Dietary Self-efficacy Research Articles

Discriminating Low to High Adherent Type 2 Patients with Diabetes by Glycosylated Hemoglobin A1c, Eating Self-Efficacy and Other Psychosocial Determinants: Difference Between Patient and Physician Adherence Models.

ObjectiveDevelop individual discriminant models using clinical and psychosocial variables for physicians and patients with diabetes based on their perceptions of patient adherence.MethodsThis was a cross-sectional research design utilizing a discriminant analysis approach. Type 2 patients on treatment for diabetes for at least 2 years prior to research were selected. Clinical data were obtained from patient records, and psychosocial variables were collected by survey instruments filled out by patients. A final sample of 200 patients was recruited.ResultsWe found a positive correlation between patient and physician assessment of patient adherence behaviors. Greater adherence efforts were associated with lower HbA1c. Better quality of the patient-physician relationship was linked to better patient adherence. Increased HbA1c, longer therapy duration and higher BMI described low patient adherence for physicians. Lower HbA1c, female gender and fewer difficulties in marital adjustment characterized high adherence for patients. Dietary self-efficacy as well as emotional and social isolation discriminated mid-level adherers in both models.ConclusionThis research confirmed that patients and physicians perceived and judged patients’ adherence behaviors differently. Physicians and patients associated different clinical and psychological factors with low and high adherence. Further research is recommended to clarify how the quality of the physician-patient as well as the patient-spouse relationship affect dietary efficacy and patient adherence. A randomized, controlled clinical trial approach is recommended to establish the effectiveness of interventions aiming to improve dietary self-efficacy on adherence outcomes.

578-P: Telemedicine Intervention Is Effective in Changing Psychological and Behavioral Correlates of Weight Loss in the REAL HEALTH-Diabetes Trial

Prior studies have shown that telemedicine (telemed) weight loss interventions are non-inferior to in-person in achieving weight loss. The REAL-HEALTH Diabetes RCT studied the effectiveness of a group lifestyle intervention (LI) for weight loss in adults with T2D and overweight/obesity. Intervention was delivered either in-person (LI-IP) or via telephone (LI-Tele) . We found clinically significant weight loss with no difference between arms. We sought to determine whether there was a difference between the LI-IP and LI-Tele arms in change of psychological and behavioral correlates of weight loss from baseline to 6 months. We compared the change scores for psychological (diabetes-related distress, depression, diet self-efficacy and autonomous motivation for regulation of diet) and behavioral (dietary restraint, fat related diet behavior) measures between the LI-IP (n=69) and LI-Tele (n=72) groups. There was no significant difference between the groups in mean age (62 years) , percent male (44.7%) , race (79.4% white) , baseline HbA1c (7.7%) and baseline BMI (34.7 kg/m2) . At 6 months, scores for all the measures improved from baseline in both arms with no significant difference between LI-IP and LI-Tele (Table 1) , demonstrating that telemed LI was as effective as the in-person intervention at improving psychological and behavioral correlates of weight loss. Disclosure J. Vakharia: None. L.M. Delahanty: Advisory Panel; Lilly Diabetes, Omada Health, Inc., WW International, Inc., ZOE Limited. Stock/Shareholder; Jana Care Inc., Omada Health, Inc., ZOE Limited. T. Thaweethai: None. D.J. Wexler: Other Relationship; Elsevier, Novo Nordisk, UpToDate. Funding T32 DK007028

Relationship Between Dietary Self-Efficacy and Religiosity Among Seventh-Day Adventists in Peru.

BackgroundMost of the studies involving members of the Seventh-Day Adventist Church (SDA) have been conducted in the United States and Canada.AimThe purpose of the study was to explore the relationship between dietary self-efficacy and religiosity among SDA members in Peru.MethodsIn this online cross-sectional study, 403 participants aged 18 to 59 years selected by convenience were included. The data collected included sociodemographic information. In addition, the Dietary Self-Efficacy Scale (DIET-SE) and the Duke University Index of Religion (DUREL) were administered. A correlation analysis was performed and multiple linear regression was used to examine the association between religiosity, dietary self-efficacy, and sociodemographic variables.ResultsDietary self-efficacy was significantly negatively correlated with all dimensions of religiosity, ie, organized religious activities (ORA), non-organized religious activities (NORA), and intrinsic religiosity (IR). In addition, participants had high dietary self-efficacy and religiosity.ConclusionAlthough religiosity dimensions did not significantly predict dietary self-efficacy, however, the non-organized religious activities dimension was the strongest predictor of dietary self-efficacy among Adventists in Peru. The present study will serve as a basis for future research to further investigate the potential positive effect of religiosity on the improvement a healthy diet and possible changes in the physical and mental health of the population.

