Investigation of factors related to healthy eating behavior based on the developed theory of planned behavior in adolescents

BACKGROUND

Adolescence is a complicated and sensitive period, and proper nutrition in this period of life can influence the quality and quantity of growth and maturity. The aim of the present study is to determine the factors associated with healthy eating behavior based on the developed theory of planned behavior in adolescents.

MATERIALS AND METHODS

This is a descriptive-correlational study in which 400 female students of the first grade of high school in Bandar Anzali participated. Among the junior high schools in this city, two schools were randomly selected and sampling was done using census method. Data collection tool was Healthy Eating Behavior questionnaire based on Theory of Planned Behavior, which includes three sections of demographic information, constructs of Theory of Planned Behavior, including attitude toward behavior, subjective norms, perceived behavioral control, and behavioral intention, and food behavior, and food habits questionnaire. The scale was evaluated and confirmed by content validity ratio, content validity index, and alpha coefficient. P value was considered significant at less than 5%. Data analysis was performed using SPSS software 24, through linear regression and Pearson's correlation.

RESULTS

As shown by linear regression analysis, the developed theory of planned behavior is able to predict 26% of the variance of healthy eating behavior, and this predictive power is related to the constructs of behavioral intention, attitude, and habits.

CONCLUSIONS

In the present study, adding the variable of habits to the theory of planned behavior showed that this variable is very effective in predicting healthy eating behavior in adolescents, just like the constructs of behavioral intention and attitude. Therefore, it is suggested to carry out educational interventions based on the developed theory of planned behavior with the focus of the mentioned structures.

Predicting the Adoption of a Sustainable Diet in Adults: A Cross-Sectional Study in Italy

Shifting food choices towards sustainability entails the analysis of dietary behavior determinants. This study aimed to explain and predict the intention to follow a sustainable diet and its adoption in a representative sample of adults (n = 838) in Italy. An online survey based on the theory of planned behavior (TPB) was developed. The adoption of a sustainable diet was measured as self-perceived behavior, adherence to the Mediterranean diet (MD), and food consumption frequencies. Psychometric analysis and correlations between attitude, subjective norms, and perceived behavioral control (PBC) with both intention and behavior assessments were evaluated. Structural equation models were used to test whether and to what extent attitude, subjective norms, and PBC explained intention and behavior. Significant associations were found between TPB constructs and the behavior measures underlining the main role of intention and PBC in affecting behavior. The applied TPB models explained behavioral intention at most (78%). The results suggested promising interventions in narrowing the attitude-behavior gap to encourage specific adult population groups in Italy to adopt virtuous food consumption habits. Beside the implementation of price mechanism strategies, educational initiatives to increase awareness about food and diet sustainability issues and the reinforcement of the perceived control on food consumption at the individual level are recommended.

Verifying the usefulness of the theory of planned behavior model for predicting illegal use of online content: the role of outcome expectancies and social loafing

Background

Currently, laypeople can earn profit by producing content; therefore, it should be noted that the unauthorized use of intellectual creations or possessions can cause legal issues and undermine the producers’ desire to create. This study verified the usefulness of the theory of planned behavior (TPB) model for predicting the illegal use of online content among South Korean college students and examined the roles played by outcome expectancies and social loafing in this model.

Methods

The participants, 369 male and female Korean college students, were aged between 18 and 31 years (M = 22.12, SD = 2.33). We measured the illegal use of online content and the factors of the TPB model, as well as outcome expectancies and social loafing with regard to participants’ illegal use of online content. Correlational analysis, stepwise regression analysis, path analysis for the TPB model, and analyses of the moderated model were performed using SPSS and AMOS.

Results

All TPB factors, outcome expectancies, and social loafing were positively correlated with the illegal use of online content. Stepwise regression analysis showed that intention, social loafing, outcome expectancies, and perceived behavioral control were significant predictors of the illegal use of online content. A TPB model, including a direct path from perceived behavioral control to behavior, was validated to analyze the illegal use of online content. This model was found to be moderated by outcome expectancy.

Conclusion

This study suggests that the TPB is useful for predicting the illegal use of online content and that outcome expectancies and social loafing also play an important role in the illegal use of online content among college students. The findings of this study provide useful information for future research and could aid in preventing illegal online content use among adolescents and young adults.

