Predicting breakfast consumption: an application of the theory of planned behaviour and the investigation of past behaviour and executive function

Driving Factors Influencing the Decision to Purchase Plant-Based Beverages: A Sample from Türkiye

In recent years, the trend toward plant-based beverages has continued to grow rapidly. This study aimed to assess the effects of sociodemographic characteristics and knowledge about plant-based beverages, subjective norms, perceived price, environmental protection, animal welfare, availability, and trust on attitudes and buying behavior toward these products. This study was conducted online using a two-part questionnaire prepared by considering the literature. This study included 935 participants, and our findings confirmed that the variable of environmental protection affects the attitude toward these products (β= 0.095; p = 0.007). Furthermore, gender, income level, lactose intolerance, and bloating due to cow's or sheep's milk influenced actual buying behavior (p < 0.05; p < 0.001). These findings indicate that people's increased environmental protection awareness will positively influence attitudes towards plant-based beverages and that individuals who do not experience lactose intolerance and bloating due to cow's or goat's milk will have lower actual buying behavior. It was also determined that individuals with lower incomes bought more plant-based beverages. In conclusion, plant-based beverage marketers need to take into account individuals' sociodemographic characteristics and environmental protection awareness when planning their marketing strategies.

Dietary behaviours and related lifestyles according to the presence or absence of skipping breakfast in Japanese adults: the JPHC-NEXT study

OBJECTIVE

To assess dietary behaviours and related lifestyles according to the presence or absence of skipping breakfast.

DESIGN

We analysed the cross-sectional data from a baseline survey of a large-scale population-based cohort study in Japan conducted in 2011-2016. Participants provided information on dietary behaviours and lifestyles through a self-administered questionnaire. Skipping breakfast was defined as not eating breakfast at least once a week and was classified according to the frequency of skipping breakfast as 1-2, 3-4 or ≥5 times/week.

SETTING

Sixteen municipalities in seven prefectural areas across Japan under the Japan Public Health Centre-based prospective study for the Next Generation.

PARTICIPANTS

112 785 residents (51 952 males and 60 833 females) aged 40-74 years.

RESULTS

After adjustment for age, socio-demographic status, drinking status and smoking status, individuals who skipped breakfast at least once a week, compared with those who ate breakfast every day, were more likely to have adverse dietary behaviours such as frequent eating out (multivariable OR = 2·08, 95 % CI (1·96, 2·21) in males and 2·15, 95 % CI (1·99, 2·33) in females), frequent eating instant foods (1·89, 95 % CI (1·77, 2·01) in males and 1·72, 95 % CI (1·56, 1·89) in females). They had late bedtime (1·85, 95 % CI (1·75, 1·95) in males and 1·98, 95 % CI (1·86, 2·11) in females) and living alone (2·37, 95 % CI (2·17, 2·58) in males and 2·02, 95 % CI (1·83, 2·21) in females), using the logistic regression model.

CONCLUSIONS

Both adult males and females who skipped breakfast were likely to eat out, to have a dietary habit of eating instant foods and have lifestyles such as late bedtime and living alone than those who ate breakfast.

Utility of temporal self‐regulation theory in health and social behaviours: A meta‐analysis

PURPOSE

Temporal self-regulation theory was developed to address an observed intention-behaviour gap across behaviours. However, a synthesis of studies has not yet been conducted to investigate the theory's utility to explain behaviour and bridge the intention-behaviour gap. This review aimed to evaluate the predictive ability of temporal self-regulation theory to understanding behaviour and pre-registered at PROSPERO (ID: CRD42021253174).

METHOD

Forward citation searches on the original theory publication through Google Scholar until May 2021 identified 37 eligible articles, including, 12,555 participants assessing at least two of the three theory constructs. Random-effects meta-analyses assessed the strength of associations between theory constructs on behaviour and random effects meta-regressions assessed moderators of behaviour.

RESULTS

Findings provide support for temporal self-regulation theory to explain behaviour with very weak (self-regulatory capacity r = .039, CI = .00, -.07) to moderate (intention r = .331, CI = .26, .40; behavioural pre-potency r = .379, CI = .32, .44) effect sizes. Further, the strength of associations varied across behaviour types and contexts. However, there was high heterogeneity across studies and some moderating effects could not be assessed due to insufficient numbers of studies assessing interactions.

CONCLUSIONS

We urge researchers to assess and report interactions for better understanding of the drivers of behaviour to develop effective interventions for positive behaviour change.

Psychometric properties and measurement invariance across gender of the Italian version of the tempest self-regulation questionnaire for eating adapted for young adults

The prevalence of overweight and obesity in young adults has increased dramatically in recent decades. The unhealthy eating habits that develop at this time can often lead to negative health consequences in the future. It is therefore important to learn about self-regulation and self-control strategies and help young adults to have healthy eating behaviours. This study aims to present an Italian version of the Tempest Self-Regulation Questionnaire for Eating (TESQ-E) adapted for young adults. The instrument assesses self-regulation and self-control strategies to counteract the desire and temptation to eat unhealthy food and to choose healthy foods. A total of 645 students (271 males and 374 females with an average age of 24.82 and SD = 4.34) took part in the study. The results of the confirmatory factor analysis supported the six first-order factors model concerning specific self-regulation strategies and a higher-order structure of the TESQ-E [χ² (152) = 336.480, p < 0.001; CFI = 0.95; RMSEA = 0.04; SRMR = 0.04]: three correlated second-order factors (addressing the temptation directly, addressing the psychological meaning of temptation, and addressing the goal directly) and one-third-order factor (self-regulatory competence). The results also confirmed the strong measurement invariance of the TESQ-E across gender. To have reliable comparisons across males and females, the latent mean differences tests were performed on the six specific self-regulation strategies. The analysis showed that females appear to prefer strategies that directly address the goal by expressing explicit intentions or plans to eat in a healthy way. Convergence validity was tested through correlations with Eating-Self-Efficacy Brief Scale (ESEBS), Emotional Eating Scale (EES), Scale of Attitudes towards Healthy Eating (SAHE), and Body Mass Index (BMI). In conclusion, the TESQ-E appears to be a psychometrically sound questionnaire that can be effectively used with young adults to measure self-regulation strategies in eating in order to plan personalised interventions for the prevention and control of the metabolic syndrome, and to reduce a wide range of diet-related diseases.

