Impact of transfer cognition on healthy dietary behaviors among Tibetan and Yi ethnic grade 7 students
-
摘要:
目的 探讨转移认知对藏族、彝族初中生健康饮食行为的影响及其在健康行动过程模型(HAPA)前意向阶段中的作用路径，为少数民族青少年的健康饮食行为干预提供参考。 方法 自行设计健康饮食行为及一般情况问卷，于2023年11月至2024年5月，分层整群随机抽取西藏拉萨市和四川省凉山彝族自治州1 228名初一学生(彝族447名，藏族781名)开展横断面调查，构建结构方程模型对健康饮食行为的相关因素进行分析。 结果 藏族、彝族初中生健康饮食行为和健康饮食行为意向得分分别为(35.72±7.43)和(11.71±2.43)分。中介模型分析结果显示，除转移认知对健康饮食行为和风险感知对健康饮食行为意向的两条直接路径均无统计学意义[标准路径系数(95%CI)分别为0.07(-0.01~0.14)，0.04(-0.04~0.13)，P值均>0.05]外，其余直接路径均有统计学意义[标准路径系数(95%CI)=0.15~0.52(0.04~0.61)，P值均＜0.05]；藏族、彝族初中生转移认知通过健康饮食行为意向间接影响健康饮食行为的中介效应为0.06(95%CI=0.04~0.09)，通过行动自我效能和健康饮食行为意向的链式中介效应为0.06(95%CI=0.04~0.09)(P值均＜0.01)；所有中介效应占总效应的比例为30.6%。 结论 藏族、彝族初中生转移认知不直接影响健康饮食行为，而是通过HAPA前意向阶段的多条路径对饮食行为产生间接影响；可在饮食行为干预中加强对青少年转移认知的培养。 Abstract:Objective To investigate the impact of transfer cognition on healthy dietary behaviors among Tibetan and Yi ethnic junior high school students by analyzing the pathway within the pre-intention phase of the health action process approach (HAPA), so as to provide a basis for developing the intervention of healthy dietary behavior among ethnic minority adolescents. Methods A questionnaire on healthy dietary behavior and general conditions was self-designed. From November 2023 to May 2024, a cross-sectional survey was conducted on 1 228 freshmen in junior high school(447 Yi and 781 Tibetan ethnic students) from Lhasa City, Xizang and Liangshan Yi Autonomous Prefecture, Sichuan Province, with a stratified cluster random method. A structural equation model was constructed to analyze the relevant factors of healthy dietary behavior. Results The scores for healthy dietary behavior and behavior intention, among Tibetan and Yi adolescents were (35.72±7.43) and (11.71±2.43). The analysis results of the mediation model showed that the direct path of transfer cognitions had no statistical significance on healthy dietary behavior, as well as risk perception on healthy dietary behavior intention [standard path coefficients (95%CI) were 0.07 (-0.01-0.14), 0.04 (-0.04-0.13), P>0.05]; the other direct paths were statistically significant [standard path coefficients (95%CI)=0.15-0.52 (0.04-0.61), P < 0.05]. The mediating effect of transfer cognitions on healthy dietary behavior through healthy dietary behavior intention among Tibetan and Yi junior high school students was 0.06 (95%CI=0.04-0.09), and the chain mediation effect through action self-efficacy and healthy dietary behavior intention on healthy dietary behavior was 0.06 (95%CI=0.04-0.09) (P < 0.01). All mediating effects accounted for 30.6% of the total effect. Conclusions Transfer cognitions could not directly influence healthy dietary behavior among Tibetan and Yi junior high school students, but rather exert an indirect effect through multiple pathways in the pre-intentional phase of the HAPA model. Interventions targeting dietary behavior should focus on enhancing adolescents' transfer cognitions. -