Reporting suspicion of child maltreatment - a 5 yr follow-up of public dental health care workers in Norway

OBJECTIVE

This study examined stability and change of Norwegian dental health care workers' mandated reporting of suspected child maltreatment from 2014 to 2019 as well as the influence on reporting practices from regional, sociodemographic- and attitudinal factors. It was hypothesised that those factors associate independently with reporting practices across the survey period.

METHODS

In 2014 a census of 1542 dental health care workers employed in the public dental health care service (PDHS) were invited to participate in an electronic survey and 1200 (response 77.8%) consented to participation. Corresponding figures in 2019 were 1791 and 1270 (response 70.9%). Of the 1200 participants in 2014, 591 participated in 2019 (follow up 49.3%).

RESULTS

A total of 58% and 25.7% of the dental health care workers confirmed ever reporting and avoidance of reporting in both survey years whereas 24.6% and 17.2% changed the status of ever- and avoiding reporting across time. The likelihood of being a stable reporter was greatest in experienced participants, those living in eastern parts of Norway and confirming professional obligations to report. At the population level, 59.6% and 79.5% confirmed ever reporting of suspected maltreatment in 2014 and 2019. Corresponding figures for confirmed avoidance of reporting were 33.9% and 37.9%.

CONCLUSION

Reporting of suspected child maltreatment is maintained at a relatively high level and varies by socio-demographic and attitudinal concerns.

Measuring university students' beliefs toward healthy snack selection

Objectives: Understanding university students' beliefs toward selecting healthy snacks is important in developing effective programs targeting healthy eating behaviors. The purpose of this research was to assess students' beliefs toward healthy snack selection and consumption. Participants: In November 2017, a convenience sample of 779 undergraduate students living on campus completed an online survey. Methods: A survey was developed to measure students' beliefs about eating healthy snacks. Paired t-tests were used to compare differences in beliefs and their importance. Independent t-tests were used to compare differences in belief responses by gender. Results: Students believed that healthy snacks were good for health and assisting with weight management. However, time management, motivation, preparation needs, and poor taste were reported as barriers to selection and consumption of healthy snacks. Conclusions: Increasing students' awareness of available food preparation facilities, developing food preparation skills, and motivation for consumption of healthy-good tasting snacks may increase healthier snacking.

Verification of a theory of planned behavior model of medication adherence in Korean adults: focused on moderating effects of optimistic or present bias

Background

To prevent or recover from a disease, the prescriptions for medications must be correct, and the patient must comply with the medication’s instructions. Therefore, this study verified the theory of planned behavior (TPB) model to predict medication adherence among Korean adults and examined the role of optimistic or present bias in that model.

Methods

The participants were 357 Korean male and female adults whose ages ranged from 18 to 76 (M = 41.53, SD = 9.89). Their medication adherence was measured with the Morisky Green Levine Scale. The study examined TPB factors with modified items related to medication adherence and optimistic bias with items developed based on the concept and on previous studies.

Results

An alternative TPB model, including a direct path from attitude to behavior, a direct path from the perceived behavioral control to the behavior, and an insignificant path from behavioral intention to behavior, was validated for Korean adults’ medication adherence. This model was found to be moderated by optimistic or present bias.

Conclusions

The findings of this study should provide useful information for future research and for medical or health professionals who wish to improve the medication adherence of their patients.

Effect of a hospital-based oral health-education program on Iranian staff: evaluating a theory-driven intervention

BACKGROUND

Tooth decay and periodontitis are among the most prevalent dental diseases globally with adverse effects on an individual's general health. Recently the prevalence of dental caries has decreased significantly, but caries epidemiology remains a major problem in dental public health. This study investigated the impact of an oral health education intervention on Theory of Planned Behavior (TPB) variables, and whether changes in these variables persisted and were associated with changes in identified oral health behaviors at 2-month follow-up.

METHODS

This descriptive pre/post test study was conducted with 160 staff in the Baqiyatallah Hospital in Tehran. Six hospital wards were selected using a randomized multi-stratified sampling frame. The size for each cluster was calculated as 22 with each ward being allocated to either the intervention or the control arm of the study. Self-report questionnaires were used to evaluate socio-demographic factors, dental attendance as well as the constructs of the augmented TPB model (attitudes, subjective norms, perceived behavioral control intentions). The intervention was an educational program based on TPB constructs delivered via direct training to half the participants. The control group was provided with usual training only. The independent-samples T-test, Repeated-Measures one-way ANOVA, and matched T-test with the significance level set at p < 0.05 were applied.

