Abstract
Objective
To confirm the applicability of the Health Action Process Approach in predicting and
explaining the healthy dietary behavior of college students.
Design
Cross-sectional survey. The data were collected though the self-administrated questionnaires.
Setting
Eight universities in Shanxi province, China.
Participants
A total of 1,933 undergraduates were randomly selected using random cluster sampling
from Shanxi, China (92.0% response; 31.7% males).
Main Outcome Measures
Each variable was measured using questionnaires.
Analysis
Data were analyzed by 2-sample t test, linear correlation, and path analysis. Significance was set at P < .05.
Results
Risk perception, self-efficacy, and positive expectancy began functioning during the
intention formation stage (P < .01). Outcome expectancy, self-efficacy, and behavioral intentions had a predictive
role in plan formation (P < .001). Action planning, positive expectancy, and self-efficacy were effective predictors
of dietary behavior (P < .001). An action plan was a mediator between behavioral intention and dietary behavior;
the mediation effect was 0.086.
Conclusions and Implications
As a first step, application of Health Action Process Approach to the dietary behavior
of Chinese college students was confirmed. Future research expanding on this study
could consider including additional sociodemographic factors in the model structure
using a broader study population.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessSNEB Member Login
SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.Subscribe:
Subscribe to Journal of Nutrition Education and BehaviorAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Analyses of research on the health of college students based on a perspective of knowledge mapping.Public Health. 2016; 137: 188-191
- Research collaboration in health management research communities.BMC Med Inform Decis Mak. 2013; 13: 52
- Dietary behaviors and body image recognition of college students according to the self-rated health condition.Nutr Res Pract. 2008; 2: 107-113
- A survey of dietary intake and nutritional status of college students [in Chinese].Modern Food Sci Technol. 2008; 24: 173-176
- Relationship between sub-health status and dietary nutrition among 1 078 college students of a university in Nanning City [in Chinese].J Mod Med Health. 2016; 32 (3266): 3261-3262
- Evaluation of dietary quality of university students in Shanxi province by DRI [in Chinese].Chin J Sch Health. 2013; 34: 1412-1414
- Investigation on the health and dietary instruction among university students [in Chinese].Modern Prev Med. 2012; 39: 2157-2158
- Effect of nutrition intervention using a general nutrition course for promoting fruit and vegetable consumption among college students.J Nutr Educ Behav. 2009; 41: 103-109
- Associations between multiple health risk behaviors and mental health among Chinese college students [in Chinese].Psychol Health Med. 2016; 21: 377-385
- Changes in eating attitudes, eating disorders and body weight in Chinese medical university students.Int J Soc Psychiatry. 2013; 59: 578-585
- Using theories of behavior change to inform interventions for addictive behaviors.Addiction. 2010; 105: 1879-1892
- Learning Theory.Cambridge University Press, Cambridge, UK2007
- Social Foundations of Thought and Action: A Social Cognitive Theory.Prentice-Hall, Upper Saddle River, NJ1986
- Using the theory of reasoned action (TRA) to understand the decision to use condoms in an STD clinic population.Health Educ Q. 1996; 23: 528
- Using an extended theory of planned behaviour to understand smoking amongst schoolchildren.Addict Res Theory. 2009; 13: 239-306
- Predictive value of aspects of the Transtheoretical Model on smoking cessation in a community-based, large-group cognitive behavioral program.Addict Behav. 2003; 28: 725-740
- A Response to Dolan.in: Oliver A Behavioural Public Policy. Cambridge University Press, Cambridge, UK2013: 209-215
- Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults.Cochrane Database Syst Rev. 2011; (CD008066)
- I act, therefore I am: athletic identity and the health action process approach predict sport participation among individuals with acquired physical disabilities.Psychol Sport Exerc. 2012; 13: 713-720
- Self-efficacy in the adoption and maintenance of health behaviors: theoretical approaches and a new model.Oncologist. 1992; 17: 217-243
- Study of college students' health management based on the Health Action Process Approach (HAPA)—taking the health dietary behaviors for example [master's thesis].Shanxi Medical University, Taiyuan, China2016
- Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA).Rehabil Psychol. 2011; 56: 161-170
- Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors.Appl Psychol. 2008; 57: 1-29
- Self-efficacy and behavioral enactment: the application of Schwarzer's Health Action Process approach to the prediction of low-risk, single-occasion drinking.J Appl Soc Psychol. 2006; 33: 339-361
- Applicability of Health Action Process approach to physical activity among Japanese university students.Jpn J Sport Psychol. 2013; 40: 125-137
- Sport participation among individuals with acquired physical disabilities: group differences on demographic, disability, and Health Action Process Approach constructs.Disabil Health J. 2015; 8: 216-222
