Fang Mingzhu, Zhang Jie, Wu Xian, Huang Xianhong, Gu Fang, Qu Xuping, Xu Liangwen
Department of Preventive Medicine, Medical College, Hangzhou Normal University, Zhejiang Leading Team of Science and Technology Innovation, Hangzhou 310036, China.
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Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Feb;49(2):156-60.
To learn the dietary fat intake behavior status and influencing psychological factors in teenagers.
According to the multi-stage stratified cluster sampling method, students were recruited from middle and high schools in Hangzhou, Wuhan and Xi'an from March to May, 2012. Chinese version of adolescent dietary fat intake behavior of psychological measurement scales was utilized in field investigations with 3 448 effective questionnaires. Under the transtheoretical model, the status quo of teenagers fat intake behavior was analyzed and it shows the relationship between stages and psychological variables, including strategy of change, decision balance and self-efficacy.
In the 3 448 participants, the proportion of girls were 52.4% (1 806/3 448) and boys were 47.6% (1 642/3 448), while the mean age was (14.85 ± 1.46). There are significant differences among distributed stages of behavior change, grouped by gender, grade and region (χ(2) values were 33.59, 20.53, 27.92, P < 0.001). In different gender groups, the number of boys in precontemplation came to the first and accounted for 24.2% (438/1 806), and the number of girls were more in contemplation and preparation stage, which accounted for 49.5% (813/1 642), and it was the least both in the action stage with the ratio 12.1% (218/1 806) and 14.7% (241/1 642) respectively; in different grade groups, the numbers of student in middle school and high school were the largest in contemplation and precontemplation stage, accounted for 24.9% (494/1 986) and 23.4% (343/1 462); and among different regions, the proportion in precontemplation, contemplation and preparation stage was not a few, and this ratio in Hangzhou, Wuhan, Xi'an area was 70.6% (801/1 135), 61.7% (649/1 052) and 68.8% (867/1 261), respectively. The number in action stage was the least of all, which were 144, 147, 168, respectively. Ordinal logistic mode showed that the four variables, including the scores of process of change, decision balance (pros), decision balance (cons) and self-efficacy, were factors which significantly affected the stages of behavior change, which showed a significant difference (F values were 155.12, 19.86, 44.59, 94.27, P < 0.001) in different stages. From precontemplation stage to action stage, the score of the process of change, decision balance (pros) and self-efficacy showed an upward trend, and achieved the highest score in the action stage (from 32.6 ± 12.8, 8.4 ± 2.9, 19.7 ± 6.9 to 48.4 ± 12.6, 10.1 ± 2.5, 25.9 ± 6.9, respectively); contrarily, the decision balance (cons) decreased with the development of behavioral stage (from 14.7 ± 4.4 to 12.2 ± 3.9). Post hoc comparison also found that the score of process of change, decision balance (pros) and self-efficacy after action stages were higher than those before action, while the score of decisional balance (cons) in the precontemplation stage was higher than that in the other 4 stages.
Fat intake behavior in teenagers showed different stages, whose psychological factors had significant influences, with decision balance (pros) hindered the progress of stages of behavior change, while other three factors played a positive role.
了解青少年膳食脂肪摄入行为现状及其影响因素。
采用多阶段分层整群抽样方法,于2012年3月至5月选取杭州、武汉和西安的初、高中学生作为研究对象。应用中文版青少年膳食脂肪摄入行为心理测量量表进行现场调查,共获得有效问卷3448份。在跨理论模型下,分析青少年脂肪摄入行为现状及其与改变策略、决策平衡和自我效能感等心理变量之间的关系。
3448名研究对象中,女生占52.4%(1806/3448),男生占47.6%(1642/3448),平均年龄为(14.85±1.46)岁。行为改变分布阶段在性别、年级和地区上差异有统计学意义(χ²值分别为33.59、20.53、27.92,P<0.001)。不同性别组中,处于未打算阶段的男生人数最多,占24.2%(438/1806),处于沉思和准备阶段的女生人数较多,分别占49.5%(813/1642),而处于行动阶段的男、女生人数最少,分别占12.1%(218/1806)和14.7%(241/1642);不同年级组中,初中和高中学生处于沉思和未打算阶段的人数最多,分别占24.9%(494/1986)和23.4%(343/1462);不同地区中,处于未打算、沉思和准备阶段的比例均较高,杭州、武汉、西安地区该比例分别为70.6%(801/1135)、61.7%(649/1052)和68.8%(867/1261),处于行动阶段的人数最少,分别为144、147、168人。有序logistic模型显示,改变过程、决策平衡(益处)、决策平衡(弊端)和自我效能感4个变量是影响行为改变阶段的因素,不同阶段差异有统计学意义(F值分别为155.12、19.86、44.59、94.27,P<0.001)。从未打算阶段到行动阶段,改变过程、决策平衡(益处)和自我效能感得分呈上升趋势,在行动阶段达到最高(分别从32.6±12.8、8.4±2.9、19.7±6.9上升至48.4±12.6、10.1±2.5、25.9±6.9);相反,决策平衡(弊端)随行为阶段进展而降低(从14.7±4.4降至12.2±3.9)。事后比较还发现,行动阶段后的改变过程、决策平衡(益处)和自我效能感得分高于行动前,而未打算阶段的决策平衡(弊端)得分高于其他4个阶段。
青少年脂肪摄入行为呈现不同阶段,心理因素对其有显著影响,决策平衡(益处)阻碍行为改变阶段进展,其他3个因素起积极作用。