Key words:
- Cognition /
- Food habits /
- Models, statistical /
- Adolescent /
- Minority groups
1) 利益冲突声明 所有作者声明无利益冲突。 -
图 1 初中生转移认知影响健康饮食行为及其HAPA前意向阶段要素的结构方程模型
注：P值均＜0.05；模型调整了年龄、性别、民族、父母文化程度和家庭经济状况等混杂变量。
Figure 1. Structural equation model of the influence of cognition transfer on healthy dietary behavior and its elements in the pre-intention phase of HAPA model among junior high school students
表 1 不同人口学特征初中生健康饮食行为意向和健康饮食行为得分比较(x±s)
Table 1. Comparison of scores for healthy dietary behavior intention and healthy dietary behavior among junior high school students with different demographic characteristics(x±s)
人口学指标 人数 健康饮食行为意向 健康饮食行为 得分 t/F值 P值 得分 t/F值 P值 年龄/岁 ＜13.94 199 11.61±2.55 -3.06 ＜0.01 35.47±7.28 -2.48 0.01 ≥13.94 1 029 12.19±2.39 37.00±8.06 性别 男 665 11.71±2.61 0.15 0.88 35.79±7.48 0.36 0.72 女 563 11.69±2.20 35.64±7.39 民族 彝族 447 10.89±2.36 -9.21 ＜0.01 32.17±5.89 -14.42 ＜0.01 藏族 781 12.17±2.34 37.75±7.47 家庭经济状况 好 119 12.52±2.70 14.15 ＜0.01 36.24±7.96 16.44 ＜0.01 中 849 11.83±2.32 34.43±6.07 差 260 10.95±2.53 32.97±6.45 父亲文化程度 小学及以下 592 11.68±2.41 1.63 0.08 35.72±7.25 4.86 ＜0.01 初中 355 11.91±2.26 36.60±7.76 高中或中专 43 12.40±2.76 36.16±7.06 大专及以上 20 12.44±3.28 38.70±10.10 不清楚 218 11.30±2.60 33.99±7.17 母亲文化程度 小学及以下 651 11.07±2.35 1.08 0.37 36.06±7.38 8.49 ＜0.01 初中 245 11.76±2.31 36.15±7.66 高中或中专 41 12.04±2.70 37.28±7.37 大专及以上 19 12.21±3.24 37.74±9.86 不清楚 272 11.34±2.56 33.66±6.76 
下载: 导出CSV
表 2 初中生健康饮食行为、转移认知和HAPA相关变量的偏相关分析(r值, n=1 228)
Table 2. Partial correlation analysis of healthy dietary behavior, transfer cognition and HAPA related variables among junior high school students(r, n=1 228)
变量 健康饮食行为 转移认知 风险感知 积极结果预期 行动自我效能 转移认知 0.28 风险感知 0.29 0.29 积极结果预期 0.29 0.46 0.42 行动自我效能 0.30 0.43 0.32 0.53 健康饮食行为意向 0.35 0.51 0.33 0.52 0.59 注：调整年龄、性别、民族、父母文化程度和家庭经济状况等混杂变量；P值均＜0.01。
下载: 导出CSV
表 3 初中生转移认知及HAPA前意向阶段核心要素的验证性因子分析
Table 3. Confirmatory factor analysis of transfer cognitions and core elements in the pre-intention phase of the HAPA model among junior high school students
条目 因子载荷 中位数 转移认知 如果经常锻炼，我更有动力吃得健康 0.73 4 当有规律地锻炼时，我更容易少吃高能量食物 0.77 4 当有规律地锻炼时，我会想吃更健康的食物 0.81 4 当减少休闲屏幕时间后，我会更容易少吃一些零食 0.69 4 当坚持按时睡觉，我会坚持吃更健康的早餐 0.77 4 当做到不饮酒时，我会更容易吃得健康 0.71 4 当做到不吸烟时，我会提醒自己均衡饮食 0.72 4 风险感知 饮食不均衡会让我没有活力 0.69 3 饮食不均衡会减缓我的身体发育 0.74 3 饮食不均衡会增加我患肥胖症等疾病的风险 0.67 3 积极结果预期 均衡的饮食有助于我长高 0.71 3 吃得健康有利于保护我的胃肠道 0.71 3 均衡的饮食可以让我保持健康 0.75 3 健康的饮食能让我保持心情愉悦 0.65 3 行动自我效能 我相信我能改善我的日常饮食，即使要从今天开始 0.69 3 我相信我可以吃得更健康，即使受到不健康食物的强烈诱惑 0.69 3 即使时间不充裕或有些懒散，我相信我能够坚持每天吃早餐 0.66 3 即使不喜欢吃蔬菜水果，我相信我仍能坚持每天吃一些保持饮食均衡 0.64 3 健康饮食行为意向 我打算多吃肉、蛋，多喝牛奶 0.65 3 我打算坚持健康的饮食模式 0.69 3 我打算接下来三天内开始吃得更健康 0.74 3 我打算接下来一个月做到均衡饮食 0.69 3
下载: 导出CSV
表 4 藏族彝族初中生转移认知对其健康饮食行为的结构方程模型分析(n=1 228)
