Promoting fruit and vegetable consumption. Testing an intervention based on the theory of planned behaviour

This study evaluated the efficacy of a theory of planned behaviour (TPB) based intervention to increase fruit and vegetable consumption. The extent to which fruit and vegetable consumption and change in intake could be explained by the TPB was also examined. Participants were randomly assigned to two levels of intervention frequency matched for intervention content (low frequency n=92, high frequency n=102). Participants received TPB-based email messages designed to increase fruit and vegetable consumption, messages targeted attitude, subjective norm and perceived behavioural control (PBC). Baseline and post-intervention measures of TPB variables and behaviour were collected. Across the entire study cohort, fruit and vegetable consumption increased by 0.83 servings/day between baseline and follow-up. Intention, attitude, subjective norm and PBC also increased (p<.05). The TPB successfully modelled fruit and vegetable consumption at both time points but not behaviour change. The increase of fruit and vegetable consumption is a promising preliminary finding for those primarily interested in increasing fruit and vegetable consumption. However, those interested in theory development may have concerns about the use of this model to explain behaviour change in this context. More high quality experimental tests of the theory are needed to confirm this result.

[1]  C. Nowson,et al.  Fruit and vegetable consumption and stroke: meta-analysis of cohort studies , 2006, The Lancet.

[2]  P. Amouyel,et al.  Fruits, vegetables and coronary heart disease , 2009, Nature Reviews Cardiology.

[3]  J. Mindell,et al.  Health Survey for England 2006. Cardiovascular disease and risk factors in adults , 2008 .

[4]  G. Kok,et al.  Intervention Mapping - Designing Theory and Evidence-Based Health Promotion Programs , 2000 .

[5]  Marie Johnston,et al.  Application of the Theory of Planned Behaviour in Behaviour Change Interventions: A Systematic Review , 2002 .

[6]  J. Karski [Health promotion]. , 1993, Wiadomosci lekarskie.

[7]  P. L. White,et al.  National nutrition survey. , 1973, JAMA.

[8]  D. C. Howell Statistical Methods for Psychology , 1987 .

[9]  C. Abraham,et al.  Interventions to change health behaviours: evidence-based or evidence-inspired? , 2004 .

[10]  Jennifer S. Mindell,et al.  Health Survey for England 2008 , 2009 .

[11]  Philippe Amouyel,et al.  Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. , 2006, The Journal of nutrition.

[12]  G. Kok,et al.  The Theory of Planned Behavior: A Review of its Applications to Health-Related Behaviors , 1996, American journal of health promotion : AJHP.

[13]  J. Grimshaw,et al.  Constructing questionnaires based on the theory of planned behaviour: A manual for health services researchers , 2004 .

[14]  Charles Abraham,et al.  RCT of a theory-based intervention promoting healthy eating and physical activity amongst out-patients older than 65 years. , 2004, Social science & medicine.

[15]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[16]  B. Mullan,et al.  Randomised controlled trial of a brief theory-based intervention promoting breakfast consumption , 2011, Appetite.

[17]  R. Shaban,et al.  ‘The Australian Immunisation Handbook 8th Edition’. National Health and Medical Research Council, Australian Government. Canberra: Commonwealth of Australia; 2003. 350 pages, ISBN 0-642-82204-2 , 2015 .

[18]  I. Ajzen The theory of planned behavior , 1991 .

[19]  R. Hide National nutrition survey. , 1992, Papua and New Guinea medical journal.

[20]  Gaston Godin,et al.  Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review , 2010, The international journal of behavioral nutrition and physical activity.

[21]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[22]  I. Ajzen,et al.  Predicting and Changing Behavior: The Reasoned Action Approach , 2009 .

[23]  Madhavi Bajekal,et al.  Health Survey for England , 2004 .

[24]  K. Lohr,et al.  The efficacy of behavioral interventions to modify dietary fat and fruit and vegetable intake: a review of the evidence. , 2002, Preventive medicine.

[25]  W. Kroeze,et al.  A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors , 2006, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[26]  W. James,et al.  A life course approach to diet, nutrition and the prevention of chronic diseases , 2004, Public Health Nutrition.

[27]  L. Nebeling,et al.  Psychosocial predictors of fruit and vegetable consumption in adults a review of the literature. , 2008, American journal of preventive medicine.

[28]  Barbara Mullan,et al.  An extension of the theory of planned behavior to predict immediate hedonic behaviors and distal benefit behaviors , 2011 .

[29]  S. Michie,et al.  Using the Internet to Promote Health Behavior Change: A Systematic Review and Meta-analysis of the Impact of Theoretical Basis, Use of Behavior Change Techniques, and Mode of Delivery on Efficacy , 2010, Journal of medical Internet research.

[30]  D. Ciliska,et al.  Effectiveness of Community-Based Interventions to Increase Fruit and Vegetable Consumption , 2000 .

[31]  Tapabrata Maiti,et al.  Principles and Practice of Structural Equation Modeling (2nd ed.) , 2006 .

[32]  Karen Glanz,et al.  The Use of Theory in Health Behavior Research from 2000 to 2005: A Systematic Review , 2008, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[33]  Alice Bows,et al.  Evidence to House of Lords Science and Technology Select Committee on Behaviour Change – Travel-Mode Choice Interventions to Reduce Car Use in Towns and Cities , 2011 .

[34]  B. Mullan,et al.  Predicting breakfast consumption: an application of the theory of planned behaviour and the investigation of past behaviour and executive function. , 2009, British journal of health psychology.

[35]  Mark A Elliott,et al.  Promoting drivers' compliance with speed limits: testing an intervention based on the theory of planned behaviour. , 2009, British journal of psychology.

[36]  M. Conner,et al.  Extending the Theory of Planned Behavior: A Review and Avenues for Further Research , 1998 .

[37]  M. Mckee,et al.  Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature. , 2005, The Journal of nutrition.

[38]  C. Abraham,et al.  A taxonomy of behavior change techniques used in interventions. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[39]  Rex B. Kline,et al.  Principles and Practice of Structural Equation Modeling , 1998 .

[40]  S. Michie,et al.  Theory of planned behaviour cognitions do not predict self-reported or objective physical activity levels or change in the ProActive trial. , 2011, British journal of health psychology.

[41]  J. Who,et al.  Diet, nutrition and the prevention of chronic diseases : report of a Joint WHO/FAO Expert Consultation , 2003 .

[42]  B. Mullan,et al.  Self-regulation versus habit: The influence of self-schema on fruit and vegetable consumption , 2012, Psychology & health.

[43]  Ralf Schwarzer,et al.  Self-efficacy in the adoption and maintenance of health behaviors: Theoretical approaches and a new model. , 1992 .

[44]  A L Le Faou,et al.  Health promotion in France. Toward a new way of giving medical care. , 1995, Hospital topics.

[45]  M. Mckee,et al.  Getting children to eat more fruit and vegetables: a systematic review. , 2006, Preventive medicine.

[46]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[47]  M. Conner,et al.  Efficacy of the Theory of Planned Behaviour: a meta-analytic review. , 2001, The British journal of social psychology.