Beliefs Underlying the Decision to Eat Breakfast: The Role of Theory-based Behavioral Analysis in the Development of Policy, Communication and Educational Interventions for Healthy Eating

By Susan E. Middlestadt, Laurel D. Stevenson, Chia-Ling Hung, Maria Leia Roditis, Alyce D. Fly and Jylana L. Sheats.

Published by Food Studies: An Interdisciplinary Journal

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Policy, communication, and education efforts to influence any social or health outcome are more effective if based on an understanding of the underlying behaviors and their determinants. This conceptual paper outlines how behavioral theory can help design interventions for one healthy eating behavior, eating breakfast. More specifically, the paper illustrates how a prominent health behavior theory, the Reasoned Action Approach, can be used to guide formative research to identify factors underlying people’s decisions. Select findings are presented from three studies of beliefs underlying eating breakfast: online surveys with 1185 undergraduates from a large university in Indiana; in-depth interviews with 61 adults from four Indiana worksites; and 63 in-depth interviews with students from three middle schools in rural Indiana. Analyses of data from the undergraduates demonstrated the role of self-efficacy. Analyses of data from the working adults revealed the importance of normative beliefs about what employers believed. Analyses comparing consequences perceived by adults with those perceived by middle school students found that both groups believed that eating breakfast would provide energy but only middle school students believed that eating breakfast would improve alertness. For each finding, the theory is presented, the finding is described, implications for interventions are suggested, and the need for additional research is outlined. In sum, theory-based behavioral research can help develop interventions at intrapersonal, interpersonal, and environmental levels that are warranted to encourage healthy eating.

Keywords: Behavioral Analysis, Reasoned Action Approach, Health Behavior Theory, Breakfast Consumption, Public Health Interventions

Food Studies: An Interdisciplinary Journal, Volume 1, Issue 4, pp.45-54. Article: Print (Spiral Bound). Article: Electronic (PDF File; 687.416KB).

Dr. Susan E. Middlestadt

Associate Professor, Department of Applied Health Science, Indiana University, Bloomington, USA

Dr. Middlestadt is an Associate Professor in the School of Public Health, Indiana University, Bloomington, IN. She conducts applied research to help design and evaluate theory-based and empirically-grounded health promotion, communication, and social marketing programs. Her interests include behavioral, evaluation, and intervention research on physical activity and nutrition behaviors underlying obesity and other chronic diseases. Her research has supported the development of social and behavior change programs for school-aged youth, young adults, women and men of reproductive age, and older adults in the United States and in developing countries. She has worked in community, school, clinic, worksite, and mass media settings. Dr. Middlestadt teaches courses to prepare students to use models and theories of health behavior and to design health interventions.

Dr. Laurel D. Stevenson

Research Associate, Applied Health Science, School of Public Health - Bloomington, Indiana University, USA

Dr. Stevenson received her PhD in Health Behavior and her Master of Public Health degrees from Indiana University and she did her undergraduate work at the University of Michigan. Her research interests include mechanisms to build community capacity, participatory and qualitative research methods, theories of health behavior, and maternal/child health. She currently works as an independent research consultant.

Chia-Ling Hung

Research Associate, Applied Health Science, School of Public Health - Bloomingon, Indiana University, USA

Ms. Hung is a doctoral student in the PhD program in Health Behavior, School of Public Health, Indiana University, Bloomington, IN. She holds a Masters in Physical Education from the National College of Physical Education and Sports, Taiwan. For her dissertation, she is conducting a meta-analysis of behavior change campaigns in healthy eating, physical activity, tobacco prevention, and other health behaviors to investigate the role of social marketing principles and techniques in making behavior change interventions more effective.

Dr. Maria Leia Roditis

Center for Tobacco Education and Research, University of California, San Francisco, San Francisco, USA

Dr. Roditis received a PhD in Bioanthropology, a Master of Public Health, and a MA in Anthropology, all from Indiana University. She uses an interdisciplinary social science perspective to research and address health issues. She has studied the environmental, historical, and social factors that affect rates of overweight and obesity among populations of adolescents in Greece. She is currently a Postdoctoral Research Fellow at the Center for Tobacco Research and Education, University of California, San Francisco, CA.

Dr. Alyce D. Fly

Associate Professor, Applied Health Science, School of Public Health - Bloomington, Indiana University, USA

Dr. Alyce D. Fly is an Associate Professor of Dietetics and Nutrition Science at Indiana University. Her research laboratory explores the effects of meal patterns on vascular health in healthy and overweight people, and factors that contribute to childhood obesity. She teaches courses in advanced nutrition and human metabolism, and food chemistry and leads a weekly research seminar.

Dr. Jylana L. Sheats

Postdoctoral Fellow, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, USA

Dr. Sheats received a PhD in Health Behavior from Indiana University and a Master of Public Health from the Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA. Her research focuses on the psychosocial, behavioral and environmental determinants of physical activity and healthy eating and the impact of contextual factors on the health outcomes of minority and aging populations. She is currently a Postdoctoral Research Fellow, Stanford Prevention Center, Stanford University, School of Medicine, Stanford, CA.