Exploring the impact of genetic beliefs about specific eating behaviors on dietary self-efficacy.

Future personalized approaches to weight management are likely to include consideration of genetic influences on eating behaviors. This study explores whether genetic beliefs about eating behaviors influence dietary self-efficacy and confidence. In a survey of 261 individuals of various weight statuses, we find that endorsing genetic causes of two specific eating behaviors (taste preference and disinhibition) predicts poorer dietary self-efficacy for people who exhibit these eating behaviors. This suggests there may be utility to considering eating behaviors individually when it comes to predicting the influence of genetic information provision in the service of precision medicine interventions. Individuals with high disinhibited eating and/or bitter taster status may be particularly sensitive to interpreting genetic predisposition information in ways that undercut self-efficacy and confidence.

Adolescent Self-Efficacy for Diet and Exercise Following a School-Based Multicomponent Lifestyle Intervention.

Self-efficacy is perhaps the most important parameter associated with behavioral changes. The main aim of this study was to provide insight into the diet and exercise self-efficacy of Greek adolescents and how they could be modified via a multilevel multicomponent school-based lifestyle intervention. Secondary aims were to study the associations of students’ dietary and exercise self-efficacy indices with their anthropometric and sociodemographic parameters. A representative sample of the adolescent population in Attica, consisting of 1610 adolescents aged 12–17 years, recruited from 23 public high schools in three municipalities of the Attica area in Greece, received a three-component lifestyle educational intervention for health promotion and underwent screening for characteristics of metabolic syndrome with the use of portable telemedicine. All assessments and anthropometric measurements were performed at baseline and after the 6-month intervention. Anthropometric measurements included body mass index, waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR). Assessment tools included the Self-efficacy for Diet and the Self-efficacy for Exercise questionnaires, as well as the Mediterranean Diet Quality Index in Children and Adolescents (KIDMED). Analysis included 1020 adolescent students (421 males and 599 females), who completed the self-efficacy questionnaires pre- and post-intervention. Overall, the dietary (p < 0.001) and exercise (p < 0.001) self-efficacy increased significantly post-intervention. Post-intervention, all adolescents decreased their abdominal obesity indices (WC, WHtR, WHR), and this improvement was even more pronounced and significant (p = 0.019, p = 0.019, p = 0.023 respectively) in the adolescents with overweight/obesity. Post-intervention, the proportion of adolescents with normal weight increased from 73.9% to 78.6%, whereas the proportion of adolescents with overweight and obesity decreased from 20.4% to 15.9% and from 5.7% to 5.5%, respectively. Abdominal obesity also decreased from 10.4% to 9.0%. Female adolescents achieved significantly (p = 0.010) higher changes in diet self-efficacy than males. Other sociodemographic characteristics such as family structure, parental age, parental educational level and family income showed non-significant differences. Adolescents with higher KIDMED scores manifested significantly higher dietary and exercise self-efficacy than those with lower KIDMED scores. Both adolescents with normal weight and overweight/obesity manifested a reciprocal relation between diet and exercise self-efficacy. Multicomponent lifestyle interventions in the school environment may provide a first step in students’ behavior changes and provide grounds for future prevention programs in youth.

Low Healthy Diet Self-Efficacy and Intentions Associated with High Sweet Snacks and Sugar Sweetened Beverages Consumption among African American Adolescents Recruited from Low-Income Neighborhoods in Baltimore.

Psychosocial factors may influence consumption patterns of sweet snacks and sugar sweetened beverages (SSB), which are potential risk factors for obesity among African American (AA) adolescents. We used multivariable linear and logistic regression models to examine cross-sectional associations among psychosocial factors, sweet snacks and SSB consumption, and BMI z-scores in 437 AA adolescents aged 9–14 years living in low-income neighborhoods in Baltimore City, U.S.A. Mean caloric intake from sugar was 130.64 ± 88.37 kcal. Higher sweet snacks consumption was significantly associated with lower self-efficacy (adjusted Odds Ratio (aOR) = 0.81; 95% CI = 0.71 to 0.93) and lower food intentions scores (0.43; 0.30 to 0.61). Higher SSB consumption was associated with lower outcome expectancies (aOR = 0.98; 95% CI = 0.96–0.99), lower self-efficacy (0.98; 0.96 to 0.99), and lower food intentions (0.91; 0.87 to 0.95). No significant association was found between SSB and sweet snacks consumption and weight status. Psychosocial factors may play a role in sugar consumption behaviors among AA adolescents in low-income neighborhoods. Further studies are needed to improve our understanding of causal mechanisms of this association.