Use of Mobile Grocery Shopping Application: Motivation and Decision-Making Process among South Korean Consumers

With the revitalization of the online grocery trading market, many consumers are using mobile applications to purchase groceries. Although past studies were conducted on online grocery purchases, few measured mobile app users in a conceptual model that combines both motivational needs and behavioral components. Grounded in the uses and gratifications theory and the theory of planned behavior, this study investigated utilitarian motives, hedonic motives, experiential motives, attitudes, subjective norms, perceived behavioral control, purchase intention, and purchase behavior among mobile grocery app users in South Korea. As an additional analysis, a comparison between users and non-users of mobile grocery apps was implemented. The results showed that the utilitarian motives of grocery app users significantly influenced attitudes, attitudes and subjective norms influenced user intention, and user intention influenced grocery purchase behavior. Users showed statistically higher utilitarian motives, hedonic motives, and attitudes than non-users. The results suggest that South Korean consumers hold positive attitudes toward mobile grocery shopping and that the opinions of others may influence the decision to use the services. Mobile groceries in South Korea may have the potential for continued growth if individuals’ perceived control of the service improves. Implications and suggestions for future research are discussed.

Interventions to change purchasing behaviour in supermarkets: a systematic review and intervention content analysis

This systematic review and intervention content analysis used behavioural science frameworks to characterise content and function of interventions targeting supermarket shoppers' purchasing behaviour, and explore if coherence between content and function was linked to intervention effectiveness. Study eligibility: in-store interventions (physical supermarkets) with control conditions, targeting objectively measured food and/or non-alcoholic drink purchases, published in English (no date restrictions). Eleven electronic databases were searched; reference lists of systematic reviews were hand-searched. Methodological quality was assessed using the GATE checklist. A content analysis was performed to characterise intervention content and function, and theoretical coherence between these, using the Behaviour Change Wheel, Behaviour Change Techniques Taxonomy, and Typology of Interventions in Proximal Physical Micro-Environments (TIPPME). Forty-six articles (49 interventions) met inclusion criteria; 26 articles (32 interventions) were included in the content analysis. Twenty behaviour change techniques (BCTs), and four TIPPME intervention types were identified; three BCTs ('Prompts/cues', 'Material incentive', and 'Material reward') were more common in effective interventions. Nineteen interventions solely employed theoretically appropriate BCTs. Theoretical coherence between BCTs and intervention functions was more common in effective interventions. Effective interventions included price promotions and/or in-store merchandising. Future research should explore the effect of specific BCTs using factorial study designs. PROSPERO Registration: CRD42017071065.

Hispanic mothers' accounts of vaccinating their adolescent children against HPV: features of the clinic visit

ABSTRACTObjective: Despite the widespread availability of the human papillomavirus (HPV) vaccine in the US, rates of vaccination among Hispanic adolescents lag behind those of other recommended vaccines. Understanding what happens during the HPV vaccination visit should provide important insight into communication between health care providers and Hispanic mothers and identifies areas where communication can be improved. As such, this qualitative study explored Hispanic mothers' experiences during their adolescent child's HPV vaccination visit.Design: Fifty-one participants completed individual interviews. Transcripts were analyzed using a conventional content analysis approach to identify emergent categories or themes.Results: We identified three features of the HPV vaccination visit including: the primary reason for the visit, the type of counseling the mother received about the vaccine and the type of HPV vaccine recommendation received. Most mothers reported that their child was vaccinated against HPV at a routine well-child visit. Some mothers reported that they received in-depth counseling about the vaccine, while others received brief or no counseling from the provider. Mothers also reported receiving either a strong recommendation to vaccinate, a recommendation to vaccinate that emphasized her choice, or no recommendation to vaccinate.Conclusion: Most Hispanic mothers report that they received counseling and a recommendation from their adolescent child's health care provider before vaccinating. However, most of the mothers first heard about the HPV vaccine at the vaccination visit. Mothers who had previously heard about the vaccine outside of the clinic, reported making an appointment specifically for their child to be vaccinated against HPV. Together, these findings indicate a need to raise awareness of the vaccine and to promote HPV vaccination more strongly in this population. Education efforts should target mothers in community settings, in addition to clinic settings in order to increase awareness and vaccination in this population.

Accentuating the Interrelation between Consumer Intention and Healthy Packaged Food Selection during COVID-19: A Case Study of Pakistan

This study contemplates the factors that influence consumer intention, before and during the eruption of COVID-19, for the selection of healthy packaged food in Pakistan. The extant studies have identified two distinct attitudes of consumers about food label information: one is its usefulness and the second elucidates the avoidance. Hence forth, the current study contributes to the extant literature while signifying both reasons which motivate consumers to read food labels and reasons which discourage consumers from consult food labels at the point of purchase. Moreover, the impact of subjective norms and self-efficacy for healthy packaged food intentions has also been examined for both before the emergence of COVID-19 and during the spread of COVID-19. The underpinning of the proposed model has been justified by the behavioral reasoning theory. The cross-sectional data of 14,455 students has was collected from 10 universities through Microsoft Teams and Zoom. AMOS 21 was employed for the final analysis. The results indicate that before COVID-19 the subjective norms and self-efficacy were not the stimulating factors for the selection of healthy packaged food. On the contrary, during the COVID-19 outbreak, the subjective norms and self-efficacy divulged a significant effect. Moreover, the reasons to consult food labels are positively significant whereas the reasons to avoid food labels have negatively affected the consumer, both before COVID-19 and during COVID-19 outbreak, while endorsing healthy packaged food. Conclusively, COVID-19 has been proved to be a deterrent for unhealthy packaged food lovers while being a blessing for healthy packaged food.

