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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
To examine associations of the frequency of eating at fast-food restaurants with demographic, behavioural and psychosocial factors and dietary intake in African American adults.
Self-reported data from a population-based cross-sectional survey of 658 African Americans, aged 20–70 years, in North Carolina. An 11-page questionnaire assessed eating at fast-food restaurants, demographic, behavioural and diet-related psychosocial factors, and dietary intake (fruit, vegetable, total fat and saturated fat intakes, and fat-related dietary behaviours).
The participants were aged 43.9±11.6 years (mean±standard deviation), 41% were male, 37% were college graduates and 75% were overweight or obese. Seventy-six per cent reported eating at fast-food restaurants during the previous 3 months: 4% usually, 22% often and 50% sometimes. Frequency of eating at fast-food restaurants was positively associated with total fat and saturated fat intakes and fat-related dietary behaviours (P < 0.0001) and inversely associated with vegetable intake (P < 0.05). For example, mean daily fat intake was 39.0 g for usually/often respondents and 28.3 g for those reporting rare/never eating at fast-food restaurants. Participants who reported usual/often eating at fast-food restaurants were younger, never married, obese, physically inactive and multivitamin non-users (all P < 0.01). Frequency of eating at fast-food restaurants was positively associated with fair/poor self-rated health, weak belief in a diet–cancer relationship, low self-efficacy for healthy eating, weight dissatisfaction, and perceived difficulties of preparing healthy meals and ordering healthy foods in restaurants (all P < 0.05). Frequency of eating at fast-food restaurants did not differ significantly by sex, education, smoking, ability to purchase healthy foods or knowledge of the Food Guide Pyramid.
Eating at fast-food restaurants is associated with higher fat and lower vegetable intakes in African Americans. Interventions to reduce fast-food consumption and obesity in African Americans should consider demographic and behavioural characteristics and address attitudes about diet–disease relationships and convenience barriers to healthy eating.
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