Table 4. Structural equation modeling analysis of transfer cognitions on their healthy dietary behavior in Tibetan and Yi junior high school students(n=1 228)
路径 非标准化系数(标准误) 标准路径系数(95%CI) P值 直接路径 转移认知→风险感知 0.21(0.02) 0.37(0.29~0.45) ＜0.01 转移认知→积极结果预期 0.09(0.02) 0.19(0.10~0.28) ＜0.01 转移认知→行动自我效能 0.26(0.02) 0.52(0.44~0.59) ＜0.01 转移认知→健康饮食行为意向 0.12(0.02) 0.24(0.17~0.31) ＜0.01 转移认知→健康饮食行为 0.45(0.27) 0.07(-0.01~0.14) 0.10 风险感知→积极结果预期 0.28(0.03) 0.32(0.24~0.40) ＜0.01 风险感知→健康饮食行为意向 0.04(0.03) 0.04(-0.04~0.13) 0.32 风险感知→健康饮食行为 1.87(0.42) 0.15(0.08~0.21) ＜0.01 积极结果预期→健康饮食行为意向 0.16(0.05) 0.16(0.04~0.27) 0.01 行动自我效能→积极结果预期 0.46(0.04) 0.46(0.37~0.56) ＜0.01 行动自我效能→健康饮食行为意向 0.49(0.05) 0.51(0.41~0.61) ＜0.01 健康饮食行为意向→健康饮食行为 3.35(0.59) 0.23(0.15~0.32) ＜0.01 间接路径 转移认知→风险感知→健康饮食行为 0.38(0.10) 0.06(0.03~0.09) ＜0.01 转移认知→健康饮食行为意向→健康饮食行为 0.40(0.10) 0.06(0.04~0.09) ＜0.01 转移认知→风险感知→健康饮食行为意向→健康饮食行为 0.03(0.03) 0.00(-0.00~0.01) 0.27 转移认知→积极结果预期→健康饮食行为意向→健康饮食行为 0.05(0.03) 0.01(0.00~0.02) 0.01 转移认知→行动自我效能→健康饮食行为意向→健康饮食行为 0.42(0.10) 0.06(0.04~0.09) ＜0.01 转移认知→风险感知→积极结果预期→健康饮食行为意向→健康饮食行为 0.03(0.01) 0.01(0.00~0.01) 0.01 转移认知→行动自我效能→积极结果预期→健康饮食行为意向→健康饮食行为 0.06(0.03) 0.01(0.00~0.02) 0.01
下载: 导出CSV
-
[1] WHO. Adolescent health[EB/OL]. (2024-06-05)[2025-01-25]. https://www.who.int/ .[2] 徐洪吕, 陶芳标. 关注多民族青少年饮食行为与心理健康[J]. 中国学校卫生, 2024, 45(2): 153-156, 167. doi: 10.16835/j.cnki.1000-9817.2024047XU H L, TAO F B. Focus on the dietary behaviors and mental health among multi-ethnic adolescents[J]. Chin J Sch Health, 2024, 45(2): 153-156, 167. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024047 [3] ZHANG C Q, ZHANG R, SCHWARZER R, et al. A Meta-analysis of the health action process approach[J]. Health Psychol, 2019, 38(7): 623-637. doi: 10.1037/hea0000728 [4] RALF S, ALEKSANDRA L. How to overcome health-compromising behaviors[J]. Eur Psychol, 2008, 13(2): 141-151. doi: 10.1027/1016-9040.13.2.141 [5] BARNETT S M, CECI S J. When and where do we apply what we learn: a taxonomy for far transfer[J]. Psychol Bull, 2002, 128(4): 612-637. doi: 10.1037/0033-2909.128.4.612 [6] FERRER R, KLEIN W M. Risk perceptions and health behavior[J]. Curr Opin Psychol, 2015, 1(5): 85-89. [7] FLEIG L, NGO J, ROMAN B, et al. Beyond single behaviour theory: adding cross-behaviour cognitions to the health action process approach[J]. Br J Health Psychol, 2015, 20(4): 824-841. doi: 10.1111/bjhp.12144 [8] BANDURA A, FREEMAN W H, LIGHTSEY R. Self-efficacy: the exercise of control[J]. J Cogn Psychother, 1997, 13(2): 158-166. http://psycnet.apa.org/psycinfo/1997-08589-000 [9] 吕榕霞, 黄礼妍, 何丽, 等. 中国孕妇及儿童青少年食物频率问卷信效度系统综述[J]. 