From action planning and plan enactment to fruit consumption: moderated mediation effects

Abstract

ObjectivesSufficient fruit consumption is beneficial for a healthy live. While many Dutch adults intent to eat the recommended amount of fruit, only 5–10% of the population actually adheres to the recommendation. One mechanism that can help to narrow this gap between intention and actual fruit consumption is action planning. However, action planning is only assumed to be effective if plans are enacted. This study assessed which action plans are made and enacted, and further aimed to investigate two main hypotheses: 1. the effect of action planning (at T1) on fruit consumption (at T2) is mediated by plan enactment (at T3); 2. positive intentions (2a), high self-efficacy (2b) and a strong habit to eat fruit (2c) enhance the mediation of plan enactment, whereas a strong habit to eat snacks (2d) hinders the mediation of plan enactment.MethodsThis study was a self-reported longitudinal online survey study. A total of 428 participants filled in a survey, measuring demographic factors (e.g. gender, age, education level), several socio-cognitive constructs (i.e. attitudes, self-efficacy, habit, action planning, plan enactment), and fruit consumption, at three points in time (baseline, after 1 month, and after 3 months). Mediation and moderated mediation analyses were used to investigate the planning-plan enactment- fruit consumption relationship.ResultsUp to 70% of the participants reported to have enacted their T1 action plans at T2. Action planning on fruit consumption was fully mediated by plan enactment (Hypothesis 1). All four proposed moderators (i.e. intention, self-efficacy, habit to consume fruit, and habit to consume snacks) significantly influenced the mediation (Hypotheses 2a-2d). Mediation of plan enactment was only present with high levels of intention, high levels of self-efficacy, strong habits to eat fruit, and weak habits to eat snacks.ConclusionThe study suggests the importance of plan enactment for fruit consumption. Furthermore, it emphasizes the necessity of facilitating factors. High levels of intention, self-efficacy and a strong habit to consume fruit clearly aid the enactment of action plans. This suggests that when these factors are moderately low, plan enactment may fail and thus an intervention may require first steps to foster these moderating factors.

Validation of an instrument for perceived factors affecting fruit and vegetable intake based on Pender's health promotion model

“…Gholami et al also showed that eating habits had the greatest impact on F&V intake ( 34 ) . In the present study, the reliability coefficient of this construct was 0·85, which was optimal; however, it was lower than that of the Gholami (0·90) and Kasten (0·95) studies ( 19 , 28 ) . Other models and theories have also been applied to develop instruments regarding the predictors of F&V intake such as the theory of planned behaviour and the stages of change model.…”

“…Thus, studies conducted in recent decades have focused mainly on perception of generation and maintenance of healthy behaviour ( 17 ) . The identification of mediation factors has an effective role in formulating intervention programmes ( 19 ) . One of such factors is to attract social support for healthy nutrition, which can be attributed to the positive effect and encouragement of others to have healthy eating habits ( 20 ) .…”

Investigating the predictive power of constructs of extended Pender's health promotion model and some background factors in fruit and vegetable consumption behavior among government employees

“…[ 14 ] In this regard, it is very important to develop programs with an emphasis on the need to consider the facilitators of consuming F and V. The findings of Kasten et al in the Netherlands showed that high levels of intention and self-efficacy as well as strong habits of consuming F and V clearly help to develop action plans. [ 15 ] In the meantime, models and theories can be used as a guide to discover health-related processes[ 16 ] and identify the factors affecting the adoption of health-oriented behaviors (e.g., attitudes, norms, self-efficacy, environmental or social considerations, or a combination of them) to plan and develop appropriate interventions. [ 17 ] Since theories and models increase productivity and effectiveness by eliminating inappropriate factors and focusing on the most important issues, theory-based interventions are more effective than those that are not developed based on scientific theories.…”

Exploring and improving treatment adherence in patients with type 2 diabetes mellitus using eHealth

“…Research has, for instance, shown that factors such as knowledge and risk perceptions may play an important role as factors determining motivational factors such as attitudes and self-efficacy (45). Additionally, only a limited amount of the variance of behavior is explained by intention, and therefore the role of developing and enacting action plans should be addressed in order to understand and change behavior (46)(47)(48)(49)(50).…”

“…on how to anticipate low self-efficacious situations, on what goals are feasible and realistic, and on how to prepare an intended behavior. Such factors -also referred to as action plans -are likely to facilitate enactment of intentions, and could yield information to be addressed in interventions (56), and have been shown to increase the chance of translating intentions into the desired goal behavior (46,49,50). Consequently, these factors were addressed in our intervention.…”