A nudge in the right direction: the role of food choice architecture in changing populations' diets

Populations' diets typically fall short of recommendations. The implication of this on ill health and quality of life is well established, as are the subsequent health care costs. An area of growing interest within public health nutrition is food choice architecture; how a food choice is framed and its influence on subsequent food selection. In particular, there is an appeal to manipulating the choice architecture in order to nudge individuals' food choice. This review outlines the current understanding of food choice architecture, theoretical background to nudging and the evidence on the effectiveness of nudge strategies, as well as their design and implementation. Interventions emphasising the role of nudge strategies have investigated changes to the accessibility, availability and presentation of food and the use of prompts. Empirical studies have been conducted in laboratories, online and in real-world food settings, and with different populations. Evidence on the effectiveness of nudge strategies in shifting food choice is encouraging. Underpinning mechanisms, not yet fully explicated, are proposed to relate to salience, social norms and the principle of least effort. Emerging evidence points to areas for development including the effectiveness of choice architecture interventions with different and diverse populations, and the combined effect of multiple nudges. This, alongside further examination of theoretical mechanisms and guidance to engage and inspire across the breadth of food provision, is critical. In this way, the potential of choice architecture to effect meaningful change in populations' diets will be realised.

A Conceptual Model of Long-Term Weight Loss Maintenance: The Importance of Cognitive, Empirical and Computational Approaches

Living with obesity is related to numerous negative health outcomes, including various cancers, type II diabetes, and cardiovascular disease. Although much is known about the factors associated with obesity, and a range of weight loss interventions have been established, changing health-related behaviours to positively affect obesity outcomes has proven difficult. In this paper, we first draw together major factors that have emerged within the literature on weight loss to describe a new conceptual framework of long-term weight loss maintenance. Key to this framework is the suggestion that increased positive social support influences a reduction in psychosocial stress, and that this has the effect of promoting better executive functioning which in turn facilitates the development of healthy habits and the breaking of unhealthy habits, leading to improved ongoing maintenance of weight loss. We then outline how the use of computational approaches are an essential next step, to more rigorously test conceptual frameworks, such as the one we propose, and the benefits that a mixture of conceptual, empirical and computational approaches offer to the field of health psychology.

The association of healthy lifestyle behaviors with mental health indicators among adolescents of different family affluence in Belgium

BACKGROUND

Healthy lifestyles may contribute to better mental health, which is particularly important in adolescence, an age at which half of all mental health problems first occur. This association may be even more relevant in adolescents of low family affluence, who show more mental health problems, as well as more unhealthy lifestyles. This study investigated healthy lifestyle behaviors, namely sufficient sleep and physical activity, daily breakfast intake, low levels of alcohol use or smoking, in relation to mental health and symptoms of mental health problems (feelings of depression, anxiety, stress and self-esteem) among adolescents from different family affluence. Furthermore, the moderating role of family affluence was examined in those relations.

METHODS

Adolescents aged 12-18y were recruited via a random sample of schools in Flanders, Belgium. A total of 1037 adolescents participated (mean age = 15.2, 49.8% female). Independent samples t-tests, Mann Whitney U-tests and χ²-tests determined the differences in healthy lifestyle behaviors and mental health indicators between adolescents of low-medium and high family affluence. Regression analyses assessed the association between healthy lifestyles and mental health outcomes and the moderating role of family affluence.

RESULTS

All healthy lifestyle behaviors were associated with at least one mental health outcome, with the exception of alcohol consumption. Adolescents from low-medium family affluence had lower levels of physical activity, less often took breakfast, had lower levels of alcohol consumption and reported lower self-esteem than adolescents from high family affluence. The results showed no moderating effect of family affluence for the association between healthy lifestyle and mental health.

CONCLUSION

These findings support the value of integrating healthy lifestyle behaviors in interventions for mental health promotion, for both youth of low-medium and high family affluence.

Social-Psychological Factors in Food Consumption of Rural Residents: The Role of Perceived Need and Habit within the Theory of Planned Behavior

To address the problem of malnutrition in poor rural areas of China, this study aims to examine the effects of social-psychological factors in food consumption of rural residents in poor counties of Southwest China. In addition, it investigates the role of perceived need and habit within the theory of planned behavior (TPB) in predicting food consumption. A survey with random sampling was conducted on rural residents (n = 424), and the theoretical frameworks of both the standard and extended TPB were applied for comparison purposes. Structural equation modeling was applied to test the relationships among constructs. Consumption of five food items was studied, respectively: meat, eggs, dairy, fish, and fruits. Results showed that incorporation of perceived need and habit substantially increased the explanatory power of the TPB, but these factors only had significant direct effects on intention rather than behavior. Perceived need and habit are stronger predictors of intention than any other TPB construct for consumption of all food items except for meat. We found indirect effects of the constructs in the extended TPB model on consumption to be different across food items. Practical implications to improve consumption of different food items were proposed accordingly.

A systematic review and meta-analysis of the executive function-health behaviour relationship

Objective

This study provides the first comprehensive meta-analysis of the relationship between executive function (EF) and performance of health behaviours in healthy populations.

Method

Electronic databases (MEDLINE, Embase, PsycINFO, Web of Science) were searched, and forward and backward citation tracking was undertaken to identify articles investigating the relationship between EF and health behaviour. Studies were eligible if they examined the direct correlational relationship between EF and health behaviour in healthy populations, were available in English and published in peer-reviewed journals in any year.

