Dietary Self-efficacy Research Articles

Self-Efficacy and Self-Reported Dietary Behaviors in Adolescents at an Urban School With No Competitive Foods.

Over one third of U.S. adolescents are overweight. A descriptive, cross-sectional study examined the relationship between student dietary self-efficacy (SE), sugar-sweetened beverages, and low-nutrient energy-dense food consumption, and exposure to a healthy school food environment without competitive foods. The sample consisted of 292 urban, primarily African American students aged 11 to 16 years. Mantel-Haenszel χ(2) analyses revealed a significant but weak linear trend for girls between number of school meals and SE to drink less soda, χ(2)(1) = 6.882, p = .008, and between semesters attended with SE to eat more fruits and vegetables, χ(2)(1) = 5.908, p = .015. Obese students had significantly higher scores for two SE items than nonobese students, that is, plan better nutrition, χ(2)(1) = 3.998, p = .045, and eat healthy at a fast-food restaurant, χ(2)(1) = 4.078, p = .043. Further study of adolescent SE for healthy eating and school-based, food-focused obesity prevention interventions is needed.

간호대학생의 체질량지수와 채소섭취 행동변화단계별 식이효능감, 비만스트레스, 비만관련 삶의 질 비교

Purpose This study was carried outto compare dietary self-efficacy, obesity stress, and obesity-related quality of life (OQOL) according to BMI and stages of change in vegetable consumption. Method A convenience sample of 326 nursing students agreed to complete a questionnaire. Data were collected from October 7 to October 18, 2013. Result Obesity stress and obesity-related quality of life were significantly different according to BMI. Dietary self-efficacy showed a significant difference between the pre-contemplation/contemplation stage, preparation stage, and action/maintenance stage (F=50.18, p<.001). With obesity stress, there was a significant difference between the PC/C, P, and A/M stages (F=17.63, p<.001). Dietary self-efficacy had a positive correlation with OQOL (r=.11, p<.001) and a negative correlation with obesity stress (r=-.14, p=.012). And obesity stress had a negative correlation with OQOL (r=-.45, p<.001). Conclusion These findings emphasize that nutritional-intervention programs for changes in behavior during the PC/C and P stages of change in vegetable consumption need to develop strategies to enhance dietary self-efficacy for nursing students. Keywords: BMI, Behavior, Self-efficacy, Obesity stress, Quality of life 주요어: 체질량지수, 행동, 식이효능감, ë¹„ë§ŒìŠ¤íŠ¸ë ˆìŠ¤, 삶의 질

Predictors of initial weight loss among women with abdominal obesity: a path model using self-efficacy and health-promoting behaviour.

To identify predictors of initial weight loss among women with abdominal obesity by using a path model. Successful weight loss in the initial stages of long-term weight management may promote weight loss maintenance. A longitudinal study design. Study participants were 75 women with abdominal obesity, who were enrolled in a 12-month Community-based Heart and Weight Management Trial and followed until a 6-month assessment. The Weight Efficacy Lifestyle, Exercise Self-Efficacy and Health Promoting Lifestyle Profile-II measured diet self-efficacy, exercise self-efficacy and health-promoting behaviour respectively. All endogenous and exogenous variables used in our path model were change variables from baseline to 6months. Data were collected between May 2011-May 2012. Based on the path model, increases in both diet and exercise self-efficacy had significant effects on increases in health-promoting behaviour. Increases in diet self-efficacy had a significant indirect effect on initial weight loss via increases in health-promoting behaviour. Increases in health-promoting behaviour had a significant effect on initial weight loss. Among women with abdominal obesity, increased diet self-efficacy and health-promoting behaviour were predictors of initial weight loss. A mechanism by which increased diet self-efficacy predicts initial weight loss may be partially attributable to health-promoting behavioural change. However, more work is still needed to verify causality. Based on the current findings, intensive nursing strategies for increasing self-efficacy for weight control and health-promoting behaviour may be essential components for better weight loss in the initial stage of a weight management intervention.

