Eisenberg Miriam H, Lipsky Leah M, Gee Benjamin, Liu Aiyi, Nansel Tonja R
Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D.
Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of child Health and Human Development, Bethesda, M.D.
Vulnerable Child Youth Stud. 2017;12(3):226-240. doi: 10.1080/17450128.2017.1308045. Epub 2017 Apr 12.
A family-based behavioral nutrition intervention grounded in Social Cognitive and Self-Determination Theories showed an increased intake of whole plant foods. This study examined 1) whether the intervention changed parent diet-related attitudes/beliefs, 2) whether these attitudes/beliefs were associated with youth diet quality, and 3) the moderating roles of youth age and parent nutritional knowledge. Youth with type 1 diabetes and their parents (n = 136, mean ± SD youth age = 12.6 ± 2.8 years) participated in an 18-month trial targeting intake of whole plant foods. Parents reported attitudes/beliefs (self-efficacy, outcome expectations, perceived barriers, autonomous and controlled motivation) for providing healthy food to their families, and type 1 diabetes-specific nutrition knowledge at 6, 12, and 18 months. Whole Plant Food Density (WPFD; cup or ounce equivalents per 1000 kcal of whole grains, fruit, vegetables, legumes, nuts and seeds) was calculated from 3-day youth food records. Linear mixed models estimated the intervention effect on parent attitudes/beliefs, associations of parent attitudes/beliefs with youth WPFD and the moderating roles of parent nutrition knowledge and youth age. There was no effect of the intervention on parent attitudes/beliefs. Across groups, higher parent self-efficacy and autonomous motivation were positively associated with youth WPF. Parent perceived barriers and negative outcome expectations were inversely associated with youth WPFD, especially when parents had higher nutrition knowledge. Youth age did not modify any associations. Parent diet-related attitudes/beliefs were associated with youth diet quality, highlighting the importance of parent psychosocial factors across this age range. Despite a positive effect on youth diet, the intervention did not affect parent attitudes/beliefs, suggesting it worked through a different mechanism.
一项基于家庭的行为营养干预措施，以社会认知理论和自我决定理论为基础，该措施使全植物性食物的摄入量有所增加。本研究调查了：1）该干预措施是否改变了家长与饮食相关的态度/信念；2）这些态度/信念是否与青少年的饮食质量相关；3）青少年年龄和家长营养知识的调节作用。1型糖尿病青少年及其父母（n = 136，青少年平均年龄±标准差 = 12.6 ± 2.8岁）参与了一项为期18个月的试验，该试验以全植物性食物的摄入量为目标。家长报告了在第6、12和18个月时为家人提供健康食物的态度/信念（自我效能感、结果期望、感知障碍、自主动机和受控动机）以及1型糖尿病特定的营养知识。全植物性食物密度（WPFD；每1000千卡全谷物、水果、蔬菜、豆类、坚果和种子的杯数或盎司当量）根据青少年3天的食物记录计算得出。线性混合模型估计了干预措施对家长态度/信念的影响、家长态度/信念与青少年WPFD之间的关联以及家长营养知识和青少年年龄的调节作用。干预措施对家长态度/信念没有影响。在所有组中，较高的家长自我效能感和自主动机与青少年的WPF呈正相关。家长感知到的障碍和负面结果期望与青少年WPFD呈负相关，尤其是当家长有较高的营养知识时。青少年年龄并没有改变任何关联。家长与饮食相关的态度/信念与青少年的饮食质量相关，突出了这个年龄范围内家长心理社会因素的重要性。尽管对青少年饮食有积极影响，但干预措施并未影响家长的态度/信念，这表明其作用机制不同。