Results

Sixty-one articles covering 65 tests were included in a random effects meta-analysis. Several moderators were assessed, including: the type, and addictiveness of the health behaviour; the type of EF measure; study design, and sample characteristics. Overall EF had a significant, but small correlation with health behaviour; EF was significantly positively associated with health-protective behaviours and significantly negatively associated with health-damaging behaviours. There was considerable heterogeneity in the observed effect sizes, but this was not explained by the examined moderators.

Conclusions

Although the meta-analysis indicates a significant effect for EF on health behaviour, effect size is small. Due to the complex nature of EF, more research is required to further elucidate the relationship between EF and health behaviour in its entire conceptualization.

The status and predictors of hypertension preventive nutritional behaviors in adolescents based on the constructs of the Theory of Planned Behavior

Background

Malnutrition is an important factor affecting hypertensive incidence. Since the unhealthiest nutritional behaviors are rooted in childhood attitudes and experiences, applying educational interventions to these age groups will be most useful in the formation of preventive nutritional behaviors.

Objective

To determine the predictive power of the TPB on hypertension in junior high-school students.

Methods

The present cross-sectional study was conducted on 160 junior high-school students in Kashmar, Iran in academic year commencing 2-13-2014, selected through random sampling. The participants completed a researcher-made questionnaire consisting of a demographic information form and a section to evaluate the constructs of the TPB. The data collected were analyzed in SPSS-16 using the correlation Wilcoxon statistics test, the one-way ANOVA and multiple linear regression analysis.

Results

The mean age of the students was 13.51. A total of 47% of the students had snacked on potato chips and cheese puffs, 45% had eaten high-fat foods and 51.2% had eaten cookies and chocolates within the past week. The variable of behavioral intention predicted 32% of the variations in preventive nutritional behaviors by itself. The Pearson product-moment correlation analysis found that hypertension preventive nutritional behaviors were significantly correlated with attitude (p<0.001, r=0.38), perceived behavioral control (p<0.001, r=0.38), and behavioral intention. Moreover, significant correlations were observed between subjective norms and attitude (p<0.028, r=0.173), perceived behavioral control and attitude (p<0.003, r=0.231), behavioral intention and attitude (p<0.001, r=0.370), behavioral intention and subjective norms (p<0.030, r=0.171) and between behavioral intention and perceived behavioral control (p<0.001, r=0.484).

Conclusion

The examined students revealed an adequate adherence to preventive nutritional behaviors. Nutrition education interventions should be developed based on variables such as behavioral intention and its determinants, i.e. attitude, perceived behavioral control and subjective norms.

The effects of health promotion model-based educational program on self-care behaviors in patients undergoing coronary artery bypass grafting in Iran

Background and aim

Post-operative self-care behaviors, have positive effects on increase in adaptability, and reduce cardiac surgery patients’ disability. The present study is carried out aimed at determining the effect of education based on a health promotion model on the patients’ self-care behaviors after coronary artery bypass surgery.

Methods

This is a semi-experimental study carried out in Mazandaran (Iran) in 2016. Two hundred and twenty patients who participated in the study were selected using a simple random sampling method from a population of postoperative patients, and divided into control and experimental groups (110 patients in each) using block (AABB) randomization. Self-designed self-care questionnaires based on a health promotion model were distributed among the patients once before and three months after intervention. The data were analyzed by SPSS-22, Chi-Square tests, Mann-Whitney and ANCOVA at the significance level of p<0.05.

Results

The average score of total self-care behaviors in cardiac surgery patients was not significant between the two groups before education (p=0.065), but after training, a significant difference was observed between the two groups (p<0.001). The analysis of ANOVA with repeated measure indicated that following the intervention, significant difference was observed between the two groups in terms of improvement of self-care behaviors after excluding the effect of pre-test and controlling demographic and health-related characteristics.

Conclusions

Developing and implementing a training program based on the health promotion model can enhance self-care behaviors and reduce the number of admissions in patients after cardiac surgery.

Identifying Eating Occasion-Based Opportunities to Improve the Overall Diets of Australian Adolescents

Adolescents in Australia have a poor dietary intake, leading to large numbers of them being at risk for inadequate intake of micronutrients, and excessive intake of less healthful dietary components. This study examined dietary intakes at multiple eating occasions to identify opportunities for more targeted recommendations and strategies to improve dietary intakes among adolescents. Data from the first 24-h recall of 14-18 years old in the 2011-2012 National Nutrition and Physical Activity Survey were analysed (n = 772). Participant-defined eating occasions were classified as breakfast, lunch, dinner or other eating occasions combined. The mean percent contribution to the total day intake of top shortfall nutrients (calcium, magnesium, vitamin A, iron), discretionary calories, saturated fat, free sugars and sodium, as well as nutrient density, the foods consumed and the percent of consumers at each eating occasion, were calculated. Breakfast had the lowest prevalence of consumers (81%), contributed the least to total daily energy (14.6%) and almost a quarter of daily calcium and iron. Other eating occasions combined contributed 47.5% of free sugars and were top contributors of daily calcium (34.6%) and magnesium (31.7%). Discretionary foods contributed 32.4% of the energy at lunch, and the sodium content at lunch was 415 mg/1000 kJ. Key opportunities identified for adolescents were to increase breakfast consumption, given the high nutrient densities of breakfasts consumed; improve overall lunch quality, particularly the sodium content; promote the intake of milk, fruit and a variety of vegetables at both lunch and dinner; maintain healthful choices at in-between meal eating occasions while focusing on decreasing the intake of discretionary foods.

