Adolescent sugar-sweetened beverage consumption: An extended Health Action Process Approach☆
Section snippets
The current study and hypotheses
The aim of the current study was to apply an extended version of the HAPA (Fig. 1) to predict SSB consumption in adolescents attending secondary school. The HAPA was extended to incorporate habit, to represent effects of non-conscious, automatic processes that lead to SSB consumption, and perceived affordability of SSBs, to account for a key environmental factor likely to affect SSB consumption. In addition, given the relatively small effects of risk perceptions in the model, particularly for
Participants
Participants (N = 450; 227 males and 223 females) were adolescent students aged 12–17 years recruited from three secondary schools in three districts of Hong Kong. Specifically, 10 students were recruited from each class in each school and a total of 15 classes (form 1 to form 5) from each school, resulting a total of 150 students from each school. A statistical power analysis using the gamma-exponential method (Kock & Hadaya, 2018) revealed that a minimum sample size of 114 was required to
Preliminary analyses
Means, standard deviations, composite reliability coefficients, and inter-correlations for all model variables are presented in Table 2. Reliability coefficients for all measures were all larger than the 0.700 cut-off criterion. The only exception was the behavior measures, which were assessed by a combined index of frequencies and volumes. Correlations among psychological constructs were generally positive and statistically significant, except the correlations of outcome expectancy with
Discussion
Excessive consumption of added sugars constitutes a major global threat to health, with consumption of SSB making a substantive contribution to excess added sugar consumption among adolescents (Popkin, 2012). To date, there is a dearth of research that has investigated the psychological correlates of adolescent SSB consumption. The aim of the current study was to test an extended version of the HAPA to predict adolescent SSB consumption. The model incorporated constructs relating to key
Conclusion
The current study applied an extended version of the Health Action Process Approach to predict adolescents’ SSB consumption. The HAPA was extended to include constructs relating to non-conscious processes, habit, and environmental factors, and perceived affordability of SSBs. Current findings supported proposed effects among the motivational variables, and effects of intention on SSB consumption, but effects of volitional factors such as planning constructs and stage-specific self-efficacy were
References (81)
The theory of planned behavior
Organizational Behavior and Human Decision Processes
(1991)- et al.
Home sweet home: Parent and home environmental factors in adolescent consumption of sugar-sweetened beverages
Academic Pediatrics
(2017) - et al.
Habit as mediator of the relationship between prior and later physical activity: A longitudinal study in older adults
Psychology of Sport and Exercise
(2015) Habit and physical activity: Theoretical advances, practical implications, and agenda for future research
Psychology of Sport and Exercise
(2019)- et al.
Using meta-analytic path analysis to test theoretical predictions in health behavior: An illustration based on meta-analyses of the theory of planned behavior
Preventive Medicine
(2016) - et al.
The reasoned action approach applied to health behavior: Role of past behavior and tests of some key moderators using meta-analytic structural equation modeling
Social Science & Medicine
(2018) - et al.
Predicting sugar consumption: Application of an integrated dual-process, dual-phase model
Appetite
(2017) - et al.
Patterns of sugar-sweetened beverage consumption amongst young people aged 13–15 years during the school day in Scotland
Appetite
(2017) - et al.
Development of a brief questionnaire to assess habitual beverage intake (BEVQ-15): Sugar-sweetened beverages and total beverage energy intake
Journal of the Academy of Nutrition and Dietetics
(2012) - et al.
