Abstract| Volume 54, ISSUE 7, SUPPLEMENT , S24, July 2022

P014 Nutrition Knowledge, Attitudes, Beliefs, and Practices among Adults in Urban and Rural Areas in the Free State, South Africa


      Designing comprehensive nutrition education programs requires understanding nutrition-related knowledge, attitudes, beliefs, and practices (NKABP) of people. Globally, previous studies primarily focused on NKABP of children, adolescents, and adults. There are differences in living standards, dietary practices, and prevalence of diseases between rural and urban areas. Therefore, understanding the differences in NKABP between these communities is important.


      To understand the differences and correlations between NKABP among adults in urban and rural settings.

      Study Design, Setting, Participants

      Assuring Health for All in the Free-State is a cross-sectional study to determine how living in urban and rural areas predisposes population to chronic diseases. It was approved by the Ethics Committee of the Faculty of Health Sciences, University of Free State. The rural and urban parts of the study were conducted in 2007 and 2009, respectively. Participants were adults aged 25-64 years.

      Measurable Outcome/Analysis

      The outcomes are NKABP, measured by a reliable questionnaire. Shapiro-Wilk test was used for normality testing. Due to non-normal distribution, Mann-Whitney tests were performed to compare continuous data. Spearman correlation analyzed the associations between NKABP domains.


      The sample included 363 (42.91%) urban and 483 (57.09%) rural adults, predominantly females (78.17%). The preliminary analysis shows adults in rural areas have significantly higher nutrition knowledge (9 ± 2 vs. 8 ± 2, P <0.001), attitudes (7 ± 1 vs. 5 ± 1, P <0.001), and beliefs (5 ± 0 vs. 4 ± 1, P <0.001) compared to those in urban areas. There were significant positive correlations in both urban and rural areas between knowledge and attitudes [r = 0.11(P = 0.03); r = 0.272(P <0.001)] knowledge and beliefs [r = 0.128(P = 0.01); r =0.2(P <0.001)], and attitudes and beliefs [r = 0.199(P <0.001); r = 0.401(P <0.001)]. However, associations between knowledge and practices [r = 0.122(P = 0.007)], and beliefs and practices [r = 0.113(P = 0.01)] were significant in rural areas and association between attitudes and practices [r = 0.122(P = 0.02)] was significant in urban areas.


      Adults in rural areas have better NKAB, and their knowledge and beliefs were correlated with practices. Future nutrition education interventions are required to increase NKAB and translating them into practices, especially among adults in urban areas in the Free State province.


      The National Research Foundation (NRF) supported Assuring Health for All in the Free-State (AHA-FS) study financially, however, this part of the research is not funded.


      Supplementary data related to this article can be found at