a1 Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
a2 Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
a3 Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
a4 Center for Gastrointestinal Biology and Disease, Division of Digestive Diseases and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Objective To examine associations of various psychosocial factors with fruit and vegetable intake in African-American adults.
Methods A cross-sectional survey of a population-based sample of 658 African-Americans, aged 18–70 years, in North Carolina. Information was collected on diet-related psychosocial (predisposing, reinforcing and enabling) factors based on the PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation) planning framework; demographic, lifestyle and behavioural characteristics, and fruit and vegetable intake.
Results The mean participant age was 43.9 years (standard deviation 11.6), 57% were female and 76% were overweight/obese. Participants expressed healthy beliefs regarding many of, but not all, the psychosocial factors. For example, although half of the respondents believed it is important to eat a diet high in fruits/vegetables, only 26% knew that ≥ 5 daily servings are recommended. The strongest associations of the psychosocial factors with fruit/vegetable intake were for predisposing factors (e.g. belief in the importance of a high fruit/vegetable diet and knowledge of fruit/vegetable recommendations) and one reinforcing factor (social support), with differences between the healthiest and least healthy responses of 0.5–1.0 servings per day. There was evidence of effect modification by gender in associations between psychosocial factors and fruit/vegetable consumption (e.g. self-efficacy was only significant in women), with higher intakes and generally healthier responses to the psychosocial variables in women than men.
Conclusions Interventions to increase fruit/vegetable intake in African-Americans may be more effective if they focus primarily on predisposing factors, such as knowledge, self-efficacy and attitudes, but not to the exclusion of reinforcing and enabling factors. The psychosocial factors that are targeted may also need to be somewhat different for African-American men and women.
(Received June 08 2006)
(Accepted November 21 2006)
(Online publication February 20 2007)