Understanding healthy eating behaviour within the context of the modern food environment

Abstract

The prevention of chronic disease requires understanding and intervention related to both individual and environmental level determinants. However, traditional approaches to chronic disease prevention and management have primarily been focused at the individual level, with limited attention toward environmental level influences on health behaviour. This lack of comprehensiveness is partially due to a paucity of complex theoretical frameworks for clarifying the influences of personal cognitive, and broader environmental, variables on a range of health behaviours. Therefore, the purpose of this research was to expand and test a popular health behaviour theory, Social Cognitive Theory (SCT), to include influences of the perceived food environment on healthy eating behaviour. This study involved two phases. Phase 1 expanded SCT to include a perceived food environment construct through review of the food environment literature. Phase 2 conducted a cross-sectional study of 201 adults (age 35 to 69 years) using an online survey to test the expanded SCT informed by phase 1. Data analysis included descriptive statistics and structural equation modeling (SEM) to compare the traditional and expanded SCT model. Results demonstrated no significant model fit, with no improvement in oveall fit with the inclusion of the perceived food environment. However, the expansion of SCT to include perceived food environment attributes altered the pathways of influence within the social cognitive model, suggesting that the presence of perceived environment measures is important for understanding how perceived environments might mediate the effect of personal cognitive influences on eating behaviour. These findings have implications for food environment research, the development of ecological theories, the field of health promotion and the prevention of chronic disease.