Nutr Res Pract.  2011 Aug;5(4):337-348.

Utilizing the Health Belief Model to predicting female middle school students' behavioral intention of weight reduction by weight status

• Park DY

Abstract

Weight reduction behavior is common among adolescent girls. The present study examined the status of weight reduction behavior and factors affecting the behavioral intention of weight reduction using the Health Belief Model (HBM) for female middle school students by weight category. Survey data was collected from three girl's middle schools in Gyeongju, Korea. A total of 299 female middle school students participated in this study. The questionnaire had questions about general characteristics, weight reduction behavior, and variables of HBM (perceived threat, perceived benefits, perceived barriers, cues to action, self-efficacy in dietary life and exercise, and behavioral intention of weight reduction). Descriptive statistics, Chi-square tests, ANOVA, and multiple regression analysis were applied to analyze the variables. A higher percentage of students in the overweight group attempted weight reduction than those in the underweight and the normal weight groups (P < 0.001). Among students who had attempted weight reduction, 73% tried diet therapy, while 78% tried exercise. Students in the normal and overweight groups showed significantly higher threat (P < 0.01) and cues to action (P < 0.001) than those in the underweight group. As for perceived benefits, barriers, and self-efficacy in dietary life and exercise, there were no significant differences among weight groups. Students in the overweight group showed the strongest intention of weight reduction and there were significant differences among the three weight groups (P < 0.001). Perceive threat (P < 0.01), cues to action (P < 0.001), and perceived self-efficacy (P < 0.01) were significantly associated to behavioral intention of weight reduction for all respondents. For the underweight group, perceived threat (P < 0.05) and perceived self-efficacy (P < 0.01) were the significant variables. For the overweight group, cue to action was the significant variable (P < 0.05).

Keyword

Health Belief Model; weight reduction; female middle school students

MeSH Terms

Adolescent
Cues
Female
Humans
Intention
Korea
Overweight
Surveys and Questionnaires
Thinness
Weight Loss

Reference

1. Choi IS, Ro HK. A comparison study on middle school students of Gwangju and Jeonnam in terms of dietary behavior, body perception and weight control concerns according to BMI. J Korean Soc Food Sci Nutr. 2010. 39:383–391.

2. Kim JE, Min HS. Weight-related perceptions, practices and eating behaviors of middle school students: associations with BMI. Korean J Community Nutr. 2008. 13:13–23.

3. Kang HW, Lee SS. Obesity and weight control prevalence of middle school students in Seoul, Gyeonggi area. Korean J Nutr. 2006. 39:674–683.

4. Lee JS, Ha BJ. A study of the dietary attitude, dietary self-efficacy and nutrient intake among middle school students with different obesity indices in Gyeong-Nam. Korean J Community Nutr. 2003. 8:171–180.

5. Al Sabbah H, Vereecken C, Abdeen Z, Kelly C, Ojala K, Németh A, Ahluwalia N, Maes L. Weight control behaviors among overweight, normal weight and underweight adolescents in Palestine: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004). Int J Eat Disord. 2010. 43:326–336.

6. Kelly C, Molcho M, Nic Gabhainn S. Patterns in weight reduction behaviour by weight status in schoolchildren. Public Health Nutr. 2009. 13:1229–1236.

7. Ojala K, Vereecken C, Välimaa R, Currie C, Villberg J, Tynjälä J, Kannas L. Attempts to lose weight among overweight and nonoverweight adolescents: a cross-national survey. Int J Behav Nutr Phys Act. 2007. 4:50.

8. Neumark-Sztainer D, Story M, Hannan PJ, Perry CL, Irving LM. Weight-related concerns and behaviors among overweight and nonoverweight adolescents: implications for preventing weight-related disorders. Arch Pediatr Adolesc Med. 2002. 156:171–178.

9. Baker JL, Olsen LW, Sørensen TI. Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med. 2007. 357:2329–2337.

10. Neovius M, Sundström J, Rasmussen F. Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study. BMJ. 2009. 338:b496.

11. Fonseca H, Gaspar de Matos M. Perception of overweight and obesity among Portuguese adolescents: an overview of associated factors. Eur J Public Health. 2005. 15:323–328.

12. Mallick MJ. Health hazards of obesity and weight control in children: a review of the literature. Am J Public Health. 1983. 73:78–82.

13. Pesa J. Psychosocial factors associated with dieting behaviors among female adolescents. J Sch Health. 1999. 69:196–201.

14. Spear BA. Does dieting increase the risk for obesity and eating disorders? J Am Diet Assoc. 2006. 106:523–525.

15. Brener ND, Eaton DK, Lowry R, McManus T. The association between weight perception and BMI among high school students. Obes Res. 2004. 12:1866–1874.

16. Park HS. A study on body image and influences on the intention to reduce food intake of female high school students. 1998. Gyeongju: Dongguk University;[master's thesis].

