@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2020;7(1):37-43

Background
... [1, 2]. Nutrition is very important in childhood and adolescence because of their developmental stages, in which the nutritional needs is increased and affect health [3].
Previous Studies
... [4-9]. Despite the improvement in the overall health status of Iranian children in recent years, the prevalence of unhealthy eating habits, such as snacks and fast foods with low nutritional value is alarming. The results of a study on Iranian students' eating habits by Klishadi et al. showed that Iranian students consume sweets, salty snacks, and fast foods. However, their daily intake of fruits, vegetables and dairy products was less than the recommended amount, which can endanger their health [10]. In a systematic and meta-analysis study conducted in Iran in 2015, in urban and rural areas snack consumption was 20.3%, chips was 25.8%, carbonated beverages was 21.5% and chocolate and pastry was 30.8% [11]. It is necessary to use health education models and theories in order to identify the main factors affecting the behavior and relationships between these factors [12]. The theory of reasoned action (TRA) was developed by Ajzen and Fishbein [13] and is one of the most successful theories of behavior change. … [13, 14].
Aim(s)
The purpose of this study was to predict the determinants of nutritional behaviors of high school female students using the extended TRA.
Research type
This study was a cross-sectional descriptive-analytical research.
Research society, place and time
This study was carried out on the eighth and ninth grade female high school students in Ahvaz in 2018-19.
Sampling method and number
First, based on random cluster sampling, four educational districts of Ahwaz were randomly selected. Two high schools for girls of that district were selected by simple random sampling, and then from each school, two eighth grade classes, and one ninth grade class were randomly selected and all students in each class were studied. Finally, 173 students were enrolled.
Used devices&materials
Data were collected using a written questionnaire. This tool was developed and adjusted using similar studies, review of texts and experts’ views. The questionnaire consisted of three parts; the first part consisted of demographic characteristics and source of nutritional information, which was assessed by multiple choice questions, including parents, the Internet, social media, and others. The second part included the extended TRA constructs, such as self-efficacy construct, including attitudes toward behavior, abstract norms, behavioral intention, and self-efficacy. The third part of the questionnaire assessed nutritional behaviors of the students. Data analysis was done using structural equation modeling and SPSS 23 and AMOS software. Also descriptive statistics (mean and standard deviation for quantitative variables, frequency and percentage for qualitative variables) and statistical tests, such as Chi-square, independent t-test and Pearson correlation coefficients were used. In structural equation modeling, there are several indicators for testing the model fit [13]. … [14 - 16].
Findings by Text
173 students with a mean age of 14.01 ± 0.75 years participated in the study, of whom 116 cases (67.1%) were in the eighth grade and 57 cases (32.9%) were in the ninth grade. The mean number of family members was 4.87 ± 1.17. Regarding birth order, 38.7% of the students were the first child. The mean age of the fathers and mothers was 45.63 ± 7.34 and 39.31 ± 5.59 years, respectively. Also, 89.6% of the mothers were housewives and only 4.0% were illiterate. Moreover 52.6% of the fathers had non-governmental jobs and 3.5% were illiterate. In terms of the source of nutrition information, 64.7% of the students received the nutrition information mostly from their parents (Table 1).There was a direct and significant correlation between attitude, abstract norms, intention, and perceived self-efficacy and among the constructs of the extended TRA, self-efficacy (r = 0.68) and attitude (r = 0.51) showed the highest correlation with intention and self-efficacy (r = 0.46) and intention (r = 0.43) had the highest correlation with students' nutritional behaviors (Table 2).Path analysis showed a positive and significant relationship between TRA constructs and students' nutritional behaviors, and the model was well-fitted (p = 0.016; Table 3).Behavioral intention explained 28% of variance of attitude, 15% of abstract norms, and 49% of self-efficacy and self-efficacy was the strongest and abstract norms were the weakest predictors of behavioral intention. Also, 56% of behavioral intention changes and 24% of students' nutritional behavior changes were predicted by extended TRA. In extended TRA, self-efficacy was the strongest predictor of nutritional behavior (β = 0.32) and behavioral intention predicted only 22% of the variance of the behavior (Fig. 1).
Main comparison to the similar studies
Among the model constructs, self-efficacy showed the highest correlation with students' nutritional intentions and behaviors. In this regard, the results of the study by Diddarlo et al. [17] to identify the factors influencing self-care behaviors of diabetic women based on the extended TRA showed that the constructs of the model had a significant positive relationship with each other and self-efficacy had the highest correlation with behavioral intention. The results of a study by Taghipour et al. [12] study to investigate the application of extended TRA to predict self-care behaviors of diabetic patients, showed that self-efficacy was more associated with intention and dietary behaviors. ... [18, 19].Our results showed that the relationship between abstract norms and behavioral intention was weaker than the relationship between attitude and self-efficacy with intention, and abstract norms were the weakest predictor of behavioral intention. In Tavusi et al. [13] study, abstract norms were the weakest predictor of behavioral intention in drug use. ... [20-22].
Suggestions
None.
Limitations
One of the limitations of this study was the time-consuming process of obtaining permission from the Department of Education and also self-reported method to complete the scale.
Conclusions
The extended TRA including the self-efficacy construct is a suitable theory for predicting nutritional behaviors of female students and since self-efficacy is the strongest and most effective construct in predicting students' behavioral intention and nutritional behaviors, the extended TRA is more efficient than TRA.
Acknowledgments
The authors are grateful to the Department of Education of Khuzestan province, Department of Education of Ahwaz (District 3), administrators, officials and students of the public high schools for girls and their parents for their contribution to this study.
Conflict of interest
None.
Ethical Permissions
This study was extracted from a Research approved by the Academic Center for Education (ID: 20-3025) (ethics code: IR.ACECR.ROYAN.REC.1395.49).
Funding Sources
This study was extracted from a Research approved by the Academic Center for Education.

TABLES and CHARTS

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