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Article Title

Improving Confidence to Eat Better Among Young Adults –– Gender Differences in 3-Month Results of the MENU GenY Online Intervention

Publication Date

8-15-2016

Keywords

nutrition, young adults

Abstract

Background/Aims: Improving food choices requires both internal resources, particularly confidence in ability to change, and external challenges or temptations. Self-efficacy and social influence, especially through informal close relationships, play important roles in health behavior. We assessed dietary and self-efficacy changes related to dietary choices by gender and initial fruit and vegetable intake among young adults enrolled in a randomized online intervention trial to improve food choices.

Methods: Young adults, 21–30 years old, from integrated health systems in urban Michigan and rural Pennsylvania enrolled and were randomized into Arm 1 (control website), Arm 2 (tailored and age-targeted website) or Arm 3 (Arm 2 website + email coaching). Baseline and 3-month online surveys included questions assessing fruit and vegetable (F/V) intake, and confidence about eating healthy foods in a number of circumstances (e.g. when really hungry, tired, with friends). Repeated measures ANOVA and F-tests compared overall and groups by study arm, gender and baseline F/V intake.

Results: Of 1,390 (81% of baseline, 71% women) completing the 3-month survey, mean gain in F/V intake was 1.0 (SD: 1.4), 1.0 (SD: 1.5) and 1.2 (SD: 1.5) servings by Arms 1, 2 and 3, respectively; those with low (1 or fewer) F/V at baseline (n = 153) improved by 2+ servings, across arms, with no differences by gender. Greatest self-efficacy improvement, regardless of gender, was in eating well in front of friends (P < 0.0001), making good choices eating out (P < 0.0001) and eating healthy when depressed/in a bad mood (P < 0.0001); men also gained in self-efficacy to eat healthy around junk food (P < 0.001). The low baseline F/V group resembled men and gained self-efficacy to prepare healthy meals (P < 0.001) and avoid higher-fat foods.

Conclusion: Internal perceptions of self-efficacy across a number of social situations and internal conditions in both men and women corresponded to personal experience of working to eat more F/V. More self-confidence improvements occurred in those starting with lowest rates of healthy eating, and those who ultimately made the greatest gains in dietary change, regardless of gender.

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