Different Psychosocial Factors Are Associated With Different Intention and Self-Efficacy Toward Eating Breakfast Among Japanese Breakfast Skippers

A cross-sectional study was conducted among 7593 adults to clarify lifestyle and psychosocial characteristics of breakfast skippers with different intention and self-efficacy toward eating breakfast. Data were obtained from Japan’s national survey in 2009. Multinomial logistic regression analyses were performed to examine the characteristics of each breakfast skipper (having intention and self-efficacy toward eating breakfast [IS], having intention but not self-efficacy [INS], and not having intention to eat breakfast [NI]) compared with breakfast eaters. IS men were less likely to demonstrate understanding of healthy eating. INS and NI men were more likely to eat alone. INS and NI women were less likely to demonstrate understanding of healthy eating. NI men and women were less likely to report weight management behavior. Current smoking and being sleep-deprived were commonly associated with breakfast skipping in both sexes. Our results suggested the need for approaches considering type of breakfast skippers (eg, different intention and self-efficacy).

Cognitive remediation therapy plus behavioural weight loss compared to behavioural weight loss alone for obesity: study protocol for a randomised controlled trial

BACKGROUND

Current research indicates that obese individuals have cognitive deficits in executive function, leading to difficulties with planning, impulse control and decision-making. High levels of inflammation have been proposed to contribute to executive function deficits in individuals with obesity.

METHODS/DESIGN

One hundred and seventy-six obese participants will be randomly assigned to one of two groups: (1) behavioural weight loss alone (BWL) group = 8 sessions of individual BWL sessions plus 12 group BWL sessions or (2) Cognitive Remediation Therapy for Obesity (CRT-O) plus BWL group (CRT-O + BWL) = 8 sessions of individual CRT-O plus 12 group BWL sessions. The study is double blind - participants will only be told that two weight-loss treatments are being compared and research assistants conducting outcome assessments will not know participants' group allocation. Blood tests will be conducted to measure inflammatory markers. Measurement points will be at baseline, post treatment and 1-year follow-up. The primary outcomes will be differences between treatment groups in percentage weight loss, executive function, binge eating and an examination of whether changes in executive function predict changes in weight and binge eating. Secondary outcome measures will examine changes on inflammation, quality of life, and grazing behaviour and whether these predict changes in executive function and weight.

DISCUSSION

If CRT-O + BWL is more effective in assisting people to lose weight long term than BWL alone it should significantly improve treatment outcomes. This study expands upon our recent trial which showed that CRT-O enhanced executive function and weight loss in obese adults. The current study is strengthened by several factors: it is double-blind, it uses an active control, has a larger sample size, and measures inflammation to examine the mechanisms.

TRIAL REGISTRATION

The RCT is registered with the Australian New Zealand Registry of Clinical Trial, trial identifier: ACTRN12616000658415 . Registered on 20 May 2016.

Applying an extended theory of planned behavior to predicting violations at automated railroad crossings

Based on an extended Theory of Planned Behavior (TPB, Ajzen, 1985, 1991), we conducted surveys in order to explain and predict violations at a railroad crossing, among pedestrians (n=153) and car drivers (n=151). Measures were made with respect to three chronologically related railroad crossing situations that varied in risk level. The situations were described in scenarios and depicted on photographs. The participants were recruited in the suburbs of Paris, at two automated railroad crossings with four half-barriers. We found that the pedestrians had stronger crossing intentions than did car drivers, especially at the more congested crossing of the two under study. For both categories of road users, intentions and the amount of intention variance explained by the extended TPB factors decreased significantly with risk level. In the most dangerous situations, risk-taking was the most unlikely and the least predictable Self-reported past frequency of crossing against safety warning devices was the main predictor of the intention to commit this violation again, especially among males, followed by the attitude and the injunctive norm in favor the violation. Moreover, car drivers were influenced in their crossing intentions by the descriptive norm. The presence of another vehicle on the tracks when the safety warning devices were activated was perceived not as facilitating, but as an additional risk factor. The discussion addresses the importance of taking into account these determinants of violations in conceiving countermeasures. Our findings could be especially useful for conceiving risk-communication campaigns.

Executive functioning and dietary intake: Neurocognitive correlates of fruit, vegetable, and saturated fat intake in adults with obesity

Obesity is a significant public health issue, and is associated with poor diet. Evidence suggests that eating behavior is related to individual differences in executive functioning. Poor executive functioning is associated with poorer diet (few fruits and vegetables and high saturated fat) in normal weight samples; however, the relationship between these specific dietary behaviors and executive functioning have not been investigated in adults with obesity. The current study examined the association between executive functioning and intake of saturated fat, fruits, and vegetables in an overweight/obese sample using behavioral measures of executive function and dietary recall. One-hundred-ninety overweight and obese adults completed neuropsychological assessments measuring intelligence, planning ability, and inhibitory control followed by three dietary recall assessments within a month prior to beginning a behavioral weight loss treatment program. Inhibitory control and two of the three indices of planning each independently significantly predicted fruit and vegetable consumption such that those with better inhibition and planning ability consumed more fruits and vegetables. No relationship was found between executive functioning and saturated fat intake. Results increase understanding of how executive functioning influences eating behavior in overweight and obese adults, and suggest the importance of including executive functioning training components in dietary interventions for those with obesity. Further research is needed to determine causality as diet and executive functioning may bidirectionally influence each other.

Mothers' intentions to vaccinate their teenaged children against human papillomavirus, as predicted by sex in South Korea: An application of the theory of planned behavior

AIM

This study was conducted in order to examine the intention of mothers to vaccinate their teenaged children against human papillomavirus (HPV) infection, according to the children's sex. Based on the theory of planned behavior, the study identified the sex-specific predictors of mothers' intention to vaccinate their teenaged children against HPV.

METHODS

This was a descriptive survey study that included, as participants, 200 mothers whose teenaged children were not vaccinated against HPV.

RESULTS

The mothers' experience with HPV vaccination was a significant predictor of their childrens' HPV vaccination status. For the mothers of sons, subjective norms, attitudes, and perceived behavioral control were found to be significant predictors of intention of HPV vaccination, with an explanatory power of 69.5%. For those with daughters, only attitudes and subjective norms were significant predictors, with an explanatory power of 79.6%.