RESULTS

Findings revealed significant variations between the two groups immediately after the educational intervention concerning the attitudes, subjective norms, perceived behavioral control, intentions to seek treatment, oral health behavior as well as decayed, missing, and filled teeth and bleeding on probing (p<0.001). Two months after the intervention, except for the brushing construct (p = 0.18), the differences between the two groups were all statistically significant (p<0.001).

CONCLUSION

Our findings affirm the positive effect an oral health education program has on enhancing the attitudes, subjective norms, perceived behavioral control, intentions and behavior of staff in this hospital. The results of our study confirm that developing and applying an educational intervention in accordance with the theory of planned behavior can lead to significant changes in the knowledge, attitudes, and behavior of hospital staff regarding preventing tooth decay.

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

OBJECTIVE

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

DESIGN

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

SETTING

Singapore.

PARTICIPANTS

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

RESULTS

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

CONCLUSIONS

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

The Impact of Autonomy-Framed and Control-Framed Implementation Intentions on Snacking Behaviour: The Moderating Effect of Eating Self-Efficacy

BACKGROUND

Autonomy-supportive implementation intention exercises have been shown to facilitate goal-directed behaviour (Koestner et al., ). The current study explored whether eating self-efficacy moderated the impact of autonomy-framed versus control-framed implementation intentions to reduce high-calorie snack intake.

METHODS

The study employed a randomised prospective design, involving two waves of data collection conducted in 2016. At Time 1, UK participants (N = 300) completed an online questionnaire which asked them to report their snacking behaviour over the previous 7 days. Participants were subsequently asked to form either an autonomy-framed implementation intention or a control-framed implementation intention. Seven days later, participants reported their consumption of high-calorie snacks and completed a measure of eating self-efficacy.

RESULTS

Hierarchical multiple regression analysis revealed that eating self-efficacy moderated the effects of implementation intention framing. Autonomy-framed implementation intentions had a greater impact on the avoidance of snacking for high eating self-efficacy participants than did control-framed implementation intentions. In contrast, for low eating self-efficacy participants, control-framed implementation intentions had more impact than did autonomy-framed implementation intentions.

CONCLUSIONS

The results suggest that if implementation intentions to promote healthy diet are to be effective, the role of eating self-efficacy should be considered, and the design of interventions adapted accordingly.

Self-affirmation improves self-control over snacking among participants low in eating self-efficacy

OBJECTIVE

Individuals low in eating self-efficacy are at particular risk of engaging in unhealthy eating behaviours, including the consumption of high calorie snacks. The elevated levels of snacking displayed by these individuals can largely be attributed to their experiencing low self-control over the avoidance of such foods (Hankonen, Kinnunen, Absetz, & Jallinoja, 2014). Interventions are thus required to boost self-control over snacking among those low in eating self-efficacy. Self-affirmation has been shown to boost self-control among individuals with depleted resources in other domains (Schmeichel & Vohs, 2009). The purpose of the current study was to test the hypothesis that a self-affirmation manipulation would similarly increase self-control over snacking for individuals low in eating self-efficacy.

METHODS

At baseline, participants (N = 70) completed measures of dietary restraint and eating self-efficacy. In the main study, participants completed either a self-affirmation or a control task immediately before undertaking a joystick category judgment task that assessed self-control over snacking.

RESULTS

Hierarchical multiple regression analysis revealed the predicted significant interaction between eating self-efficacy and self-affirmation, demonstrating that self-affirmation moderated the association between eating self-efficacy and self-control over snacking. Johnson-Neyman regions of significance confirmed that for participants low in eating self-efficacy the self-affirmation manipulation resulted in higher levels of self-control. Unexpectedly, however, for participants high in eating self-efficacy the self-affirmation manipulation was found to be associated with lower levels of self-control.

