运用跨理论模型分析青少年蔬果摄入行为

Research on the behavior of fruit and vegetable intake in adolescents with Transtheoretical Model

目的了解青少年蔬果摄入行为现状及影响因素，探讨相关健康教育措施。方法采用多阶段抽样法在杭州城区抽取1677名中小学生，采用美国在运动及营养评价和咨询项目中制定的青少年蔬菜水果摄入行为量表（中文版），进行有关蔬果摄入行为调查，运用跨理论模型对中小学生的蔬果摄入量、蔬果摄入行为阶段、行为过程、决策平衡、自我效能现状进行分析。结果青少年平均蔬果摄入量为（3．21±1．50）份／d（“I份的量”指100g经烹饪的蔬菜或100g水果）。蔬果摄入行为处于意向阶段的人数最多，占36．91％（619／1677）。蔬果摄人行为变化过程、决策平衡（正面因素）、自我效能均与行为阶段发展存在正相关[r过程=0．38、r决策（正）=0．26、r效能=0．33，t值依次为16．78、11．02、14．31，P值均〈0．05]，青少年蔬果摄入量与行为变化阶段、自我效能存在正相关（β阶段=0．665，t=35．07，P〈0．05；β效能=0．050，t=2．63，P〈0．05）与决策平衡（负面因素）存在着负相关[β决策（负）=-0．051，t=-2．84，P〈0．05]。结论青少年蔬果摄入量偏少，随着行为阶段的发展及自我效能的改善，蔬果摄入量也相应增加。对青少年蔬果摄入行为干预时应使其认识到达到推荐摄入量的益处、增强其信心。

Objective To study the current situation and factors influencing the behavior of fruit and vegetable intake in adolescents, and to discuss health education strategy related to the behavior. Methods 1677 students were selected from primary school and middle school in urban area of Hangzhou by a multistage sampling method. The behavior of fruit and vegetable intake was surveyed by questionnaires of the patient-centered assessment and counseling for exercise plus nutrition project （ PACE ＋ ） for adolescent - scale of fruit and vegetable consumption, and analyzed by Transtheoretical Model on the servings of intake, the stage of change, process of change, decisional balance and the current status of self-efficacy. Results The average intake of fruit and vegetable in adolescents was （3.21 ± 1.50） servings per day （ ＂one serving＂ means 100 g cooked vegetable or 100g fruit）. The behavior of consuming fruit and vegetable in most of the adolescents was in the contemplation stage, accounting for 36. 91% （619/1677）. The process of behavior change, decisional balance （Pros） and self-efficacy existed a positive correlation with the process of stage （rp = 0. 38, raeoiioal decialcnal balarce（Pmax） = 0. 26, rasfficacy = 0. 33, t values were 16. 78, 11.02 and 14. 31, P 〈 0.05 ）. The servings of fruit and vegetable intake existed a positive correlation with stage transition and selfefficacy（βsiage trvaition = 0. 665, t = 35.07, P 〈 0. 05 ;βnelf.efncary = 0. 050, t = 2. 63, P 〈 0. 05 ）, and existed a negative correlation with decisional balance （Cons） （βdeeisional balance （Cons） =- 0. 051, t = -2. 84, P 〈 0. 05 ）. Conclusion Fruit and vegetable intake of these adolescents are under the recommended dietary intake. Along with behavior stage development and self-efficacy improvement, the intake of fruit and vegetable also increased correspondingly. Intervention strategies should aim at improving the awareness of adolescents on the health benefits of fruit and vegetable intake and promoting their confidence to reach the recommended servings.