- Predicting food hygiene: an investigation of social factors and past behaviour in an extended model of the Health Action Process Approach.Appetite. 2010; 54: 126-133
- Validation and psychometric evaluation of physical activity belief scale among patients with type 2 diabetes mellitus: an application of health action process approach.Health Promot Perspect. 2016; 6: 71-79
- Adherence to a daily flossing regimen in university students: effects of planning when, where, how and what to do in the face of barriers.J Clin Periodontol. 2006; 33: 612-619
- Stage-specific effects of an action control intervention on dental flossing.Health Educ Res. 2007; 22: 332-341
- Barriers and facilitators to improve fruit and vegetable intake among WIC-eligible pregnant Latinas: an application of the Health Action Process Approach framework.J Nutr Educ Behav. 2016; 48: 468-477
- Testing two stage assessments in a Chinese college student sample: correspondences and discontinuity patterns across stages.Psychol Sport Exerc. 2013; 12: 306-313
- Applying the pre-intentional phase of the Health Action Process Approach (HAPA) model to investigate factors associated with intention on consistent condom use with various types of female sex partners among males who inject drugs in China.AIDS Care. 2016; 61: 1-10
- Enhancing Web-based mindfulness training for mental health promotion with the health action process approach: randomized controlled trial.J Med Internet Res. 2015; 17: e8
- The role of planning and self-efficacy in condom use among men who have sex with men: an application of the Health Action Process Approach model.Health Psychol. 2011; 30: 119-128
- Web-based intervention for physical activity and fruit and vegetable intake among Chinese university students: a randomized controlled trial.J Med Internet Res. 2017; 19: 106
- A study on the applicability of the health action process approach to the dietary behavior [master's thesis].Peking University, Beijing, China2012http://d.g.wanfangdata.com.cn/Thesis_Y2218196.aspxDate accessed: June 15, 2016
- Health-promoting lifestyles and depression in urban elderly Chinese.PLoS ONE. 2015; 10 (e0117998)
- Knowledge, attitude, and behaviors related to eating out among university students in China.Int J Environ Res Public Health. 2016; 13: 696
- The Guidelines on Snacks for Chinese and Adolescents.Acta Nutrimenta Sinica. 2008; 2: 123-124
- Reliability and validity of adult eating behavior evaluation questionnaire [in Chinese].Med Soc (Berkeley). 2006; 19: 20-23
- Understanding and modeling health behavior: the multi-stage model of health behavior change.J Health Psychol. 2006; 11: 37-50
- Bridging the intention–behaviour gap: planning, self-efficacy, and action control in the adoption and maintenance of physical exercise.Psychol Health. 2005; 20: 143-160
- Social-cognitive predictors of health behavior: action self-efficacy and coping self-efficacy.Health Psychol. 2000; 19: 487-495
- Self–other judgments and perceived vulnerability to victimization.J Pers Soc Psychol. 1986; 50: 502-510
- Goal achievement: the role of intentions.Eur Rev Soc Psychol. 1993; 4: 141-185
- AMOS: Analysis of Moment Structures.Psychometrika. 1994; 59: 135-137
- Evaluating a model of parental influence on youth physical activity.Am J Prev Med. 2003; 25: 277-282
- Investigating the incremental validity of employee engagement in the prediction of employee effectiveness: a meta-analytic path analysis.Hum Resour Manage Rev. 2017; 27: 108-120
- Development and validation of a destination personality scale for mainland Chinese travelers.Tourism Manage. 2017; 59: 338-348
- Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women.Health Psychol. 2007; 26: 507-512
- Adoption and maintenance of four health behaviors: theory-guided longitudinal studies on dental flossing, seat belt use, dietary behavior, and physical activity.Ann Behav Med. 2007; 33: 156-166
- Intention–behavior relations: a conceptual and empirical review.Eur Rev Soc Psychol. 2011; 12: 1-36
- Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence.Psychol Bull. 2006; 132: 249-268
- The theory of planned behavior.Organ Behav Hum Decis Process. 1991; 50: 179-211
- Social-cognitive predictors of physical exercise adherence: three longitudinal studies in rehabilitation.Health Psychol. 2008; 27: 54-63
- A review of the outcome expectancy construct in physical activity research.Ann Behav Med. 2005; 29: 70-79
- The motivation to eat a healthy diet: how intenders and nonintenders differ in terms of risk perception, outcome expectancies, self-efficacy, and nutrition behavior.Polish Psychol Bullet. 2005; 36: 171-174
- Predicting physical exercise in cardiac rehabilitation: the role of phase-specific self-efficacy beliefs.J Sport Exerc Psychol. 2005; 27: 135-151
- Prediction of stage transitions in fruit and vegetable intake.Health Educ Res. 2009; 24: 596-607
- Predicting transitions from preintentional, intentional and actional stages of change.Health Educ Res. 2009; 24: 64-75
Article info
Publication history
Published online: December 22, 2017
Accepted:
September 28,
2017
Footnotes
Conflict of Interest Disclosure: The authors' conflict of interest disclosures can be found online with this article on www.jneb.org.
Identification
Copyright
© 2017 Society for Nutrition Education and Behavior. Published by Elsevier, Inc. All rights reserved.