CONCLUSIONS

Findings supported the hypothesis that a self-affirmation manipulation would boost self-control over snacking among individuals low in eating self-efficacy. Self-affirmation may thus provide a useful technique for strengthening self-control in relation to the avoidance of unhealthy foods among individuals who find it difficult to manage challenging dietary situations.

Food Addiction Beliefs Amongst the Lay Public: What Are the Consequences for Eating Behaviour?

PURPOSE OF REVIEW

The current paper reviews recent research on perceptions of food addiction in the lay public. It also examines the potential consequences of such beliefs for eating behaviour.

RECENT FINDINGS

Surveys suggest that, within community samples, the majority of individuals believe that certain foods are addictive, and that food addiction causes obesity. Further, many people believe themselves to be 'food addicts', and these individuals demonstrate increased patterns of aberrant eating. However, there is also initial experimental evidence to suggest that believing oneself to be a food addict leads to short-term food restriction.

SUMMARY

To reconcile these findings, a self-perpetuating relationship between food addiction beliefs and aberrant eating is proposed. Specifically, in the short term, food addiction beliefs may encourage individuals to avoid certain foods. However, attempts at restriction may eventually lead to increased cravings and disinhibition, thus reinforcing perceptions of oneself as a food addict. These possibilities merit scrutiny in future research.

Old Clothes and an Older Look

Social cognition models (SCMs) have been described by Ingham as old clothes fit only for the jumble, yet their use in investigations of health behaviour performance in recent years has proliferated rather than declined. In a critique of the literature, this paper highlights a range of theoretical, methodological and performance-based limitations of the SCM approach and demonstrates that a ceiling has now been reached whereby more than half the variance in health behaviour performance is routinely unexplained, despite all efforts to improve the models. A major conceptual flaw within the SCM approach is identified and it is argued that `health behaviours', as generally defined, do not exist and that health-related activities only acquire meaning and significance on the basis of their relationship to the broader social prac- tices of which they form a part. A `new look' is proposed for research in this field which takes this alternative conceptualization into account.

The theory of planned behaviour and discrete food choices: a systematic review and meta-analysis

The combination of economic and social costs associated with non-communicable diseases provide a compelling argument for developing strategies that can influence modifiable risk factors, such as discrete food choices. Models of behaviour, such as the Theory of Planned Behaviour (TPB) provide conceptual order that allows program designers and policy makers to identify the substantive elements that drive behaviour and design effective interventions. The primary aim of the current review was to examine the association between TPB variables and discrete food choice behaviours. A systematic literature search was conducted to identify relevant studies. Calculation of the pooled mean effect size (r(+)) was conducted using inverse-variance weighted, random effects meta-analysis. Heterogeneity across studies was assessed using the Q- and I(2)-statistics. Meta-regression was used to test the impact of moderator variables: type of food choice behaviour; participants' age and gender. A total of 42 journal articles and four unpublished dissertations met the inclusion criteria. TPB variables were found to have medium to large associations with both intention and behaviour. Attitudes had the strongest association with intention (r(+)  = 0.54) followed by perceived behavioural control (PBC, r(+)  = 0.42) and subjective norm (SN, r(+)  = 0.37). The association between intention and behaviour was r(+)  = 0.45 and between PBC and behaviour was r(+)  = 0.27. Moderator analyses revealed the complex nature of dietary behaviour and the factors that underpin individual food choices. Significantly higher PBC-behaviour associations were found for choosing health compromising compared to health promoting foods. Significantly higher intention-behaviour and PBC-behaviour associations were found for choosing health promoting foods compared to avoiding health compromising foods. Participant characteristics were also found to moderate associations within the model. Higher intention-behaviour associations were found for older, compared to younger age groups. The variability in the association of the TPB with different food choice behaviours uncovered by the moderator analyses strongly suggest that researchers should carefully consider the nature of the behaviour being exhibited prior to selecting a theory.

Factor structure of health and oral health-related behaviors among adolescents in Arusha, northern Tanzania

OBJECTIVE

This study aimed to evaluate the factor structure of health and oral health-related behaviors and it's invariance across gender and to identify factors associated with behavioral patterns.

MATERIALS AND METHODS

A cross-sectional study included 2412 students attending 20 secondary schools in Arusha. Self-administered questionnaires were completed at school.