Trajectory Analysis and Predictors of the Percentage of Body Fat Among Chinese Sleeve Gastrectomy Patients.

BackgroundThe weight loss in Chinese patients after sleeve gastrectomy is different, and the differences can be evaluated through the trajectories of the percentage of body fat (BF%). Patients’ baseline psychosocial factors may be associated with these trajectories.Materials and MethodsWe selected 267 patients who received sleeve gastrectomy for the first time. The BF% at baseline and 1, 3, 6, 12 months after surgery and baseline psychosocial variables were retrospectively collected. The trajectory model was established according to BF% based on the growth mixture model. The baseline psychosocial variables were compared among different trajectory classes.ResultsFour types of trajectory classes were obtained. The differences in preoperative dietary self-efficacy, exercise self-efficacy, depression, social support, working status, alcohol consumption, and gender among the classes were statistically significant. The pairwise comparison of the above variables revealed that the differences of gender, dietary self-efficacy and exercise self-efficacy among classes were highly effective.ConclusionFemale gender, low dietary self-efficacy and low exercise self-efficacy were predictors for poor BF% trajectory in sleeve gastrectomy patients. Health professionals can early identify patients who are most likely to lose weight in a not-ideal manner based on the above predictors.

The Effects of Horticultural Activity Program on Vegetable Preference of Elementary School Students.

This study was conducted to investigate effects of a horticultural activity program based on a mediating variable model for improving vegetable preference among elementary students. A quasi-experimental design was employed with 136 students and 136 primary carers in Seoul, South Korea. Based on the mediation model for improving children’s vegetable preference, 12 sessions were conducted, including gardening, nutrition education, and cooking activities using harvests. The program was conducted weekly for 12 weeks from March to July 2019. To investigate the effect of this program, mediating factors of the children were evaluated before and after the program. Pearson correlation analysis was used to identify the mediating factors. The nutrition index, attitude, knowledge, and eating habits of the primary carers were evaluated. Results showed children’s nutrition and gardening knowledge, dietary self-efficacy, outcome expectancies, and vegetable preference were significantly improved (p < 0.001). Primary carers showed significant improvement in the nutrition index, knowledge, and attitude (p < 0.05). The correlation analysis confirmed that most of the mediating factors had significant correlations (p < 0.05). Therefore, administering a structured program involving horticultural activities and nutrition education as mediating factors for 12 sessions was effective in improving eating behavior for vegetables elementary school students and primary carers.

Evaluation of Associated Factors with Nutrition Behavior and Dietary Self-efficacy for Healthy Food Choice among Primary School Students

Objective: The aim of the study was to investigate the associated factors with nutrition behavior and dietary self-efficacy for healthy food choices among primary school students.&#x0D; &#x0D; Methods: The study is a cross-sectional research conducted with 4th grade students in the city center of Eskisehir in the 2018 academic year. The study group consisted of 402 students studying in six primary schools in the city center of Eskisehir. Data of the study were collected using a questionnaire including socio-demographic characteristics, Food Behavior Scale (FBS), and Children Dietary Self-efficacy Scale (CDSS).&#x0D; &#x0D; Results: The mean age of the students in the study group was 9.88 ± 0.44 years and 51.0% of the students were female. Of the participants 19.9% were overweight and 10.2% were obese. While female students in CDSS chose healthy food with a mean ± SD 65% ± 24 percentages, male students chose healthy food with a mean ± SD 55% ± 25 percentages (p

Predictors of long-term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis.

