Perceived barriers mediate the association between self-efficacy and fruit and vegetable consumption among students attending alternative high schools

Abstract

Compared to students attending regular high schools, alternative high school students are more likely to be racial/ethnic minorities, have higher levels of poverty, and higher rates of risky and poor health behaviors, including weight-related behaviors like limited fruit and vegetable intake. However, little is known about fruit/vegetable intake among alternative high school students. This study examined whether perceived barriers to healthy eating mediated the association between self-efficacy to eat healthy foods and fruit/vegetable consumption among alternative high school students. The cross-sectional study population consisted of students (N=145) attending six alternative high schools in the St Paul-Minneapolis, MN, area who were participants in an obesity prevention pilot study and completed a baseline survey during fall 2006. Mixed model linear regression, adjusting for sociodemographic characteristics, was used to test a series of regression models performed according to mediation analysis procedures. Students' mean age was 17.3 years; 52% were male, 63% were low-income, and 61% were from racial/ethnic minorities. Students reported a mean fruit/vegetable intake of 3.6 servings per day, mean self-efficacy to eat healthy score of 22.2 (range 3 to 35), and mean barriers to eating healthy score of 6.9 (range 3 to 13). Perceived barriers to healthy eating fully mediated the relationship between self-efficacy and fruit/vegetable consumption (Sobel test statistic 2.7, P=0.007). Interventions targeting the dietary practices of alternative high school students should include components to decrease perceived barriers as a way to increase self-efficacy and ultimately fruit/vegetable intake.

Figure 1. Mediation analysis assessing the relationship of self-efficacy to eat healthy and perceived barriers to health eating and fruit and vegetable consumption among participants

b₁= association between self-efficacy to eat healthy and fruit and vegetable consumption b₂= association between self-efficacy to eat healthy and perceived barriers to healthy eating b₃= association between perceived barriers to healthy eating and fruit and vegetable consumption b₄= (mediation test) association between self-efficacy to eat healthy and fruit and vegetable consumption, with barriers to healthy eating included in the model Statistical significance is indicated by the following: *=p<0.05; **= p<0.01; ***=p<0.001