CONCLUSION

The application of the theory of planned behavior is an effective method to determine the predictors of children's HPV vaccination status. In order to improve the HPV vaccination rate of teenaged children, strategies for education and effective promotion that involve mothers should be developed.

The reasoned/reactive model: A new approach to examining eating decisions among female college dieters and nondieters

Female college students are prone to unhealthy eating patterns that can impact long-term health. This study examined female students' healthy and unhealthy eating behaviors with three decision-making models. Specifically, the theory of reasoned action, prototype/willingness model, and new reasoned/reactive model were compared to determine how reasoned (logical) and reactive (impulsive) factors relate to dietary decisions. Females (N=583, M_age=20.89years) completed measures on reasoned cognitions about foods (attitudes, subjective norms, nutrition knowledge, intentions to eat foods), reactive cognitions about foods (prototypes, affect, willingness to eat foods), dieting, and food consumption. Structural equation modeling (SEM) revealed the new reasoned/reactive model to be the preeminent model for examining eating behaviors. This model showed that attitudes were related to intentions and willingness to eat healthy and unhealthy foods. Affect was related to willingness to eat healthy and unhealthy foods, whereas nutrition knowledge was related to intentions and willingness to eat healthy foods only. Intentions and willingness were related to healthy and unhealthy food consumption. Dieting status played a moderating role in the model and revealed mean-level differences between dieters and nondieters. This study highlights the importance of specific factors in relation to female students' eating decisions and unveils a comprehensive model for examining health behaviors.

Applying an extended theory of planned behaviour to predict breakfast consumption in adolescents

BACKGROUND/OBJECTIVES

Breakfast skipping increases during adolescence and is associated with lower levels of physical activity and weight gain. Theory-based interventions promoting breakfast consumption in adolescents report mixed findings, potentially because of limited research identifying which determinants to target. This study aimed to: (i) utilise the Theory of Planned Behaviour (TPB) to identify the relative contribution of attitudes (affective, cognitive and behavioural) to predict intention to eat breakfast and breakfast consumption in adolescents and (ii) determine whether demographic factors moderate the relationship between TPB variables, intention and behaviour.

SUBJECTS/METHODS

Questionnaires were completed by 434 students (mean 14±0.9 years) measuring breakfast consumption (0-2, 3-6 or 7 days), physical activity levels and TPB measures. Data were analysed by breakfast frequency and demographics using hierarchical and multinomial regression analyses.

RESULTS

Breakfast was consumed everyday by 57% of students, with boys more likely to eat a regular breakfast, report higher activity levels and report more positive attitudes towards breakfast than girls (P<0.001). The TPB predicted 58% of the variation in intentions. Overall, the model was predictive of breakfast behaviours (P<0.001), but the relative contribution of TPB constructs varied depending on breakfast frequency. Interactions between gender and intentions were significant when comparing 0-2- and 3-6-day breakfast eaters only highlighting a stronger intention-behaviour relationship for girls.

CONCLUSIONS

Findings confirm that the TPB is a successful model for predicting breakfast intentions and behaviours in adolescents. The potential for a direct effect of attitudes on behaviours should be considered in the implementation and design of breakfast interventions.

Executive functions and consumption of fruits/ vegetables and high saturated fat foods in young adults

Executive functions play a critical role in regulating eating behaviors and have been shown to be associated with overeating which over time can result in overweight and obesity. There has been a paucity of research examining the associations among healthy dietary behaviors and executive functions utilizing behavioral rating scales of executive functioning. The objective of the present cross-sectional study was to evaluate the associations among fruit and vegetable consumption, intake of foods high in saturated fat, and executive functions using the Behavioral Rating Inventory of Executive Functioning-Adult Version. A total of 240 university students completed the Behavioral Rating Inventory of Executive Functioning-Adult Version, the 26-Item Eating Attitudes Test, and the Diet subscale of the Summary of Diabetes Self-Care Activities Questionnaire. Multiple linear regression analysis was conducted with two separate models in which fruit and vegetable consumption and saturated fat intake were the outcomes. Demographic variables, body mass index, and eating styles were controlled for in the analysis. Better initiation skills were associated with greater intake of fruits and vegetables in the last 7 days (standardized beta = -0.17; p < 0.05). Stronger inhibitory control was associated with less consumption of high fat foods in the last 7 days (standardized beta = 0.20; p < 0.05) in the multiple linear regression analysis. Executive functions that predict fruit and vegetable consumption are distinct from those that predict avoidance of foods high in saturated fat. Future research should investigate whether continued skill enhancement in initiation and inhibition following standard behavioral interventions improves long-term maintenance of weight loss.

Satiety and the Self-Regulation of Food Take in Children: a Potential Role for Gene-Environment Interplay

Child eating self-regulation refers to behaviors that enable children to start and stop eating in a manner consistent with maintaining energy balance. Perturbations in these behaviors, manifesting as poorer child eating self-regulation, are associated with higher child weight status. Initial research into child eating self-regulation focused on the role of parent feeding styles and behaviors. However, we argue that child eating self-regulation is better understood as arising from a complex interplay between the child and their feeding environment, and highlight newer research into the heritable child characteristics, such as cognitive ability, that play an important role in this dynamic. Therefore, child eating self-regulation arises from gene-environment interactions. Identifying the genes and environmental influences contributing to these will help us tailor our parental feeding advice to the unique nature of the child. In this way, we will devise more effective advice for preventing childhood obesity.