17. Ryu HK. Factors affecting the weight control intention of the female adolescent by body size-in Daegu area. Korean J Community Living Sci. 2005. 16:83–93.

18. Neumark-Sztainer D, Paxton SJ, Hannan PJ, Haines J, Story M. Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. J Adolesc Health. 2006. 39:244–251.

19. Alwan H, Viswanathan B, Paccaud F, Bovet P. Is accurate perception of body image associated with appropriate weight-control behavior among adolescents of the Seychelles. J Obes. 2011. 2011:817242.

20. Levine MP, Smolak L, Hayden H. The relation of sociocultural factors to eating attitudes and behaviors among middle school girls. J Early Adolesc. 1994. 14:471–490.

21. Eisenberg ME, Neumark-Sztainer D, Story M, Perry C. The role of social norms and friends' influences on unhealthy weight-control behaviors among adolescent girls. Soc Sci Med. 2005. 60:1165–1173.

22. Hutchinson DM, Rapee RM. Do friends share similar body image and eating problems? The role of social networks and peer influences in early adolescence. Behav Res Ther. 2007. 45:1557–1577.

23. Leahey TM, LaRose JG, Fava JL, Wing RR. Social influences are associated with BMI and weight loss intentions in young adults. Obesity (Silver Spring). 2011. 19:1157–1162.

24. Kang YJ, Jin KN, Lee HR. Factors influencing weight control intention of obese adolescents. J Korean Soc Study Obes. 1998. 7:142–156.

25. Lee CM. The effect of health belief and self-efficiency on weight-control behavior and intention to obesity control among elementary schoolers. 2004. Daegu: Catholic University of Daegu;[master's thesis].

26. O'Connell JK, Price JH, Roberts SM, Jurs SG, McKinley R. Utilizing the Health Belief Model to predict dieting and exercising behavior of obese and nonobese adolescents. Health Educ Q. 1985. 12:343–351.

27. Nejad LM, Wertheim EH, Greenwood KM. Comparison of the Health Belief Model and the Theory of Planned Behavior in the prediction of dieting and fasting behavior. E-Journal of Applied Psychology: Social Section. 2005. 1:63–74.

28. Garcia K, Mann T. From 'I wish' to 'I will': Social-cognitive predictors of behavioral intentions. J Health Psychol. 2003. 8:347–360.

29. McKinley CJ. Investigating the influence of threat appraisals and social support on healthy eating behavior and drive for thinness. Health Commun. 2009. 24:735–745.

30. Moore SE, Harris C, Wimberly Y. Perception of weight and threat to health. J Natl Med Assoc. 2010. 102:119–124.

31. Korean Ministry of Education, Science and Technology [Internet]. cited August 4. Seoul: '06~'08 Results of school health examination;Available from: http://www.korea.kr/expdoc/viewDocument.ref?id=25401.

32. Kim MH. A study on the relations of health promoting daily life style and self-efficiency about boys' obesity [master's thesis]. 2000. Seoul: Chung-Ang University.

33. Kang YJ. Factors influencing weight control behavior and intention of obese children and adolescents [Ph.D. thesis]. 1997. Seoul: Yonsei University.

34. Lee JI. A study on obese children's self-efficiency and health promotion behavior [Ph.D. thesis]. 2001. Kyongbuk: Kyungsan University.

35. Kim JY, Son SJ, Lee JE, Kim JH, Jung IK. The effects of body image satisfaction on obesity stress, weight control attitudes, and eating disorders among female junior high school students. J Korean Home Econ Assoc. 2009. 47:49–59.

36. Kim BR, Kim YS. Dietary behaviors, body satisfaction and factors affecting the weight control interest according to gender of middle school students in Wonju area. J Korean Soc Food Sci Nutr. 2010. 39:1295–1304.

37. Park HA, Rhie SG, Won HR. Comparative study on dietary behavior, nutrition knowledge and cognition of body image, weight control and nutrition education of middle school students according to gender. Korean J Community Living Sci. 2007. 18:481–491.

38. Ryu HK, Yoon JS, Park DY. A study of factors influencing weight control behavior in adolescent females. Korean J Community Nutr. 1999. 4:561–567.

39. Ryu HK, Park JA. Perception of body image, eating disorder, eating behaviors and subjective health status of female high school and college students in Daegu area. Korean J Community Living Sci. 2002. 13:69–80.

40. Neumark-Sztainer D, Wall M, Eisenberg ME, Story M, Hannan PJ. Overweight status and weight control behaviors in adolescents: Longitudinal and secular trends from 1999 to 2004. Prev Med. 2006. 43:52–59.

41. Boyd EM, Reynolds JR, Tillman KH, Martin PY. Adolescent girls' race/ethnic status, identities, and drive for thinness. Soc Sci Res. 2011. 40:667–684.

42. Kim NY, Jung IS, Kim JS. A comparative study on the self-efficacy and health promoting behavior between obese and normal weight middle school students. J Korean Community Nurs. 2001. 12:828–837.