Diet self-efficacy and physical self-concept of college students at risk for eating disorders

Background: Both eating disorders and body image dissatisfaction affect a high proportion of college students. Self-esteem and self-efficacy may be protective factors for eating disorders. The aim of this study was to evaluate diet self-efficacy, the confidence to maintain or lose weight, and its association with physical self-concept using data from an online survey of health literacy, body image and eating disorders. Methods: This cross-sectional study collected online survey data from college student within the United States. The inclusion criteria allowed for 1612 college students, ages 17-35 years (597 males, 1015 females) belonging to the following racial/ethnic categories: Black (187); White, non-Hispanic (244), Hispanic (1035), and Other (146). Specifically, the study aimed to examine a) whether and to what degree diet self-efficacy and physical self-concept were associated with risk of eating disorders; b) the interaction of gender by ethnicity on diet self-efficacy, physical self-concept and risk of eating disorders; and, c) the relationship of diet self-esteem with physical self-description and body mass index in college students. Results: Negative dieting self-efficacy was associated with a lower score on physical self-concept [B = -0.52 (-0.90,-0.15), p = .007]. Males had a higher physical self-concept as compared to females [B = 14.0 (8.2, 19.8), p

Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial.

Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM). Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n = 24) or wait control (n = 26) and postintervention qualitative interviews with participants. Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up. Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance. Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

아동과 청소년의 식이자기효능감, 사회적 지지, 우울 및 체중조절행위 간의 관계

This study examines the relationships between dietary self-efficacy, social support, depression, and weight-control behavior of children and adolescents. A total of 593 students (280 children and 313 adolescents) from schools in Seoul, Gyeonggi-do, Jeollabuk-do, and Daegu were surveyed using scales for dietary self-efficacy, social support, depression, and weight-control behavior. The data were analyzed through a frequency analysis, means and standard deviations, a t-test, a one-way ANOVA, the Tukey test, the Pearson's correlation, and a stepwise multiple regression analysis. According to the results, weight-control behavior was more likely in girls than boys, high-school students than elementary-school students, and obese/overweight students than normal/underweight students. The factors influencing children's weight-control behavior were general eating habits, the BMI, depression, food choice, and family support, in that order, and those influencing adolescents' weight-control behavior were general eating habits, gender, and the BMI, in that order. These results are expected to be useful as basic data for developing weight-control programs for children and adolescents.

The effects of the DASH diet education program with omega-3 fatty acid supplementation on metabolic syndrome parameters in elderly women with abdominal obesity.

BACKGROUND/OBJECTIVESThe purpose of this study was to investigate the overall effects of a tailored Dietary Approaches to Stop Hypertension (DASH) nutritional intervention program which included omega-3 fatty acids supplementation, on dietary self-efficacy, dietary knowledge, and dietary behaviors in Korean elderly women with abdominal obesity. Furthermore, we investigated the effects of the program on metabolic syndrome parameters including the antioxidant capacities in these subjects.SUBJECTS/METHODSA randomized, controlled trial was conducted for 8 weeks. The experimental group (n = 21) received a weekly tailored nutritional program for 8 weeks and the control group (n = 18) received only one educational session. The clinical survey was conducted before and after the intervention period.RESULTSAfter the intervention, dietary self-efficacy (P = 0.023), frequency of fruit intake (P = 0.019), and dietary fiber intake (P = 0.044) were higher in the experimental group than in the control group. The oxidative stress (P < 0.001) was lower in the experimental group than in the control group. Moreover, low density lipoprotein (LDL) cholesterol (P = 0.023) had significantly decreased in the experimental group but not in the control group after the intervention.CONCLUSIONSThe intervention program including omega-3 fatty acid supplementation had a positive effect on dietary self-efficacy, dietary behaviors, and oxidative stress among aged women with abdominal obesity.

Lifestyle Intervention for Filipino Americans at Risk for Diabetes

The aims of this study were to determine recruitment and retention feasibility, changes in self-efficacy for diet and exercise, and weight and fasting insulin level change after a lifestyle intervention in a community park. A randomized wait-list control design was used to recruit 50 Filipino American participants into a flexible eight-week curriculum. The retention rate was 88%. A weight loss of 1.52 kg (p < .05) and a waist reduction of 5.46 cm (p < .05) were found in the intervention group. Significant predictors for weight loss were gender and marital status. The intervention showed promise for this community program.

