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

Monday, 9 November 2015: 2:05 PM

Carol Shieh, DNSc, MPH, RNC-OB
Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, IN, USA
Michael Weaver, PhD, FAAN, RN
Indian University School of Nursing, Indianapolis, IN, USA
Kathleen Newsome, BSN, RN
Medical Surgical Department, Saint Joseph Regional Medical Center, Plymouth, IN, USA
Kathleen Hanna, PhD, RN
Nebraska Medical Center College of Nursing, Omaha, NE, USA
Mulubrhan Mogos, PhD, BSN, MSN
Center for Research and Scholarship, Indiana University School of Nursing, Indianapolis, IN, USA

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 90th 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.