should be considered in health promotion programs.