Abstract: Objective: This study explored the possibility of integrating Health Belief Concepts as additional predictors of intention to adopt a recommended diet-category within the Theory of Planned Behavior (TPB). Methods: The study adopted a Sequential Exploratory Mixed Methods approach. Qualitative data were generated on attitude, subjective norm, perceived behavioral control and perceptions on predetermined diet-categories including perceived susceptibility, perceived benefits, perceived severity and cues to action. Synthesis of qualitative data was done using constant comparative approach during phase 1. A survey tool developed from qualitative results was used to collect information on the same concepts across 237 legible Type 2 diabetics. Data analysis included use of Structural Equation Modeling in Analysis of Moment Structures to explore the possibility of including perceived susceptibility, perceived benefits, perceived severity and cues to action as additional intention predictors in a single nested model. Results: Two models-one nested based on the traditional TPB model {χ2=223.3, df = 77, p = .02, χ2/df = 2.9; TLI = .93; CFI =.91; RMSEA (90CI) = .090(.039, .146)} and the newly proposed Planned Behavior Health Belief Model (PBHB) {χ2 = 743.47, df = 301, p = .019; TLI = .90; CFI=.91; RMSEA (90CI) = .079(.031, .14)} passed the goodness of fit tests based on common fit indicators used. Conclusion: The newly developed PBHB Model ranked higher than the traditional TPB model with reference made to chi-square ratios (PBHB: χ2/df = 2.47; p=0.19 against TPB: χ2/df = 2.9, p=0.02). The integrated model can be used to motivate Type 2 diabetics towards healthy eating.
Abstract: Many studies have applied the Theory of Planned
Behavior (TPB) in predicting health behaviors among unique
populations. However, a new paradigm is emerging where focus is
now directed to modification and expansion of the TPB model rather
than utilization of the traditional theory. This review proposes new
models modified from the Theory of Planned Behavior and suggest
an appropriate study design that can be used to test the models within
physical activity and dietary practice domains among Type 2
diabetics in Kenya. The review was conducted by means of literature
search in the field of nutrition behavior, health psychology and
mixed methods using predetermined key words. The results identify
pre-intention and post intention gaps within the TPB model that need
to be filled. Additional psychosocial factors are proposed to be
included in the TPB model to generate new models and the efficacy
of these models tested using mixed methods design.
Abstract: This study applied the Theory of Planned Behavior
model in predicting dietary behavior among Type 2 diabetics in a
Kenyan environment. The study was conducted for three months
within the diabetic clinic at Kisii Hospital in Nyanza Province in
Kenya and adopted sequential mixed methods design combing both
qualitative and quantitative phases. Qualitative data was analyzed
using grounded theory analysis method. Structural equation modeling
using maximum likelihood was used to analyze quantitative data.
The results based on the common fit indices revealed that the theory
of planned behavior fitted the data acceptably well among the Type 2
diabetes and within dietary behavior {χ2 = 223.3, df = 77, p = .02,
χ2/df = 2.9, n=237; TLI = .93; CFI =.91; RMSEA (90CI) = .090(.039,
.146)}. This implies that the Theory of Planned Behavior holds and
forms a framework for promoting dietary practice among Type 2
diabetics.