Formative research on HAPA model determinants for fruit and vegetable intake: target beliefs for audiences at different stages of change

Abstract

Theoretically driven health communications are needed to promote fruit and vegetable intake among people at different stages of change. The Health Action Process Approach, a clearly speci-15 fied model and good predictor of fruit and vegetable intake, was used as a framework to guide a formative research for the development of health messages targeting individuals at either a nonintentional or intentional stage of change. A 20 mixed-method approach was used, combining eight focus groups (n ¼ 45) and a questionnaire (n ¼ 390). Target beliefs for people at both stages were identified under five theoretical constructs (risk perception, outcome expectancies, action 25 planning, coping planning and self-efficacy). Highlighting health problems due to low fruit and vegetable consumption, health benefits, weight reduction and pleasure and enhancing self-efficacy to increase fruit and vegetable 30 intake are the main guidelines for designing messages to non-intenders. For intenders, messages should reassure them of their ability to maintain adequate fruit and vegetable consumption, outline specific plans for increased consumption, 35identify barriers such as preparation, forgetting or being tired and unwilling to eat fruits and vegetables and suggest strategies to overcome them, such as presenting some practical examples on how to include fruits and vegetables 40 when eating out.

Protocol for a cluster randomised controlled trial on information technology-enabled nutrition intervention among urban adults in Chandigarh (India): SMART eating trial

“…It established that the majority of the target audience was at the pre-contemplation stage of change, which was different to other studies where participants were classified into various stages [65]. In contrast to developed countries where processed foods form the bulk of diet, the formative research confirmed that Indians have preference for home cooked food which is consumed by all family members.…”

An App to Improve Eating Habits of Adolescents and Young Adults (Challenge to Go): Systematic Development of a Theory-Based and Target Group–Adapted Mobile App Intervention (Preprint)

“…The HAPA as stage model is an interesting template for the theory-based development of dietary health messages that can be adapted to persons at different stages of the behavior change process [38] and was successfully applied in several nutrition behavior change interventions, e.g. [39][40][41].…”

“…This shall boost self-efficacy and thereby help to overcome barriers and to achieve target behavior [34,41]. Visual feedback through progress bars were used to replace possible missing intrinsic motivation for behavior change [32].…”

Towards an integrated approach to food behaviour: Meat consumption and substitution, from context to consumers

“…As it becomes increasingly acknowledged that awareness and sensitization campaigns alone are often not enough to effectively change eating habits, many scholars are in favour of more focused interventions to change such habits (e.g., Godinho, Alvarez, & Lima, 2013;Schwarzer, 2008;Silva, Marques, & Teixeira, 2014;Verplanken & Wood, 2006). In fact, the outline provided on several variables relevant to meat consumption and substitution indicates that there are key issues at distinct levels which are linked to food choice and behaviour (Figure 3).…”

“…For instance, the HAPA model distinguishes between a motivational phase, which leads to forming a behavioural intention, and a volitional phase, which leads to translating the intention into action. Individuals will firstly need to be motivated to change, and only then they should benefit from acquiring and employing a set of skills to implement the desired change (Godinho et al, 2013;Schwarzer, 2008).…”