The school food environment: Associations with adolescent soft drink and snack consumption
American Journal of Preventive Medicine
(2008)
Adolescent screen-viewing behaviour is associated with consumption of sugar-sweetened beverages: The role of habit strength and perceived parental norms
Appetite
Child and adolescent obesity: Part of a bigger picture
Lancet
Relation between consumption of sugar-sweetened drinks and childhood obesity: A prospective, observational analysis
Lancet
Intake of sugar-sweetened beverages and weight gain: A systematic review
American Journal of Clinical Nutrition
Factors influencing the frequency of children's consumption of soft drinks
Appetite
Sugary beverages represent a threat to global health
Trends in Endocrinology and Metabolism
A new proposed guidance system for beverage consumption in the United States
American Journal of Clinical Nutrition
The evolving understanding of physical activity behavior: A multi-process action control approach
PLS path modeling. Computational Statistics &
Data Analysis
Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia
American Journal of Clinical Nutrition
Exploring the theory of planned behavior to explain sugar-sweetened beverage consumption
Journal of Nutrition Education and Behavior
Theories of reasoned action and planned behavior as models of condom use: A meta-analysis
Psychological Bulletin
Distinguishing perceptions of control from self‐efficacy: Predicting consumption of a low‐fat diet using the Theory of Planned Behavior
Journal of Applied Social Psychology
Examining predictors of physical activity among inactive middle-aged women: An application of the Health Action Process Approach
Psychology and Health
Determinants of adolescents' soft drink consumption
Public Health Nutrition
Sugar‐added beverages and adolescent weight change
Obesity Research
The public health and economic benefits of taxing sugar-sweetened beverages
New England Journal of Medicine
Response-order effects in survey methods: A randomized controlled crossover study in the context of sport injury prevention
Journal of Sport & Exercise Psychology
Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: Observational study
British Medical Journal
Alcohol consumption and the theory of planned behavior: An examination of the cognitive mediation of past behavior
Journal of Applied Social Psychology
Dietary guidelines for Americans
Journal of the American Medical Association
Impact of the Berkeley excise tax on sugar-sweetened beverage consumption
American Journal of Public Health
A review and analysis of the use of ‘habit’in understanding, predicting and influencing health-related behaviour
Health Psychology Review
Which survey questions change behavior? Randomized controlled trial of mere measurement interventions
Health Psychology
Social ecological approaches to individuals and their contexts: Twenty years of health education & behavior health promotion interventions
Health Education & Behavior
Trends and affordability of cigarette prices: Ample room for tax increases and related health gains
Tobacco Control
Sugar-sweetened beverage consumption and risks of obesity and hypertension in Chinese children and adolescents: A national cross-sectional analysis
Nutrients
An integrated behavior-change model for physical activity
Exercise and Sport Sciences Reviews
Implementation intention and planning interventions in health psychology: Recommendations from the Synergy expert group for research and practice
Psychology and Health
DEBATE: Do behavioral interventions work in the real world?
International Journal of Behavioral Nutrition and Physical Activity
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2022, AppetiteCitation Excerpt :However, research on the relationship between self-efficacy and SSB consumption has shown inconsistent results. One study (Cho & Kim, 2018) has reported that self-efficacy is associated with SSB consumption, whereas other studies (Gesualdo & Yanovitzky, 2019; Zhang, Wong, Zhang, Hamilton, & Hagger, 2019) have not identified an association. Additionally, one study (Deliens, Clarys, De Bourdeaudhuij, & Deforche, 2015) suggested that self-efficacy is associated with soft drink consumption but not energy drink consumption.
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2020, Journal of the Academy of Nutrition and DieteticsCitation Excerpt :This model was intended to address the shortcomings that arise from applying a single theory to understand the psychological influences on health. Although it was developed to address physical activity behaviors, this model has also been effectively used in nutrition research to understand the consumption of sugar sweetened beverages in adolescents,70 and to predict fruit and vegetable64 and sugar71 consumption in adults. The use of integrated models in dietary behavior change interventions should be further explored.
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2020, AppetiteCitation Excerpt :One possibility is that measurement imprecision may be responsible for the small effects, for example implicit attitudes reflect general attitudes towards the behavior and, therefore, lack correspondence with the specific behavior. An alternative is that the current study did not adequately capture the full gamete of behavioral determinants, such as environmental effects (e.g., availability, proximity of sugar-rich foods)(Zhang et al., 2019), self-control (Hagger, Gucciardi, Turrell, & Hamilton, 2019; Hagger, Hankonen, et al., 2019), response inhibition (Allom, Mullan, Cowie, & Hamilton, 2016), and personality and individual differences (Vo & Bogg, 2015) all of which have been shown to be related to dietary behaviors. Future research may consider incorporating these constructs as determinants within the integrated model.
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Martin S. Hagger's contribution was supported by a Finland Distinguished Professor (FiDiPro) award from Business Finland (Grant no. 1801/31/2015).