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To examine associations of various psychosocial factors with fruit and
vegetable intake in African-American adults.
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.
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.
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
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