생활습관개선 프로그램이 성인의 식이행동과 신체활동 및 심혈관위험요인에 미치는 효과: 중재 3개월 결과를 중심으로

Objectives: The aim of this study was to evaluate the effects of a lifestyle modification program for Korean adults with cardiovascular disease risk factors on their health behaviors and health status. Methods: A total of 448 adults with abdominal obesity and additional cardiovascular disease risk factors(high blood pressure, low HDL-cholesterol, high triglyceride or high blood glucose) were randomly assigned to either an intensive intervention group (IIG, n=216) or a minimal intervention group(MIG, n=232). Participants in the IIG received lifestyle modification program which consisted of health counseling with nutrition assessment, health booklet and health diary, while those in MIG received minimal information. Results: The participants in the IIG significantly improved dietary habits(p<.05), retrained eating(p<.001), external eating(p<.01) behaviors, leisure time physical activity(p<.05), dietary self-efficacy(p<.01), exercise self-efficacy(p<.01) and MetS score(p<.001) after 3 months. In addition, the participants in the IIG showed more improvement in dietary habits(p<.05) compared with those in the MIG. Conclusion: The lifestyle modification program was effective in improving some health

Psychometric evaluation of dietary self-efficacy and outcome expectation scales in female college freshmen.

Lifestyle interventions commonly measure psychosocial beliefs as precursors to positive behavior change, but often overlook questionnaire validation. This can affect measurement accuracy if the survey has been developed for a different population, as differing behavioral influences may affect instrument validity. The present study aimed to explore psychometric properties of self-efficacy and outcome expectation scales-originally developed for younger children-in a population of female college freshmen (N = 268). Exploratory principal component analysis was used to investigate underlying data patterns and assess validity of previously published subscales. Composite scores for reliable subscales (Cronbach's α ≥ .70) were calculated to help characterize self-efficacy and outcome expectation beliefs in this population. The outcome expectation factor structure clearly comprised of positive (α = .81-.90) and negative outcomes (α = .63-.67). The self-efficacy factor structure included themes of motivation and effort (α = .75-.94), but items pertaining to hunger and availability cross-loaded often. Based on cross-loading patterns and low Cronbach's alpha values, respectively, self-efficacy items regarding barriers to healthy eating and negative outcome expectation items should be refined to improve reliability. Composite scores suggested that eating healthfully was associated with positive outcomes, but self-efficacy to do so was lower. Thus, dietary interventions for college students may be more successful by including skill-building activities to enhance self-efficacy and increase the likelihood of behavior change.

A brief intervention increases fruit and vegetable intake. A comparison of two intervention sequences

Background and Purpose: To evaluate the effectiveness of two subsequent intervention components (motivational and self-regulatory components), placed in different order, to promote fruit and vegetable (FV) intake. Methods: After baseline assessment, university students (N = 205, aged 18–26 years) were allocated to two groups. One group received a motivational intervention (outcome expectancies, risk perception, and task self-efficacy) followed by a self-regulatory intervention (planning and dietary self-efficacy) after 17 days. The second group received the same intervention conditions in the opposite order. Follow-up assessments were done after another 17 days. Results: Both intervention sequences yielded gains in terms of FV intake and self-efficacy. However, this gain was only due to the self-regulatory component whereas the motivational component did not contribute to the changes. Moreover, changes in intention and self-efficacy mediated between intervention sequence and follow-up behavior, suggesting that improving these proximal predictors of FV intake was responsible for the behavioral gains. Conclusions: Findings highlight the superiority of a self-regulatory intervention over a motivational intervention when it comes to dietary changes in this sample of young adults. Moreover, changes in dietary self-efficacy may drive nutritional changes.

Intervention completion rates among African Americans in a randomized effectiveness trial for diet and physical activity changes.

