This is the first study to examine the behavioral intention of using infant formula among the overall community rather than just mothers. Inputs from community members are highly valued in choice of feeding and use theory to frame the research. It was conducted in one of the largest Chinese population outside of Asian, New York City. As the fastest growing Asian subgroup in the US, studies that focus on their health choices are long overdue.
To examine which of the constructs within Theory of Planned Behavior (TPB) best predict Behavioral Intention of using or recommending formula.
Study Design, Settings, Participants
This cross-sectional study (n = 434) used a validated 65-item survey instrument available in English/Chinese that asked about the key TPB constructs. More than half (53%) were born in China; more than one-third (36.5%) had less than a high school diploma; average age was 38.
Multiple regression was conducted and a stepwise procedure was employed. Adjusted R square index was used to account for the difference in number of predictors within each construct.
The importance of each construct in predicting the Behavioral Intention varied by group. For the overall Chinese community, Beliefs, Injunctive Norms, and Perceived Behavioral Control, in that order, accounted for 44.8% of the variance of Behavioral Intention. For those who were born in China, Injunctive Norms, Beliefs, and Perceived Behavioral Control, in that order, accounted for 42.5% of the variance. For those who were in the lowest acculturation level, Injunctive Norms, Beliefs, and Perceived Difficulty, in that order, accounted for 32.1% of the variance.
Beliefs about the consequences and injunctive norms (approval or disapproval of significant others) are the most important motivators of the intention to use or recommend formula. Whether it is Beliefs or Injunctive Norms that produces the most variance in Behavioral intention depends on where the person was born and their acculturation level. These findings can be used to design appropriate nutrition education.