A novel framework for analysing stakeholder interest in healthy foods: A case study on iodine biofortification

Despite the availability of novel strategies to prevent micronutrient malnutrition, such as biofortification, limited understanding of stakeholders often hampers their success. We build upon the existing literature on protection motivations (PMT) and technology acceptance (TAM) to develop an integrated PMTAM model for analyzing stakeholders' reactions, on both the supply and demand sides. Regarding the latter, the case of the iodine biofortified food chain is used to evaluate African households' interest. All model constructs, and threat appraisal in particular, are decisive in determining the uptake of biofortification, while also social demographics and own nutrition status play an important role.

Modelling protection behaviour towards micronutrient deficiencies: Case of iodine biofortified vegetable legumes as health intervention for school-going children

BACKGROUND/OBJECTIVES

Despite successes recorded in combating iodine deficiency, more than 2 billion people are still at risk of iodine deficiency disorders. Rural landlocked and mountainous areas of developing countries are the hardest hit, hence the need to explore and advance novel strategies such as biofortification.

SUBJECTS/METHODS

We evaluated adoption, purchase, and consumption of iodine biofortified vegetable legumes (IBVL) using the theory of protection motivations (PMT) integrated with an economic valuation technique. A total of 1,200 participants from three land-locked locations in East Africa were recruited via multi-stage cluster sampling, and data were collected using two, slightly distinct, questionnaires incorporating PMT constructs. The survey also elicited preferences for iodine biofortified foods when offered at a premium or discount. Determinants of protection motivations and preferences for iodine biofortified foods were assessed using path analysis modelling and two-limit Tobit regression, respectively.

RESULTS

Knowledge of iodine, iodine-health link, salt iodization, and biofortification was very low, albeit lower at the household level. Iodine and biofortification were not recognized as nutrient and novel approaches, respectively. On the other hand, severity, fear, occupation, knowledge, iodine status, household composition, and self-efficacy predicted the intention to consume biofortified foods at the household level; only vulnerability, self-efficacy, and location were the most crucial elements at the school level. In addition, results demonstrated a positive willingness-to-pay a premium or acceptance of a lesser discount for biofortification. Furthermore, preference towards iodine biofortified foods was a function of protection motivations, severity, vulnerability, fear, response efficacy, response cost, knowledge, iodine status, gender, age. and household head.

CONCLUSIONS

Results lend support for prevention of iodine deficiency in unprotected populations through biofortification; however 'threat' appraisal and socio-economic predictors are decisive in designing nutrition interventions and stimulating uptake of biofortification. In principle, the contribution is threefold: 1) Successful application of the integrated model to guide policy formulation; 2) Offer guidance to stakeholders to identify and tap niche markets; 3) stimulation of rural economic growth around school feeding programmes.

From perceived autonomy support to intentional behaviour: Testing an integrated model in three healthy-eating behaviours

A motivational model integrating self-determination theory, the theory of planned behaviour, and the health action process approach was tested in three samples in three behavioural contexts: fruit and vegetable, breakfast, and snack consumption. Perceived support for autonomous (self-determined) forms of motivation from parents and autonomous motivation from self-determination theory were hypothesised to predict intention and behaviour indirectly via the mediation of attitude and perceived behavioural control from the theory of planned behaviour. It was also expected that planning strategies would mediate the effect of intention on behaviour. Relations in the proposed models were expected to be similar across the behaviours. A two-wave prospective design was adopted. Three samples of high-school students (total N = 1041; 59.60% female; M age = 17.13 years ± 1.57) completed measures of perceived autonomy support, autonomous motivation, theory of planned behaviour constructs, planning strategies and behaviour for each of the three behavioural contexts. Three months later, 816 participants (62,24% female; M age: 17.13 years, SD = 1.58) of the initial sample self-reported their behaviour referred to the previous three months. Structural equation models provided support for the key hypothesised effects of the proposed model for the three health-related behaviours. Two direct effects were significantly different across the three behaviours: the effect of perceived autonomy support on perceived behavioural control and the effect of attitude on intention. In addition, planning strategies mediated the effect of intention on behaviour in fruit and vegetable sample only. Findings extend knowledge of the processes by which psychological antecedents from the theories affect energy-balance related behaviours.

Social Cognitive Predictors of Breakfast Consumption in Primary School's Male Students

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.

Socioeconomic status and executive function: developmental trajectories and mediation

Childhood socioeconomic status (SES) predicts executive function (EF), but fundamental aspects of this relation remain unknown: the developmental course of the SES disparity, its continued sensitivity to SES changes during that course, and the features of childhood experience responsible for the SES-EF relation. Regarding course, early disparities would be expected to grow during development if caused by accumulating stressors at a given constant level of SES. Alternatively, they would narrow if schooling partly compensates for the effects of earlier deprivation, allowing lower-SES children to 'catch up'. The potential for later childhood SES change to affect EF is also unknown. Regarding mediating factors, previous analyses produced mixed answers, possibly due to correlation amongst candidate mediators. We address these issues with measures of SES, working memory and planning, along with multiple candidate mediators, from the NICHD Study of Early Childcare (n = 1009). Early family income-to-needs and maternal education predicted planning by first grade, and income-to-needs predicted working memory performance at 54 months. Effects of early SES remained consistent through middle childhood, indicating that the relation between early indicators of SES and EF emerges in childhood and persists without narrowing or widening across early and middle childhood. Changes in family income-to-needs were associated with significant changes in planning and trend-level changes in working memory. Mediation analyses supported the role of early childhood home characteristics in explaining the association between SES and EF, while early childhood maternal sensitivity was specifically implicated in the association between maternal education and planning. Early emerging and persistent SES-related differences in EF, partially explained by characteristics of the home and family environment, are thus a potential source of socioeconomic disparities in achievement and health across development.