现代预防医学, 2022, 49(13): 2335-2340, 2359.LV R X, HUANG L Y, HE L, et al. A systematic review of the reproducibility and validity of food frequency questionnaire among Chinese pregnant women, children and adolescents[J]. Mod Prev Med, 2022, 49(13): 2335-2340, 2359. (in Chinese) [10] LIU Q, XU H, YUAN Z, et al. A staged integrated model informing the promotion of healthy dietary behaviors in adolescents: a prospective study[J]. BMC Public Health, 2025, 25(1): 28. doi: 10.1186/s12889-024-21101-8 [11] BEHLING O, LAW K S. Translating questionnaires and other research instruments: problems and solutions[M]. Thousand Oaks, CA: Sage, 2000. [12] SCHWARZER R, LUSZCZYNSKA A, ZIEGELMANN J P, et al. Social-cognitive predictors of physical exercise adherence: three longitudinal studies in rehabilitation[J]. Health Psychol, 2008, 27(1S): S54-S63. http://www.researchgate.net/profile/Ralf_Schwarzer/publication/5604331_Social-Cognitive_Predictors_of_Physical_Exercise_Adherence_Three_Longitudinal_Studies_in_Rehabilitation/links/09e4150b729797482a000000.pdf [13] RADTKE T, KAKLAMANOU D, SCHOLZ U, et al. Are diet-specific compensatory health beliefs predictive of dieting intentions and behaviour?[J]. Appetite, 2014, 76: 36-43. doi: 10.1016/j.appet.2014.01.014 [14] DONG B, ZOU Z, SONG Y, et al. Adolescent health and healthy China 2030: a review[J]. J Adolesc Health, 2020, 67(5S): S24-S31. [15] DONNELLY J E, HERRMANN S D, LAMBOURNE K, et al. Does increased exercise or physical activity alter adlibitum daily energy intake or macronutrient composition in healthy adults?A systematic review[J]. PLoS One, 2014, 9(1): e83498. doi: 10.1371/journal.pone.0083498 [16] FLEIG L, KERSCHREITER R, SCHWARZER R, et al. 'Sticking to a healthy diet is easier for me when I exercise regularly': cognitive transfer between physical exercise and healthy nutrition[J]. Psychol Health, 2014, 29(12): 1361-1372. doi: 10.1080/08870446.2014.930146 [17] LODATO E, GOSTOLI S, TOMBA E. Psychological theoretical frameworks of healthy and sustainable food choices: a systematic review of the literature[J]. Nutrients, 2024, 16(21): 3687. http://www.mdpi.com/2072-6643/16/21/3687/htm [18] SCHUZ B, SNIEHOTTA F F, MALLACH N, et al. Predicting transitions from preintentional, intentional and actional stages of change[J]. Health Educ Res, 2008, 24(1): 64-75. http://www.researchgate.net/profile/Falko_Sniehotta/publication/5607249_Predicting_transitions_from_preintentional_intentional_and_actional_stages_of_change/links/02e7e5229bd89a7a16000000 [19] PETERS G J Y, RUITER R A C, KOK G. Threatening communication: a critical re-analysis and a revised Meta-analytic test of fear appeal theory[J]. Health Psychol Rev, 2013, 7(Sup1): S8-S31. http://www.dokeefe.net/Peters&-IP12-HPR.pdf [20] HAMILTON K, VAN DONGEN A, HAGGER M S. An extended theory of planned behavior for parent-for-child health behaviors: a Meta-analysis[J]. Health Psychol, 2020, 39(10): 863-878. [21] SCHWARZER R. Self-efficacy: thought control of action[M]. Washington, DC: Hemisphere Publishing Corp, 1992. -
点击查看大图
图(1) / 表(4)
计量
- 文章访问数: 6
- HTML全文浏览量: 3
- PDF下载量: 0
- 被引次数: 0