BackgroundSubstantial interindividual variability in response to behavioral weight loss interventions remains a critical challenge in obesity treatment. An improved understanding of the complex factors that contribute to this variability may improve obesity treatment outcomes.ObjectiveTo identify weight change trajectories during a behavioral weight loss intervention and to explore differences between trajectory groups in sociodemographic, biologic, behavioral, and psychosocial factors.MethodsAdults (n = 170, 40 ± 9 years, BMI 34 ± 4 kg/m2, 84% female) participated in an 18‐month behavioral weight loss intervention. Weight was measured at 0, 3, 6, 9, 12, 15, 18, and 24 months. Among participants with at least two weights after baseline (n = 140), clusters of longitudinal trajectories of changes in weight were identified using a latent class growth mixture model. The association between baseline factors or changes in factors over time and trajectory group was examined.ResultsTwo weight change trajectories were identified: “weight regainers” (n = 91) and “weight loss maintainers” (n = 49). Black participants (90%, 19/21) were more likely than non‐Black participants to be regainers versus maintainers (p < 0.01). Maintainers demonstrated greater increases in device‐measured physical activity, autonomous motivation for exercise, diet self‐efficacy, cognitive restraint, and engagement in weight management behaviors and greater reductions in barriers for exercise, disinhibition, and depressive symptoms over 24 months versus regainers (p < 0.05).ConclusionMaintainers and regainers appear to be distinct trajectories that are associated with specific sociodemographic, behavioral, and psychosocial factors. Study results suggest potential targets for more tailored, multifaceted interventions to improve obesity treatment outcomes.

Self-Efficacy for Healthy Eating Moderates the Impact of Stress on Diet Quality Among Family Child Care Home Providers

ObjectiveTo examine associations of stress and sleep with diet quality of family child care home (FCCH) providers, and whether self-efficacy for healthy eating influences these associations. DesignA cross-sectional analysis was performed using baseline data (2013–2015) from a randomized control trial with FCCH providers. ParticipantsThe study included 166 licensed FCCH providers, aged >18 years, from central North Carolina. Main Outcome Measure(s)Diet quality was assessed with a food frequency questionnaire, used to calculate a modified 2010-Healthy Eating Index score. Stress, sleep quality, and diet self-efficacy were measured via self-administered questionnaires. AnalysisUsing observations from 158 participants with complete data, multiple linear regression models were created to assess whether stress, sleep quality, and diet self-efficacy were associated with diet quality and whether diet self-efficacy moderated these associations (significance set at P < 0.05). ResultsIn the initial model, only diet self-efficacy was significantly associated with diet quality (β = 0.32; P < 0.001). Moderation analyses showed that higher stress was associated with lower diet quality, but only when diet self-efficacy was low. ConclusionsBuilding FCCH providers’ self-efficacy for healthy eating is an important component of health promotion and can buffer the impact of stress on their diet quality.

Associations of parenting factors and weight related outcomes in African American adolescents with overweight and obesity.

This study evaluated the associations between parenting factors and adolescent weight related outcomes in African American adolescents with overweight and obesity. Baseline heights and weights were collected from 241 African American adolescents (11-16years) with overweight and obesity. Self-reported adolescent perceptions of caregiver's parenting style (responsiveness, demandingness), parental feeding practices (monitoring, responsibility, weight related concerns, pressure-to-eat, and restriction), and their own dietary self-efficacy for healthy eating were assessed. Results demonstrated that greater parental responsiveness was significantly associated with lower adolescent body mass index (BMI) and higher adolescent dietary self-efficacy. In contrast, parental concern about adolescent weight was significantly associated with greater adolescent BMI, while greater parental responsibility for foods was associated with lower adolescent BMI. Although parental pressure-to-eat was significantly associated with higher dietary self-efficacy, greater parental restriction was associated with lower dietary self-efficacy. The results of this study highlight the importance of parental responsiveness and responsibility in understanding obesity related outcomes in African American adolescents with overweight and obesity.

Mediating role diet self-efficacy plays in the relationship between social support and diet self-management for patients with type 2 diabetes

BackgroundIt has previously been established that patients who have strong barriers to their diet self-management are more likely to have weak social support; however, the key mechanisms underlying the association between these two variables have not yet been established. This study aims to examine the potential role that diet self-efficacy plays in the relationship between social support and diet behavior in patients with type 2 diabetes mellitus (T2DM).MethodsIt was a cross-sectional survey. Three hundred-eighty patients diagnosed with T2DM were recruited for this study from five community health centers in China. The Chronic Disease Resource Scale (CIRS), Cardiac Diet Self-efficacy Scale (CDSE), and Food Control Behavior Scale (FCBS) were used to estimate participants’ utilization of social resources, diet self-efficacy, and diet self-management, respectively. The data were analyzed utilizing structural equation modelling.ResultsThe results suggest that both higher levels of social support and diet self-efficacy are related to higher levels of diet self-management. The mediating effect that diet self-efficacy has on the relationship between social support and diet self-management was significant (β = .30, p < .05), explaining 55.68% of the total effect of social support on diet self-management.ConclusionsDiet self-efficacy plays a mediating role in the association between social support and diet behavior in patients with type 2 diabetes mellitus.