Consumer purchasing behaviour towards fish and seafood products. Patterns and insights from a sample of international studies

The present systematic review was performed to assess consumer purchasing behaviour towards fish and seafood products in the wide context of developed countries. Web of Science, Scopus, ScienceDirect and Google Scholar engines were used to search the existing literature and a total of 49 studies were identified for inclusion. These studies investigated consumer purchasing behaviour towards a variety of fish and seafood products, in different countries and by means of different methodological approaches. In particular, the review identifies and discusses the main drivers and barriers of fish consumption as well as consumers' preferences about the most relevant attributes of fish and seafood products providing useful insights for both practitioners and policy makers. Finally, main gaps of the existing literature and possible trajectories for future research are also discussed.

Developing and testing a measurement tool for assessing predictors of breakfast consumption based on a health promotion model

OBJECTIVE

To develop an instrument for measuring Health Promotion Model constructs in terms of breakfast consumption, and to identify the constructs that were predictors of breakfast consumption among Iranian female students.

DESIGN

A questionnaire on Health Promotion Model variables was developed and potential predictors of breakfast consumption were assessed using this tool.

PARTICIPANTS

One hundred female students, mean age 13 years (SD ± 1.2 years).

SETTINGS

Two middle schools from moderate-income areas in Qom, Iran.

VARIABLES MEASURED

Health Promotion Model variables were assessed using a 58-item questionnaire. Breakfast consumption was also measured.

ANALYSIS

Internal consistency (Cronbach alpha), content validity index, content validity ratio, multiple linear regression using stepwise method, and Pearson correlation.

RESULTS

Content validity index and content validity ratio scores of the developed scale items were 0.89 and 0.93, respectively. Internal consistencies (range, .74-.91) of subscales were acceptable. Prior related behaviors, perceived barriers, self-efficacy, and competing demand and preferences were 4 constructs that could predict 63% variance of breakfast frequency per week among subjects.

CONCLUSIONS AND IMPLICATIONS

The instrument developed in this study may be a useful tool for researchers to explore factors affecting breakfast consumption among students. Students with a high level of self-efficacy, more prior related behavior, fewer perceived barriers, and fewer competing demands were most likely to regularly consume breakfast.

An examination of the demographic predictors of adolescent breakfast consumption, content, and context

Background

Breakfast consumption is important to health; however, adolescents often skip breakfast, and an increased understanding of the breakfast consumption patterns of adolescents is needed. The purpose of this study was to identify the predictors of breakfast eating, including the content and context, in an adolescent sample from Australia and England.

Methods

Four-hundred and eighty-one students completed an online questionnaire measuring breakfast skipping, and breakfast content (what was eaten) and context (who they ate with, involvement in preparation). Logistic regression was conducted to investigate the predictors of skipping breakfast, breakfast context, and consumption of the ten most commonly consumed foods. Chi-square analyses were used to examine differences in breakfast content according to context.

Results

Most students (88%) had consumed breakfast on the day of the survey; breakfast skipping was more common in England (18%) than in Australia (8%). Country, gender, socioeconomic status, and body mass index (BMI) were all predictors of breakfast content and context. Whether adolescents ate with others and/or were involved in breakfast preparation predicted the content of breakfast consumed.

Conclusions

This study provides a comprehensive examination of the factors underlying breakfast consumption (content and context) and has important implications for the development of evidence-based interventions to improve rates of breakfast consumption and the quality of food consumed amongst adolescents.

Maintaining healthy eating behaviour: experiences and perceptions of young adults

Purpose

– The prevalence of overweight and obesity is increasing, particularly in young adults who recently have been shown to experience more weight gain than other demographics. Research has focused on factors leading to this weight gain, implicating the abundance of unhealthy foods in the direct environment, yet limited research has examined why some individuals are able to successfully regulate their eating behaviour in this “food-rich environment”. The aim of this research was to explore the perceptions and experiences of successful healthy eaters in order to determine factors that distinguish this group from unhealthy eaters.

Design/methodology/approach

– Thirty-five healthy weight young adults, who considered themselves to be healthy eaters, participated in seven semi-structured focus groups. Key questions examined how these individuals regulated their eating behaviour and their perceptions regarding such self-control processes.

Findings

– Thematic analysis revealed that individuals who are successful at maintaining healthy eating behaviour perceive the same barriers as non-successful individuals, yet are able to employ self-control techniques to overcome these barriers. Additionally, continually exerting self-control appeared to facilitate the formation of healthy eating habits.

Research limitations/implications

– Future research may benefit from attempting to modify self-control ability and develop healthy habits.

Originality/value

– While factors leading to obesity and the cognitions of those who are overweight have been extensively examined, limited research has focused on those who are able to regulate their eating behaviour. Additionally, limited qualitative research has examined implicit theories of self-control in an eating context.

Effect of nutrition education intervention based on Pender's Health Promotion Model in improving the frequency and nutrient intake of breakfast consumption among female Iranian students

OBJECTIVE

To determine the effectiveness of nutrition education intervention based on Pender's Health Promotion Model in improving the frequency and nutrient intake of breakfast consumption among female Iranian students.

DESIGN

The quasi-experimental study based on Pender's Health Promotion Model was conducted during April-June 2011. Information (data) was collected by self-administered questionnaire. In addition, a 3 d breakfast record was analysed. P < 0·05 was considered significant.

SETTING

Two middle schools in average-income areas of Qom, Iran.

SUBJECTS

One hundred female middle-school students.

RESULTS

There was a significant reduction in immediate competing demands and preferences, perceived barriers and negative activity-related affect constructs in the experimental group after education compared with the control group. In addition, perceived benefit, perceived self-efficacy, positive activity-related affect, interpersonal influences, situational influences, commitment to a plan of action, frequency and intakes of macronutrients and most micronutrients of breakfast consumption were also significantly higher in the experimental group compared with the control group after the nutrition education intervention.

CONCLUSIONS

Constructs of Pender's Health Promotion Model provide a suitable source for designing strategies and content of a nutrition education intervention for improving the frequency and nutrient intake of breakfast consumption among female students.