Can social cognitive theory constructs explain socio-economic variations in adolescent eating behaviours? A mediation analysis

Abstract

Adolescents of low socio-economic position (SEP) are less likely than those of higher SEP to consume diets in line with current dietary recommendations. The reasons for these SEP variations remain poorly understood. We investigated the mechanisms underlying socio-economic variations in adolescents' eating behaviours using a theoretically derived explanatory model. Data were obtained from a community-based sample of 2529 adolescents aged 12-15 years, from 37 secondary schools in Victoria, Australia. Adolescents completed a web-based survey assessing their eating behaviours, self-efficacy for healthy eating, perceived importance of nutrition and health, social modelling and support and the availability of foods in the home. Parents provided details of maternal education level, which was used as an indicator of SEP. All social cognitive constructs assessed mediated socio-economic variations in at least one indicator of adolescents' diet. Cognitive factors were the strongest mediator of socio-economic variations in fruit intakes, while for energy-dense snack foods and fast foods, availability of energy-dense snacks at home tended to be strong mediators. Social cognitive theory provides a useful framework for understanding socio-economic variations in adolescent's diet and might guide public health programmes and policies focusing on improving adolescent nutrition among those experiencing socio-economic disadvantage.

Socio-economic differences in eating-related attitudes, behaviours and environments of adolescents

“…This finding is consistent with previous research (9) and is important since home availability of foods is an important predictor of adolescent eating behaviour (10) . It is noteworthy, however, that more than 25 % of all students reported that they usually have chocolates or soft drinks available at home.…”

“…This index assesses eight dimensions of deprivation using 2006 census data, based on small-area geographical units. The index deciles were categorized into three groups reflecting low deprivation (1-3), middle levels of deprivation (4-7) and high deprivation (8)(9)(10).…”

“…Similarly, previous research suggests that less healthy eating behaviours are also related to socioeconomic status. For example, adolescents experiencing greater socio-economic deprivation are less likely to eat adequate fruit and vegetables (9)(10)(11) and more likely to consume snack foods and fast food (9,12) , skip breakfast (13,14) , watch television (15,16) and buy food outside the home (17) . A range of interrelated factors are thought to influence adolescent eating behaviours.…”

Is the intention–behaviour gap greater amongst the more deprived? A meta‐analysis of five studies on physical activity, diet, and medication adherence in smoking cessation

“…Many of the papers reporting social patterning in the execution of different health behaviours did not formally test for the moderating effects of SES on the relationship between intention and self‐efficacy with behaviour (Ball et al ., 2007, 2009; Bere et al ., 2008; Cerin & Leslie, 2008; De Cocker et al ., 2012; Kamphuis et al ., 2008, 2009; Leganger & Kraft, 2003; Murray et al ., 2012). Furthermore, the few papers that did test for such moderating effects have been inconsistent, reporting no significant effects of moderation by SES on intention to be more physically active (Schüz et al ., 2012), or to eat more fruits and vegetables (Godin, Amireault, et al ., 2010), with Godin, Sheeran, et al .…”

“…Studies assessing the social patterning of intention to consume a healthier diet find that children and adults from higher socio‐economic groups have greater intentions to eat more healthily which was associated with consuming a healthier diet (Bere, van Lenthe, Klepp, & Brug, 2008; Leganger & Kraft, 2003; Sandvik, Gjestad, Samdal, Brug, & Klepp, 2009). Similar findings were reported for the social patterning of self‐efficacy and diet (Ball et al ., 2009). However, a study by Godin, Amireault, et al .…”