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Dairy intake-related attitudes, subjective norms and perceived - - PowerPoint PPT Presentation

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Dairy intake-related attitudes, subjective norms and perceived behavioural control of South African nutrition professionals Friede Wenhold Zelda White Department Human Nutrition, University of Pretoria Dairy intake-related attitudes,

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Dairy intake-related attitudes, subjective norms and perceived behavioural control of South African nutrition professionals

Friede Wenhold Zelda White

Department Human Nutrition, University of Pretoria

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Dairy intake-related attitudes, subjective norms and perceived behavioural control of South African nutrition professionals

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Introduction

  • Intakes of dairy-related nutrients of South Africans are

low (NFCS, 1999; NFCS 2005; Shisana et al, 2013)

  • SA Food-based dietary guideline “Have milk, maas or

yoghurt every day” (Vorster et al, 2013)

  • Nutrition professionals influence dietary behaviour →

their own disposition related to dairy: unknown

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Aim

To describe (in relation to dairy in general and in respect

  • f selected dairy products)
  • Behaviour: USUAL INTAKE
  • Behavioural beliefs & outcome evaluations: ATTITUDES
  • Normative beliefs and motivation to comply: SUBJECTIVE

NORMS

  • Barriers and facilitators: PERCEIVED BEHAVIOURAL

CONTROL

  • f SA nutrition professionals

→ within Theory of Planned Behaviour (TPB)

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Conceptual / theoretical framework:

THEORY OF PLANNED BEHAVIOUR (Ajzen, 1991)

Nutrition professionals Adult clients’ / Patients‘ Dairy-related ATTITUDES SUBJECTIVE NORMS (significant others) PERCEIVED BEHAVIOURAL CONTROL

Dairy-related intake

INTENTIONS Dairy-related INTAKE (= Behaviour) Own

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ATTITUDES SUBJECTIVE NORMS PERCEIVED BEHAVIOURAL CONTROL INTENTIONS BEHAVIOUR “Have 2-3 servings of milk, maas, yoghurt or cheese daily”

BEHAVIOURAL BELIEFS X OUTCOME EVALUATIONS NORMATIVE BELIEFS X MOTIVATION TO COMPLY CONTROL BELIEFS X PERCEIVED POWER

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Methods

  • Design
  • Cross-sectional survey
  • Population
  • SA Nutrition professionals registered with ADSA /

NSSA in 2015

  • Instrument development
  • TPB principles (item generation:→ elicitation: previous

studies, expert group discussion); scales→ Likert 7- point)

  • Dairy in general & specific products: → milk, maas,

yoghurt & cheese

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Methods

  • Data collection
  • Online (Qualtrics) → testing
  • Paper-based (2 CPD events in Gauteng)
  • Data analysis (Stata release 14 ; 2015)
  • Descriptive statistics according to TPB
  • Cronbach’s alpha
  • Pearson’s correlations
  • Instrumental-variables regression analysis
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Results

Description of sample: Response rate: Total number of responses: 306 Usable responses: 282 → Response rate: 15%

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Results

Description of sample: Mean age: 36.4±10.5y; 90% dietitians; 42% from Gauteng

AGE GROUP AND PROVINCE OF RESIDENCE OF RESPONDENTS

20 40 60 80 100 120 140 Number of respondents Provinces >50 y >41 - ≤50 y >30 - ≤40 y ≤30 y

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Results

Description of sample:

PRIMARY WORK ENVIRONMENT (N=282) n % Public sector: Clinical 60 21.3 Public sector: Non-clinical 15 5.3 Private sector: Non-clinical 20 7.1 Private sector: Clinical (hospital-based) 24 8.5 Private practice 90 31.9 Academic / research institution 37 13.1 Private practice 34 12.1 Total 282 100

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Dairy-related INTAKE (= Behaviour)

Dairy-related intake

INTENTIONS Dairy-related ATTITUDES SUBJECTIVE NORMS (significant others) PERCEIVED BAHEVIOURAL CONTROL

Results

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Results

General dairy intake

8.2 6.1 5.7 21.1 25.4 33.3 0.0

5 10 15 20 25 30 35 Never Once per month 2-3 times per month Once per week 2-3 times per week 4-6 times per week Every day

% Respondents "How often is your daily dairy intake 2-3 servings or more?"

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Results

Intake of selected dairy products: MILK

n % Consumption as such? Yes 127 45.5 No 152 54.5 Portion size? S (±125 mL) 44 34.6 M (±250 mL) 79 62.2 L (±500 mL) 4 3.2 Consumption with other foods? No 13 4.7 Yes 266 95.3 Companion foods (> 1 could be chosen) Coffee /Tea 242 Cereal / Porridge 219 Shakes / Drinks 104 Other 198

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Results

Intake of selected dairy products: MAAS

n % Consumption as such? Yes 32 11.5 No 247 88.5 Portion size? S (±125 mL) 19 59.4 M (±250 mL) 11 34.4 L (±500 mL) 2 6.3 Consumption with other foods? No 163 58.4 Yes 116 41.6 Companion foods (> 1 could be chosen) Cereal 31 Other 93

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Results

Intake of selected dairy products: YOGHURT

n % Consumption as such? Yes 262 93.9 No 17 6.1 Portion size? S (±100-175 mL) 209 79.8 M (±250 mL) 50 19.1 L (±250 mL) 3 1.1 Consumption with other foods? No 87 31.2 Yes 192 68.8 Companion foods (> 1 could be chosen) Cereal 143 Shakes / Smoothies 73 Other 104