The intervention completion rate is an important metric in behavioral and intervention research; trials with limited intervention completion rates may have reduced internal validity. We examined intervention completion rates among 530 African Americans who had been randomized to an integrated (INT) or disease-specific (DSE) risk education protocol as part of a comparative effectiveness trial from September 2009 to August 2012. The interventions were developed by an academic-community partnership using community-based participatory research. Intervention completion rates were determined based on attendance at all four intervention sessions. Intervention completers were participants who completed all four sessions and noncompleters were those who did not complete any session or only completed one to three sessions following randomization. Seventy-three percent of participants were intervention completers and 27% were noncompleters. There were no differences in intervention completion based on randomization to INT (72%) or DSE (75%), sociodemographic factors, or body mass index (BMI) in the total sample. Different factors were associated significantly with intervention completion within study groups. Among participants randomized to INT, the odds of intervention completion were greater with higher levels of intrinsic motivation, less exposure to information about diet and cardiovascular disease, and greater BMI. Among participants randomized to DSE, the odds of completing the intervention were associated significantly with older age and greater dietary self-efficacy. Many African Americans are likely to complete risk education interventions. Psychologic characteristics should be considered when determining intervention completion rates following randomization in behavioral and intervention trials.

Dietary self-efficacy predicts AHEI diet quality in women with previous gestational diabetes.

The purpose of this study was to examine the association of intrapersonal influences of diet quality as defined by the Health Belief Model constructs in women with recent histories of gestational diabetes. A descriptive, correlational, cross-sectional design was used to analyze relationships between diet quality and intrapersonal variables, including perceptions of threat of type 2 diabetes mellitus development, benefits and barriers of healthy eating, and dietary self-efficacy, in a convenience sample of 75 community-dwelling women (55% minority; mean age, 35.5 years; SD, 5.5 years) with previous gestational diabetes mellitus. Diet quality was defined by the Alternative Healthy Eating Index (AHEI). Multiple regression was used to identify predictors of AHEI diet quality. Women had moderate AHEI diet quality (mean score, 47.6; SD, 14.3). Only higher levels of education and self-efficacy significantly predicted better AHEI diet quality, controlling for other contributing variables. There is a significant opportunity to improve diet quality in women with previous gestational diabetes mellitus. Improving self-efficacy may be an important component to include in nutrition interventions. In addition to identifying other important individual components, future studies of diet quality in women with previous gestational diabetes mellitus are needed to investigate the scope of influence beyond the individual to potential family, social, and environmental factors.

Heart healthy online: an innovative approach to risk reduction in the workplace.

To examine whether a Web-based cardiovascular health promotion program was associated with changes in self-reported behaviors, attitudes, and biometric indicators in a population of working adults. Employees (n = 210) were recruited and randomized into either an Internet-based or control condition. Participants completed pre- and postintervention self-report assessments on diet, exercise, smoking, and mental health. Pre- and postintervention biometric screenings were also obtained on blood pressure, heart rate, weight, and hip/waist circumference. The intervention was associated with significant improvements in dietary attitudes (P = 0.003; F = 8.83), dietary intentions (P = 0.031; F = 4.72), dietary self-efficacy (P = 0.015; F = 5.97), exercise self-efficacy (P = 0.002; F = 9.51), exercise habits (P = 0.016; F = 5.94), and coping with stress (P = 0.003; F = 8.85) and depression (P = 0.036; F = 4.46). The program showed promise for promoting cardiovascular risk reduction behaviors. These results are consistent with similar Web-based interventions.

Using Health Information Technology to Prevent and Treat Diabetes

Using Health Information Technology to Prevent and Treat Diabetes

Do Health-Related Feared Possible Selves Motivate Healthy Eating?

The question of what motivates individuals to assume healthy eating habits remains unanswered. The purpose of this descriptive survey is to explore health-related feared possible selves in relation to dietary beliefs and behavior in adults. A convenience sample of 74 middle-aged employees of a health maintenance organization completed self-administered questionnaires. Health-related feared selves, current health perception, knowledge of diet-health association, dietary self-efficacy, dietary intention and intake were measured. Health-related fears were the most frequently reported feared selves, but very few of those represented illnesses and none were related to dietary intake. The number of health and body weight related fears was significantly associated with lower dietary self-efficacy and weaker intention to eat in a healthy manner. Multivariate analysis showed self-efficacy to be the only significant predictor of dietary intention. These adults may not have perceived being at risk for diet-associated illnesses, and so their feared selves did not motivate them to eat in a healthy manner. Research on the effect of hoped for health related possible selves and the perceived effectiveness of diet in reducing health risk are recommended.

