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. 2022 Sep 29:9:958611.
doi: 10.3389/fnut.2022.958611. eCollection 2022.

Validation and results of a novel survey assessing decisional balance for a whole food plant-based diet among US adults

Christine E S Jovanovic  1 , Faiza Kalam  2 , Frank Granata 4th  2 , Angela F Pfammatter  2 , Bonnie Spring  2
Affiliations

Validation and results of a novel survey assessing decisional balance for a whole food plant-based diet among US adults

Christine E S Jovanovic et al. Front Nutr. .

Abstract

Importance: Consuming a whole food plant-based diet (WFPBD) is a promising, low-risk strategy for reducing risk of prevalent chronic disease and certain cancers, with synergistic benefits for climate and environment. However, few US adults report consuming a WFPBD. Understanding the reasons for this inconsistency is important for developing and implementing interventions for promoting a WFPBD. However, no research to elucidate decisional balance driving current consumption patterns in the US exists.

Objective: This research aims to validate an online survey to assess decisional balance for the consumption of a WFPBD, describe attitudes and beliefs toward adopting a WFPBD, and evaluate socio-demographic differences in decisional balance for consuming a WFPBD among a convenience sample of US adults.

Design: Online cross-sectional data collection followed by confirmatory factor analysis (CFA), validation of internal consistency, and examination of invariance across socio-demographic variables. Sensitivity analysis of full vs. truncated survey to predict self-reported dietary patterns and consumption behaviors were evaluated. Results of the survey and significant differences by socio-demographics were assessed.

Setting: Online survey based on previous research, created via Qualtrics, and administered through MTurk.

Participants: A total of 412 US adults, majority female (66%), White (75%), 30-60 years old (54%), ≥ Bachelor's degree (85%), and earning ≥ $45K (68%).

Main outcomes and measures: Factor loadings, covariance of survey items, associations with self-reported dietary pattern and consumption measures, and differences in pros, cons, and decisional balance across socio-demographic variables.

Results: CFA reduced the survey from 49 to 12 items and demonstrated invariance across socio-demographic variables. Pros and cons varied inversely and significantly (cov = -0.59), as expected. Cronbach's α 's for subscales in the final, reduced model were high (>0.80). Pros, cons, and decisional balance in both the full and the reduced model were significantly (p < 0.05) associated with self-reported dietary pattern and consumption.

Conclusion and relevance: Our analyses indicate the WFPBD Survey is a parsimonious and psychometrically sound instrument for evaluation of decisional balance to consume a WFPBD diet among our sample of US adults. These results may be instrumental for development and deployment of interventions intended to promote consumption of a WFPBD in the US.

Keywords: confirmatory factor analysis; consumption pattern; decisional balance; nutrition behavior; psychometric properties; whole food plant-based diet.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Final (12-item) generalized logit confirmatory factor analysis (CFA) model for WFPBD Survey, with factor loadings and covariances.
FIGURE 2
FIGURE 2
Significant (p < 0.05) differences in pros, cons, and decisional balance by demographic variables.
See this image and copyright information in PMC

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