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Results

Intake of selected dairy products: CHEESE

n % Consumption as such? Yes 270 96.8 No 9 3.2 Portion size? S (± 30g) 202 75.1 M (± 80g) 66 24.5 L (± 120g) 1 0.4 Consumption with other foods? No NA Yes

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Dairy-related INTAKE (= Behaviour)

Dairy-related intake

INTENTIONS Dairy-related ATTITUDES SUBJECTIVE NORMS (significant others) PERCEIVED BEHAVIOURAL CONTROL

Results

BEHAVIOURAL BELIEFS X OUTCOME EVALUATIONS

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1 2 3 4 5 6 7 Good taste Nutritional quality Bone health Weight management Cardiovascular health Growth (e.g. infancy ) Adverse reactions Familiarity Physical activity Cancer Diabetes Environmental concerns

Milk

Behavioural beliefs: “For me 2-3 servings of milk is associated with …

Results

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1 2 3 4 5 6 7 Good taste Nutritional quality Bone health Weight management Cardiovascular health Growth (e.g. infancy ) Adverse reactions Familiarity Physical activity Cancer Diabetes Environmental concerns

Milk Maas

Behavioural beliefs

Results

Behavioural beliefs: “For me 2-3 servings of maas is associated with …

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1 2 3 4 5 6 7 Good taste Nutritional quality Bone health Weight management Cardiovascular health Growth (e.g. infancy ) Adverse reactions Familiarity Physical activity Cancer Diabetes Environmental concerns

Milk Maas Yoghurt

Behavioural beliefs: “For me 2-3 servings of yoghurt is associated with …

Results

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1 2 3 4 5 6 7 Good taste Nutritional quality Bone health Weight management Cardiovascular health Growth (e.g. infancy ) Adverse reactions Familiarity Physical activity Cancer Diabetes Environmental concerns

Milk Maas Yoghurt Cheese

Behavioural beliefs: “For me 2-3 servings of cheese is associated with …

Results

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Dairy-related INTAKE (= Behaviour)

Dairy-related intake

INTENTIONS Dairy-related ATTITUDES SUBJECTIVE NORMS (significant others) PERCEIVED BEHAVIOURAL CONTROL

Results

NORMATIVE BELIEFS X MOTIVATION TO COMPLY

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Results

Normative beliefs & Motivation to comply

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Dairy-related INTAKE (= Behaviour)

Dairy-related intake

INTENTIONS Dairy-related ATTITUDES SUBJECTIVE NORMS (significant others) PERCEIVED BEHAVIOURAL CONTROL

CONTROL BELIEFS X PERCEIVED POWER

Results

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Results

Perceived behavioural control: Nutrition professionals (=own) & adult clients

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Nutrition professionals Dairy-related ATTITUDES SUBJECTIVE NORMS (significant others) PERCEIVED BEHAVIOURAL CONTROL

Dairy-related intake

INTENTIONS Dairy-related INTAKE (= Behaviour)

Results

THEORY OF PLANNED BEHAVIOUR

Own r = 0.7 (P < 0.001) Beta = 0.728 R2 = 0.527 Internally consistent scales: Cronbach’s alpha:

  • Behavioural beliefs: 0.72
  • Outcome evaluation: 0.42
  • Normative beliefs: 0.73
  • Motivation to comply: 0.79
  • Control beliefs: 0.86
  • Perceived power: 0.81
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GENERAL PREMISE

  • Tap on nutrition professionals’ leadership roles as nutrition

educators, advocates and agents for behaviour change for nutritional health of South Africans

  • Assumption: Effectiveness of above role related to own dietary

behaviour and disposition

  • Always: Emphasis on whole diet (all FBDG’s), i.e. balance, variety,

moderation

  • Behaviour change: Function of multiple interventions - over time

Conclusions & Recommendations

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BEHAVIOUR (DAIRY INTAKE)-RELATED

  • Maintain / strengthen current high intakes of yoghurt

and cheese (emphasis: reduced fat)

  • Modify current intake patterns of milk by encouraging

“as such” consumption, particularly among children (establish life-long habits)

  • Introduce maas (e.g. comprehensive “maas drive” with

nutrition facts [→ new dairy regulations], tasting, recipes/ideas for use: familiarity & skills-based approach)

Conclusions & Recommendations

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ATTITUDE-RELATED

  • Strengthen existing positive attitudes (e.g.

nutritional value and bone health)

  • Enlighten / empower regarding controversial /

complex matters and strength of evidence (e.g. link to cancer, diabetes and environmental matters)

Conclusions & Recommendations

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SUBJECTIVE NORMS-RELATED

  • Use scientific evidence as significant other /

communication channel

  • Work through universities (i.e. professional

training)

Conclusions & Recommendations

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PERCEIVED BEHAVIOURAL CONTROL-RELATED

  • Development of tools that nutrition

professionals can use to increase their clients’ ability to include dairy in their diets (cost, perishability & access)

Conclusions & Recommendations

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Dissemination of information

Scientific poster UP: Research day (Aug 2016) IDF: Netherlands (Oct 2016) Advertorial SAJCN (Sept 2016) Full Report (Feb 2016) Stakeholder presentations (May & June 2016) Manuscript: Submitted SAJCN (June 2016)

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We gratefully acknowledge:

  • Consumer Education Project of Milk SA (Funding)
  • Technical Advisory Committee of CEP
  • ADSA & NSSA and their participating members
  • Statistical advisors, P Becker & U MacIntyre
  • Graphic designer, Nicky (Studio Nica)