Abstract:Objective: To examine the validity and reliability of Theory of Planned Behavior (TPB) scales for healthful eating for persons at risk for diabetes. Design: Cross-sectional, using a self-administered questionnaire. Setting: Community in the Midwest. Participants: 106 adults who self-identified based on one or more American Diabetes Association diabetes risks. Variables Measured: Behavioral, normative, and control beliefs; and attitude, subjective norm, perceived behavioral control, and intention to eat a healthful diet. Analysis: Construct validity was assessed with factor analyses and measurement and structural models using structural equation modeling. Reliability of the scales was assessed with Cronbach alpha and a 2-month testretest. Results: Factor analysis loadings were greater than .37. Cronbach alphas for the behavioral, normative, and control belief scales were .80, .91, and .84, respectively. The measurement model revealed that the measures were significant estimates for the TPB constructs, and they fit well as indirect measures of attitude, subjective norm, and perceived behavioral control in predicting intention to eat a healthful diet. Test-retest revealed 2-month stability of the scales. Conclusions and Implications: Scales for measuring TPB behavioral, normative, and control beliefs were valid and reliable for use with adults at risk for diabetes. Further examination with minority persons is warranted. Key Words: beliefs, health behavior, behavioral research, diabetes mellitus, theory of planned behavior Article: INTRODUCTION Diabetes mellitus and its complications (heart disease, stroke, hypertension, blindness, kidney disease) are among the leading causes of morbidity and mortality in the United States. 1 In addition to the loss of quality of life, more than $132 billion is spent annually for direct medical care and indirect costs owing to disability, work loss, and premature mortality. 2 Over 11 million adults aged 20 years or older have been diagnosed with diabetes, and 1 million adults will be newly diagnosed with diabetes each year. 3 It is estimated that an additional 5.9 million persons may have undiagnosed diabetes. 3 Age and genetic factors appear to be important in the etiology of diabetes, but they are not modifiable. However, moderate changes in diet, along with increases in physical activity, have been shown to prevent or delay type 2 diabetes. 4,5 The American Dietetic Association emphasizes that eating practices to achieve health benefits require a lifelong commitment . 6 Despite widespread efforts, in the United States many people continue to make unwise food choices that contribute to the problems of overweight and obesity, as well as to diabetes. Whitehead and Russell emphasize the difficulty of changing a person's behavior and the importance of "selling" the behavior as something palatable and appealing. 7 This idea suggests that understanding beliefs about healthful eating among persons at risk for diabetes may help to develop interventions to change these beliefs as ...