School of Nursing, University of Wisconsin-Madison, Madison, WI 53792, USA.
Nurs Res. 2010 Jan-Feb;59(1):67-75. doi: 10.1097/NNR.0b013e3181c3bd55.
Despite the increased use of ecological models in health behavior research, multilevel influences on health behaviors in rural, low-income people, an aggregate at high risk for sedentary behavior and inadequate diets, have been examined in few studies.
The purpose of this study was to describe influences on physical activity and diet in low-income, rural adults.
A cross-sectional survey was conducted using face-to-face interviews in a convenience sample of 137 low-income Anglo and Latino adults recruited from two rural Wisconsin counties. The survey included questions on health behaviors, self-efficacy, barriers, social support, and community environments. Self-report data on physical activity and fruit and vegetable intake were categorized into outcome variables of meets recommendation or does not meet recommendation. Latent class cluster analysis was used to identify clusters of participants with similar influences on health behaviors, and cluster membership was used as an independent variable in logistic regression of physical activity and diet outcomes.
Fifty-two percent of participants met a recommendation for physical activity, but only 8% met their MyPyramid recommendation for fruit and vegetable intake. Participants in the moderate self-efficacy/high safety cluster were significantly more likely than those in the low self-efficacy/moderate safety cluster to meet a recommendation for physical activity (odds ratio = 2.65). For healthy diet, participants in the low barriers cluster were significantly more likely to eat more fruits and vegetables (odds ratio = 4.13) than those in the high barriers cluster.
People with healthier behaviors were distinguished from those with less healthy behaviors by higher levels of intrapersonal, interpersonal, and community supports. Results support the importance of multilevel approaches to promoting healthy lifestyles in rural, low-income adults.
尽管生态模型在健康行为研究中的应用越来越多，但在很少的研究中考察了多层次因素对农村低收入人群健康行为的影响，这些人群总体上存在久坐行为和饮食不足的高风险。
本研究旨在描述对农村低收入成年人身体活动和饮食的影响。
在威斯康星州的两个农村县，采用便利抽样方法，对 137 名低收入的盎格鲁和拉丁裔成年人进行了横断面调查，采用面对面访谈的方式进行。该调查包括健康行为、自我效能、障碍、社会支持和社区环境方面的问题。关于身体活动和水果、蔬菜摄入量的自我报告数据被归类为满足或不满足建议的结果变量。使用潜在类别聚类分析来识别具有相似健康行为影响的参与者群体，并且将聚类成员身份用作身体活动和饮食结果的逻辑回归的自变量。
52%的参与者达到了身体活动的推荐标准，但只有 8%达到了他们的 MyPyramid 推荐的水果和蔬菜摄入量。在中等自我效能/高安全性聚类中的参与者比在低自我效能/中等安全性聚类中的参与者更有可能达到身体活动的推荐标准（比值比=2.65）。对于健康饮食，低障碍聚类中的参与者比高障碍聚类中的参与者更有可能食用更多的水果和蔬菜（比值比=4.13）。
具有更健康行为的人与具有较不健康行为的人之间的区别在于更高水平的个体内、人际和社区支持。结果支持了在农村低收入成年人中采用多层次方法促进健康生活方式的重要性。
