How Self-Efficacy and Self-Regulation Influence Nutrition and Exercise Behaviors of a Community Sample of Adults

Fruit/vegetable consumption and physical activity are beneficial for disease prevention and health promotion; however, one-third of the U.S. adults do not eat fruits and vegetables even one time a day and nearly a quarter of adults do not participate in any physical activities. Self-efficacy and self-regulation are two theory-based determinants of health promotion. Self-efficacy is perceived confidence to perform a health behavior. Self-regulation includes a spectrum of effortful activities such as goal setting, affect regulation, coping strategy development, problem solving, self-monitoring, self-reinforcement, self-evaluation, cognitive restructuring, and stimulus control. Understanding how self-efficacy and self-regulation influence nutrition and exercise behaviors will help nurses develop determinant-behavior specific intervention. This study examined (1) the association of self-efficacy and self-regulation with three nutrition behaviors and exercise and (2) how men and women differ on these determinants and health behaviors. Methods: A cross-sectional design was used and 108 adults (54 men, 54 women) were recruited from a community event in a Midwestern county. This county, as compared to the U.S. top performing counties in the 90^th percentile, has more premature deaths (6,992 vs. 5,317), adult obesity (31% vs. 25%) and physical inactivity (26% vs. 21%), and lower rates of access to exercise opportunities (48% vs. 85%) and diabetic screening (85% vs. 90%). Nutrition behaviors (fruit/vegetable consumption, dinner cooking, and restaurant eating) and exercise were measured using total days in last week a behavior was reported. Instruments measuring self-efficacy and self-regulation demonstrated excellent Cronbach’s alphas (.93 - .95). Path analysis and t-test were used for data analysis. Findings: Most of the 108 participants were Caucasian (80%) and aged 20 to 49 years old (68%). About 31% had not engaged in any physical activity and 4% had not eaten any fruits and vegetables during the week before data collection. Self-efficacy and self-regulation were associated with exercise and fruit/vegetable consumption but not with dinner cooking or restaurant eating.  Path model analysis indicated that self-efficacy had an indirect effect on fruit/vegetable consumption (IE = 0.088; SE = 0.025; 95% CI = 0.042 - 0.141), and both direct (γ21 = 0.114; 95% CI = 0.056 - 0.171) and indirect (IE = 0.082; SE = 0.022; 95% CI = 0.043 - 0.128) effects on exercise. Self-regulation directly influenced fruit/vegetable consumption (β21 = 0.619; 95% CI = 0.306 - 0.930) and exercise (β21 = 0.564; 95% CI = 0.303 - 0.825). Compared to men, women had higher fruit/vegetable consumption and more dinner cooking but no difference in self-efficacy or self-regulation. Conclusions: self-efficacy and self-regulation are associated with exercise and fruit/vegetable consumption. For fruit/vegetable consumption, self-efficacy plays an indirect role, but self-regulation exerts direct influence. Intervention that enhancing self-regulation than self-efficacy may have a better likelihood of increasing fruit/vegetable consumption in an individual or a population. For exercise, both self-efficacy and self-regulation play a direct role in influencing exercise frequency. Due to their unique contributions to health promotion behaviors, self-efficacy and self-regulation should be strategically incorporated in interventions to improve specific health behavior.