The Effect of Computerized Feedback on College Students’ Dietary Self-efficacy, Knowledge, Beliefs, and Behaviors

The Effect of Computerized Feedback on College Students’ Dietary Self-efficacy, Knowledge, Beliefs, and Behaviors

A multi-perspective focus-group approach to revise items in a dietary self-efficacy scale for older Taiwanese adults

To revise items in the Cardiac Diet Self-Efficacy Scale, Chinese version (CDSE-C) using focus groups. There is limited literature on using focus groups with older adults as well as nursing and nutrition professionals to revise a questionnaire. A qualitative research with multi-perspective focus-group approach was used from February through June 2009. Four serial focus groups were conducted including two focus groups of older adults from Taipei County (n = 6) and Yilan County (n = 6), one group of 5 nursing professionals, and one group of 4 nutritionists. Serial focus group discussions added one category to the CDSE-C (reducing salt) and 3 items, resulting in an 18-item scale with six categories: healthy eating behaviors, reducing fat and cholesterol, resisting relapse, increasing fiber and vegetable, reducing sugar, and reducing salt. This revised measure can serve as a reliable tool for assessing older Chinese adults' healthy eating self-efficacy to evaluate and improve nutritional status in this population.

Collective Efficacy and Obesity-Related Health Behaviors in a Community Sample of African Americans

The social environment is important to body mass index and obesity. However, it is unknown if perceptions of the social environment are associated with obesity-related behaviors in populations at greatest risk for being overweight or obese. We evaluated the relationship between collective efficacy and diet and physical activity in a community-based sample of African American adults who were residents in an urban area. Data were collected as part of an academic-community partnership from November 2009 to 2011. We evaluated whether participants met the recommended guidelines for diet and physical activity based on collective efficacy and their sociodemographic background, health care variables, and self-efficacy in a community-based sample of African American adults (n=338) who were residents in the Philadelphia, PA metropolitan area. Overall, many participants did not meet the recommended guidelines for fruit and vegetable intake or physical activity. The likelihood of meeting the recommended guidelines for fruit intake increased with greater levels of collective efficacy (OR 1.56, 95% CI 1.18, 2.07, p=0.002) and self-efficacy for diet (OR 1.56, 95% CI 1.19, 2.04, p=0.001). Collective efficacy was not associated with physical activity and the positive association between collective efficacy and vegetable intake was not statistically significant (OR 1.25, 95% CI 0.94, 1.65, p=0.12). It is important to determine the most effective methods and settings for improving diet and physical activity behaviors in urban African Americans. Enhancing collective efficacy may be important to improving adherence to recommended guidelines for obesity-related health behaviors.

Factors associated with health-related quality of life among overweight or obese adults.

To identify factors associated with health-related quality of life among overweight or obese adults. The obesity epidemic presents a global challenge. Obesity is associated with lower health-related quality of life; however, no study has comprehensively examined correlates of health-related quality of life in this population. A cross-sectional design. The physical component score, mental component score and eight domain scores of the Short Form-36 v2 were used to assess health-related quality of life. We identified 23 possible correlates of health-related quality of life, including age, body mass index, health and weight histories, perceived stress, cholesterol-lowering diet self-efficacy, problem-solving, binge eating, dietary intake and physical activity. Correlational analyses were used to examine the bivariate associations between correlates and health-related quality of life variables. All possible subsets regression was used to develop predictive models of health-related quality of life. The sample (n = 210) was predominantly White (84·8%), female (78·1%) and middle-aged (average age = 46·80 years). Age, body mass index, education, having children at home, and being hypertensive were identified as the best predictors of physical component score, explaining about 9% of the variance. Age, marital status, having hyperlipidaemia, perceived stress, problem-solving, self-efficacy, binge eating and barriers to healthy eating predicted mental component score, explaining approximately 48% of the variance. Physical functioning and role physical domains of health-related quality of life had similar sets of predictors, with 15% and 13% of the variance explained, respectively, while similar predictors were identified for bodily pain (6%), general health (26%), vitality (40%), social functioning (32%), role emotional (42%) and mental health (46%) domains. Psychosocial factors were associated with the mental-related quality of life. Further exploration of factors related to physical-related quality of life is warranted in this population. When working with overweight/obese adults who are trying to lose weight, nurses need to consider socio-demographic and psychosocial factors in the development of a treatment plan that will improve health-related quality of life in this population.