RESULTS

Principal component analysis of seven single health and oral health-related behaviors (tooth brushing, hand wash after latrine, hand wash before eating, using soap, intake of sugared mineral water, intake of fast foods and intake of sweets) suggested two factors labeled hygiene behavior and snacking. Confirmatory factor analyses, CFA, provided acceptable fit for the hypothesized two-factor model; CFI = 0.97. Multiple group CFA across gender showed no statistically significant difference in fit between unconstrained and constrained models (p = 0.203). Logistic regression revealed ORs for hygiene behaviors of 1.5, 0.5, 1.5, 1.5 and 0.6 if being a girl, current smoker, reporting good relationship with school, access to hygiene facilities and bad life satisfaction, respectively. ORs for snacking were 1.3, 1.4, 0.4 and 0.5 if female, in the least poor household quartile, low family socio-economic status and high perceived control, respectively.

CONCLUSION

The two factors suggest that behaviors within each might be approached jointly in health promoting programs. A positive relationship with school and access to hygiene facilities might play a role in health promotion. Provision of healthy snacks and improved perceived behavioral control regarding sugar avoidance might restrict snacking during school hours.

Determinants of oral hygiene behavior: a study based on the theory of planned behavior

OBJECTIVE

The aim of this study was to develop an index for oral hygiene behavior (OHB) and to examine potential predictors of this actual behavior based on the theory of planned behavior (TPB). Measures of oral health knowledge (OHK) and the expected effect of having healthy teeth on social relationships were included too.

MATERIAL AND METHODS

Using an Internet questionnaire, 487 participants were asked about actual OHB, attitudes (ATT), social norms (SN), perceived behavioral control (PBC), OHK, and expected social outcomes (ESO). Based on a Delphi method involving oral health professionals, a new index for OHB was developed, including tooth brushing, interdental cleaning, and tongue cleaning.

RESULTS

Regression analysis revealed that the TPB variables (ATT, SN, and PBC) and OHK explained 32.3% of the variance in self-reported OHB.

CONCLUSION

The present findings indicate that socio-psychological consequences play a role in oral health care.

Understanding eating behaviours in Spanish women enrolled in a weight-loss treatment

AIM

To identify the beliefs and attitudes of a sample of obese and overweight Spanish women undertaking a weight-loss treatment.

BACKGROUND

Obesity is a global epidemic. Weight-loss treatments focus on changing eating behaviours; however, many patients fail to adhere to the diet. This suggests that more effective behaviour-change interventions are required to help people change their eating behaviours. According to the theory of planned behaviour (TPB) human behaviour is influenced by beliefs. Identification of people's beliefs is an essential step in the design of behaviour-change interventions.

DESIGN

A qualitative approach was employed using semi-structured interviews to interview participants. Seventeen obese and overweight Spanish women enrolled in a weight-loss treatment were recruited using a criterion sample strategy.

FINDINGS

Participants' reported beliefs referring to the benefits of losing weight and the emotions related to dieting. The more positive these beliefs were the more positive their attitude towards the diet seemed to be. Findings highlight the importance of follow-ups in creating a subjective norm to maintain a diet. Perceived behavioural control to diet seemed to be related to beliefs about social support; whereas beliefs about lack of willpower to overcome temptations seemed to decrease perceived control over eating behaviours.

CONCLUSIONS

Participants reported several beliefs and attitudes that offer plausible explanations of their eating behaviours. Data from this study seemed to fit the propositions of the TPB and could be used in further research to develop effective eating behaviour-change interventions.

RELEVANCE TO CLINICAL PRACTICE

Nurses could use the TPB to assess individuals' attitudes, beliefs and expectations when following a diet. That assessment would provide insight into what aspects are relevant for individual patients when dieting, which could lead to more effective diet behaviour-change interventions being designed.

The role of norms in explaining attitudes, intention and consumption of a common food (fish) in Vietnam

The purpose of this study is to apply the conceptual framework of the theory of planned behavior (TPB) to explain the consumption of a common food (fish) in Vietnam. We seek to understand the role of norms in explaining intention to consume, and descriptive norms is included as extensions of traditional constructs such as attitude, social norms, and perceived behavioral control. The data were derived from a cross-sectional sample of 612 consumers. Structural equation modeling was applied to test the relationships between constructs, and evaluate the reliability and the validity of the constructs. The results indicate that the models fit well with the data. Attitude, social norms, descriptive norms and behavioral control all had significantly positive effect on behavioral intention. Finally, both intention and perceived behavioral control were highly associated with the frequency of consumption of the common food investigated.