Validity and reliability of a short self-efficacy instrument for hypertension treatment adherence among adults with uncontrolled hypertension

ObjectiveTo establish the reliability and validity of a self-report measure designed to assess self-efficacy for hypertension treatment adherence. MethodsThis investigation was embedded within a six-month randomized clinical trial (RCT), which demonstrated that a tailored, stage-matched intervention was more effective at improving hypertension control than usual care among individuals (n = 533) with repeated uncontrolled hypertension. The instrument used to assess self-efficacy for hypertension treatment adherence (SE-HTA) comprised three subscales that assessed diet self-efficacy (DSE), exercise self-efficacy (ESE), and medication self-efficacy (MSE). To determine SE-HTA validity and reliability, we assessed internal consistency using Cronbach’s α coefficients, conducted exploratory factor analysis, and evaluated convergent and discriminant validity, as well as test-retest reliability using Spearman’s ρ correlation coefficients. ResultsCronbach’s α (internal consistency) values for DSE, ESE, and MSE were 0.81, 0.82 and 0.74. Factor analysis and the scree plot demonstrated three distinct factors, which correspond to the three subscales contained in the SE-HTA instrument. SE-HTA possessed good convergent and discriminant validity, and moderate test-retest reliability. ConclusionThe SE-HTA instrument containing diet, exercise, and medication adherence subscales is valid and reliable in adults with uncontrolled hypertension. Practice implicationsThis SE-HTA instrument measures self-efficacy and could help facilitate behavior change in hypertension.

Barriers and Facilitators to Lifestyle Intervention Engagement and Weight Loss in People Living With Spinal Cord Injury.

Background: Individuals living with spinal cord injury (SCI) have a high prevalence of obesity and unique barriers to healthy lifestyle. Objective: To examine barriers and facilitators to engagement and weight loss among SCI participants enrolled in the Group Lifestyle Balance Adapted for individuals with Impaired Mobility (GLB-AIM), a 12-month intensive lifestyle intervention. Methods: SCI participants (N = 31) enrolled in a wait-list, randomized controlled trial where all participants received intervention between August 2015 and February 2017. Analyses of pooled data occurred in 2020 to examine cross-sectional and prospective associations of hypothesized barriers and facilitators with (1) intervention engagement, comprised of attendance and self-monitoring, and (2) percent weight change from baseline to 12 months. We performed multivariable linear regression on variables associated with outcomes at p < .05 in bivariate analyses and controlled for intervention group. Results: Participants were middle-aged (mean age, 48.26 ± 11.01 years), equally male (50%) and female, White (80.7%), and unemployed (65.6%). In participants who completed baseline surveys (n = 30), dietary self-efficacy explained 26% of variance in engagement (p < .01); among the 12-month study completers (n = 22, 71.0%), relationship issues explained 23% of variance in engagement (p < .01). Money problems, health issues unrelated to SCI, lack of motivation, and experimental group explained 57% of variance in weight loss (p for model < .01), with lack of motivation uniquely explaining 24% of variance (p < .01). Conclusion: Improving engagement and weight loss for persons with SCI in the GLBAIM program may be achieved by addressing lack of motivation, relationship issues, and nutrition self-efficacy.

The effect of affecting Dietary Self-Efficacy and Physical Activity Self-Efficacy on Health-Promoting Lifestyle in school-age obese children

The effect of affecting Dietary Self-Efficacy and Physical Activity Self-Efficacy on Health-Promoting Lifestyle in school-age obese children

A whole-food plant-based experiential education program for health care providers results in personal and professional changes.

Diet-related diseases are the primary contributor to morbidity and mortality. The risk for these diseases can be reduced with a whole-food plant-based (WFPB) diet, but most people are never counseled on this dietary pattern. An experiential education program was designed and conducted in which sample of 30 nurse practitioners, registered nurses, and physicians learned about and followed a WFPB diet for 3 weeks. The objective was for the health care providers to increase their knowledge and acceptance of WFPB diets and increase their likelihood of counseling patients on this dietary pattern. Participants completed preintervention and postintervention questionnaires assessing dietary intake, knowledge, weight, mood, energy, benefits, barriers, self-efficacy, and likelihood of continuing to follow, or counsel patients about a WFPB diet. Participants decreased intake of animal-derived foods, increased intake of WFPB foods, had improvements in mood and energy, and lost weight. Perceived barriers to following and counseling about a WFPB diet declined and self-efficacy improved. Participants were likely to continue a WFPB diet and discuss the diet with their patients. The three-week intervention changed providers' knowledge, skills, and attitudes about WFPB diets. If nurse practitioners and other providers accept WFPB diets, more patients may be educated on this dietary pattern, helping to reduce the burden of diet-related chronic diseases.

