Applying the socio-ecological model to understand factors associated with sugar-sweetened beverage behaviours among rural Appalachian adolescents.
Applying the socio-ecological model to understand factors associated with sugar-sweetened beverage behaviours among rural Appalachian adolescents.
复制标题
DOI：
10.1017/s1368980021000069
复制
发表时间：
2021-08
影响因子：
3.2
通讯作者：
Zoellner JM
中科院分区：
文献类型：
--
作者：
McCormick BA;Porter KJ;You W;Yuhas M;Reid AL;Thatcher EJ;Zoellner JM
本研究的目的是确定与青少年含糖饮料（SSB）摄入量相关的社会生态模型（SEM）中的因素。这项横断面研究调查了青少年使用以前验证的工具。分析包括描述性统计、ANOVA检验和逐步非线性回归模型（即，两部分模型）调整为集群鲁棒。在SEM的指导下，使用四步模型来确定与青少年SSB摄入相关的因素-第1步：人口统计学（即，年龄、性别），步骤2：自我（即，计划行为理论（态度、主观规范、感知行为控制、行为意图）、健康素养、媒体素养、公共健康素养），步骤3：人际关系（即，护理者的SSB行为，护理者的SSB规则）和步骤4：环境（即，归属SSB可用性）级别变量。位于阿巴拉契亚的弗吉尼亚西南部四个乡村县的八所中学。790名七年级学生（55.4%女性，44.6%男性，平均年龄12（标准差0.5）岁）。平均SSB摄入量为36.3（sd 42.5）液体盎司或433.4（sd 493.6）卡路里/天。在回归模型的最后一步，七个变量显着解释青少年的SSB消费：行为意向（P <0.05），情感态度（P <0.05），知觉行为控制（P <0.05）、健康素养（P <0.001）、照顾者行为（P <0.05）、照顾者规则（P <0.05）和家庭可用性（P <0.001）。阿巴拉契亚农村青少年的SSB摄入量几乎是全国平均水平的三倍。家庭环境是青少年SSB摄入量的最强预测因子，其次是照顾者规则，照顾者行为和健康素养。针对这些因素的未来干预措施可能会提供最大的机会，以提高青少年SSB的摄入量。
The objective of the current study was to identify factors across the socio-ecological model (SEM) associated with adolescents’ sugar-sweetened beverage (SSB) intake. This cross-sectional study surveyed adolescents using previously validated instruments. Analyses included descriptive statistics, ANOVA tests and stepwise nonlinear regression models (i.e., two-part models) adjusted to be cluster robust. Guided by SEM, a four-step model was used to identify factors associated with adolescent SSB intake – step 1: demographics (i.e., age, gender), step 2: intrapersonal (i.e., theory of planned behaviour (attitudes, subjective norms, perceived behavioural control, behavioural intentions), health literacy, media literacy, public health literacy), step 3: interpersonal (i.e., caregiver’s SSB behaviours, caregiver’s SSB rules) and step 4: environmental (i.e., home SSB availability) level variables. Eight middle schools across four rural southwest Virginia counties in Appalachia. Seven hundred ninety seventh grade students (55·4 % female, 44·6 % males, mean age 12 (sd 0·5) years). Mean SSB intake was 36·3 (sd 42·5) fluid ounces or 433·4 (sd 493·6) calories per day. In the final step of the regression model, seven variables significantly explained adolescent’s SSB consumption: behavioural intention (P < 0·05), affective attitude (P < 0·05), perceived behavioural control (P < 0·05), health literacy (P < 0·001), caregiver behaviours (P < 0·05), caregiver rules (P < 0·05) and home availability (P < 0·001). SSB intake among adolescents in rural Appalachia was nearly three times above national mean. Home environment was the strongest predictor of adolescent SSB intake, followed by caregiver rules, caregiver behaviours and health literacy. Future interventions targeting these factors may provide the greatest opportunity to improve adolescent SSB intake.