Healthy eating among 10 – 13-year-old New Zealand children: Understanding choice using the Theory of Planned Behaviour and the role of parental influence

This study examined the roles of the Theory of Planned Behaviour (TPB) and parental influence in predicting healthy eating intentions and behaviour among 10 - 13-year-old New Zealand children. Two hundred and sixty-one children completed questionnaires designed to measure the components of the TPB. In addition, their parents or caregivers completed a questionnaire examining their child-feeding practices. Subjective norm, behavioural belief, attitude and perceived behavioural control significantly predicted intentions, which, in turn, predicted self-reported dietary behaviour. Parental influence did not increase the model's explanatory power. Results support the application of the TPB to the prediction of food choice-related intention and behaviour among children; however, the role of parental influence requires further examination.

Predicting intended use of voluntary HIV counselling and testing services among Tanzanian teachers using the theory of planned behaviour

The theory of planned behaviour (TPB) provides a conceptual model for understanding individual cognitions that influence behavioural intentions and enactment of the actual behaviours. This study examined the applicability of the TPB and the additional predictive role of perceived risk in predicting intended use of voluntary HIV counselling and testing (VCT) services. We conducted a cross-sectional questionnaire survey among 918 primary school teachers in the Mwanza region, Tanzania between September 2003 and November 2003. Analysis was based on 737 teachers (mean age 38.9) who had never tested for HIV. Results of the hierarchical regression analysis indicate that perceived behavioural control and attitude toward using VCT services were significant predictors of intention to use VCT services in the TPB model. Perceived behavioural control added 12% of variance to intention over and above attitudes and subjective norms, while perceived risk added 3% of variance. Socio-economic status did not moderate the predictive value of the TPB components. The present study demonstrates that the TPB is a useful conceptual framework for predicting intended use of HIV counselling and testing services among Tanzanian teachers. A theory-based VCT intervention programme among Tanzanian teachers should mainly focus on reducing social and psychological barriers related to the use of VCT services.

Examining intention to control preschool children's sugar snacking: a study of carers in Uganda

AIM

The aims of this study were to investigate parents' intention to control their children's sugar consumption and whether that behaviour is reported to occur in 3-5-year-old preschool children according to sociodemographics and attitudinal factors derived from the Theory of Planned Behaviour (TPB).

DESIGN

Some 589 children aged 3-5 years (51% boys, response rate = 85%) attending nursery schools in Kampala Central (urban) and Nakawa (suburban), Uganda, were examined clinically for dental caries. A questionnaire to assess sociodemographic factors, sugar intake and the constructs of the TPB was completed by their parents'/caregivers in face-to-face interviews.

RESULTS

Analyses of variance revealed more positive attitudes and stronger intention to control children's intake of sugared snacks in highly as compared to less highly educated parents. Independent of educational level, parents having children with caries perceived themselves to have less control over their child's intake of sugared snacks and perceived them to be more susceptible to tooth decay compared to parents of children without caries. In multiple linear regression, the TPB provided a significant prediction of intention with attitude (b = 0.16, P < 0.001), subjective norms (b = 0.18, P < 0.001) and perceived barriers (b = 0.11, P = 0.01), significant and reported sugar intake with attitudes (b = -0.10, P = 0.02), and perceived susceptibility (b = 16, P < 0.001) all significant.

CONCLUSION

The TPB components predict parental intention to control sugar snacking and whether that behaviour occurs in preschool children. The strengths of parents' attitudes and reported level of child sugar snacking varied between diverse socioeconomic family groups. Implications for oral health education are discussed.

Temporal stability of the theory of planned behavior: a prospective analysis of sugar consumption among Ugandan adolescents

PURPOSE

This study addressed three questions: What is the power of the Theory of Planned Behavior (TPB) in predicting adolescents' intended and self-perceived consumption of non-milk extrinsic sugars using a non-intervention prospective approach? To what extent do the TPB constructs change across time following adolescents' mere exposure to an oral health survey? Do changes in self-perceived sugar consumption at follow-up associate with changes in behavioral intention as predicted by the TPB?