A Study on Effects of Nutrition Knowledge, Dietary Habits, and Dietary Self-Efficacy on Dietary Behavior in Nursing Students

A Study on Effects of Nutrition Knowledge, Dietary Habits, and Dietary Self-Efficacy on Dietary Behavior in Nursing Students

EatSmart, a Web-Based and Mobile Healthy Eating Intervention for Disadvantaged People With Type 2 Diabetes: Protocol for a Pilot Mixed Methods Intervention Study.

BackgroundPeople of low socioeconomic position (SEP) are disproportionately affected by type 2 diabetes (T2D), partly due to unhealthy eating patterns that contribute to inadequate disease self-management and prognosis. Digital technologies have the potential to provide a suitable medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge or shopping or cooking skills, in this target group.ObjectiveThis study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded, fully automated web-based and mobile-delivered healthy eating behavior change program to help disadvantaged people living with T2D to eat healthily on a budget and improve diabetes self-management.MethodsEatSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 18 to 75 years will be recruited. Participants will complete self-reported baseline assessments of their basic demographic and clinical data, dietary intake, dietary self-efficacy, and barriers to healthy eating. They will be provided with login access to the EatSmart web program, which includes six progressive skill-based modules covering healthy eating planning; smart food budgeting and shopping; time-saving meal strategies, healthy cooking methods, modifying recipes; and a final reinforcement and summary module. Over the 3-month intervention, participants will also receive 3 text messages weekly, encouraging them to review goals, continue to engage with different components of the EatSmart web program, and eat healthily. Participants will undertake follow-up assessments directly following the intervention 3 months post baseline and again after a 6-month postintervention follow-up period (9 months post baseline). Feasibility will be evaluated using the number of participants recruited and retained and objective indicators of engagement with the website. Program appeal and potential effects on primary and secondary outcomes will be assessed via the same surveys used at baseline, with additional questions asking about experience with and perceptions of the program. In-depth qualitative interviews will also be conducted 6 months post intervention to provide deeper insight into experiences with EatSmart and a more comprehensive description of the program’s appeal.ResultsThe EatSmart website has been developed, and all participants have viewed the modules as of May 2020. Results are expected to be submitted for publication in December 2020.ConclusionsThis study will provide data to address the currently limited evidence regarding whether disadvantaged populations with T2D may benefit from digitally delivered behavior change programs that facilitate eating healthily on a budget.Trial RegistrationAustralian New Zealand Clinical Trials Registry, ACTRN12619001111167; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001111167International Registered Report Identifier (IRRID)DERR1-10.2196/19488

Understanding influences on consumers’ dietary stress in healthy food buying

PurposeThis study aims to investigate relationships among body mass index (BMI), socioeconomic variables, dietary self-efficacy and consumer dietary stress in healthy food buying and explore whether different levels of personal values influence these relationships.Design/methodology/approachThe study is based on an online representative cross-sectional study with 380 food consumers. Structural equation modeling served to estimate direct, mediating and moderating effects between the studied constructs and variables.FindingsExamples of moderating and moderated mediating effects include a negative impact of BMI on dietary stress for consumers with low levels of enjoyment value but no significant effect for consumers with high levels of enjoyment. BMI also had a greater negative impact on dietary self-efficacy when the level of respect/achievement was high (vs low), and respect/achievement positively moderated the mediating effect of BMI on dietary stress through dietary self-efficacy.Research limitations/implicationsThis study focuses on analyzing healthy food buying in a particular cultural setting and may suffer from a lack of generalizability to other cultures. The results suggest that research should take into account personal values when investigating stress.Practical implicationsFood managers and health authorities can improve their ability to reduce dietary stress when addressing consumers by understanding the role of personal values in healthy food choice and the impact on mental well-being.Originality/valueThis study offers a novel, more fine-grained conceptual model of how consumers develop dietary stress when buying healthy food.