METHOD

A survey was conducted in Kampala (urban) and Lira (rural) and 1146 secondary school students completed questionnaires assessing the TPB at school (Time 1). A random sub-sample of 415 students was selected from the original survey of which 372 students were examined clinically. After 3 months (Time 2), the questionnaire was administered a second time in the sub-sample. All analyses are based on the number of students who participated on both survey occasions, n = 372.

RESULTS

Attitudes and perceived behavioral control predicted intended sugar consumption at Time 1 and Time 2, accounting for 58% (DeltaR(2) = 0.58) and 19% (DeltaR(2) = 0.19) of the variance, respectively. Time 1 intention provided significant prediction of Time 2 self-perceived sugar consumption with DeltaR(2) = 0.5. Adolescents with high-caries experience more than their counterparts with low, changed towards weaker intentions and less frequent sugar consumption across the survey period. Mean sugar consumption scores changed from 2.6 to 2.7 (ns), 3.1 to 2.6 (P < 0.001) and 2.3 to 3.2 (P < 0.001) among adolescents who, respectively, remained stable, increased and decreased their intentions across time.

CONCLUSION

This study supports the validity of the TPB in predicting intended and self-perceived sugar consumption prospectively.

Questions raised by a reasoned action approach: comment on Ogden (2003)

In her critique of social cognition or reasoned action models, J. Ogden (see record 2003-05896-016) claimed that such models are not falsifiable and thus cannot be tested, that the postulated relations among model components are true by definition, and that questionnaires used to test the models may create rather than assess cognitions and thus influence later behavior. The authors of this comment challenge all 3 arguments and contend that the findings Ogden regarded as requiring rejection of the models are, in fact, consistent with them, that there is good evidence for the validity of measures used to assess the models' major constructs, and that the effect of completing a questionnaire on cognitions and subsequent behavior is an empirical question.

Stability of oral health-related behaviour in a Norwegian cohort between the ages of 15 and 23 years

OBJECTIVE

To assess the stability in self-reported oral health behaviour in a Norwegian cohort between the ages of 15 and 23 years.

METHODS

Self-administered questionnaires were used as part of a longitudinal cohort study. In 1992, a representative sample of 963 15-year-old adolescents participated, of which 676 (70%) and 567 (58%) remained in the study at ages 18 and 23 years. A total of 389 (40% of baseline) participated at each data collection, i.e. at ages 15, 18, 19, 21 and 23 years.

RESULTS

General linear model (GLM) repeated-measures anova revealed statistically significant main effect of time with respect to soft drink and sweet consumption (F = 22.4, P < 0.001 and F = 4.3, P < 0.05, respectively). Adjusted mean scale scores of soft drink intake increased from 2.3 at age 15 years to 3.4 at age 23 years. The corresponding figures for consumption of sweets were 2.6 and 2.8. Two-way interactions achieved statistical significance with gender for soft drink consumption and toothbrushing. GLM repeated-measures with each gender revealed that soft drink consumption increased with time more extensively in boys (from 2.9 to 4.2, F = 13.5, P < 0.001) than in girls (from 1.9 to 2.6, F = 8.1, P < 0.001). Tracking or maintenance across time of the relative ranking at age 15 years occurred with all the four behaviours investigated. A total of 68-92% remained active and inactive regarding soft drink and sweet consumption, flossing and toothbrushing.

CONCLUSION

The results provide evidence of tracking and early consolidation of oral health behaviour. This adds support for the assumption given for early intervention to prevent oral diseases.

Some problems with social cognition models: a pragmatic and conceptual analysis

Empirical articles published between 1997 and 2001 from 4 health psychology journals that tested or applied 1 or more social cognition models (theory of reasoned action, theory of planned behavior, health belief model, and protection motivation theory; N = 47) were scrutinized for their pragmatic and conceptual basis. In terms of their pragmatic basis, these 4 models were useful for guiding research. The analysis of their conceptual basis was less positive. First, these models do not enable the generation of hypotheses because their constructs are unspecific; they therefore cannot be tested. Second, they focus on analytic truths rather than synthetic ones, and the conclusions resulting from their application are often true by definition rather than by observation. Finally, they may create and change both cognitions and behavior rather than describe them.