Developing a Holistic Model for Dietary Behavior Change in Urban Adolescents

Thesis Abstract

The rise in diet-related health issues among urban adolescents underscores the urgent need for effective behavioral interventions, yet existing models often neglect the multifaceted influences encompassing individual, social, and environmental factors that shape dietary choices. This study aims to develop a comprehensive holistic model for dietary behavior change tailored specifically to urban adolescents, integrating perspectives from behavioral science, social ecology, and health psychology. The research seeks to elucidate the complex interplay of personal attitudes, familial and peer influences, socio-economic status, and the built environment in shaping adolescents’ dietary habits, thereby providing a nuanced framework to inform targeted interventions. The study employs a mixed-methods research design, combining quantitative surveys and qualitative focus group discussions to achieve an in-depth understanding of dietary behaviors within this demographic. The quantitative component involves a cross-sectional survey of 1,200 adolescents aged 12 to 19 years, recruited via stratified random sampling from five diverse urban secondary schools. Data collection instruments include a validated Food Frequency Questionnaire (FFQ), a Self-Efficacy in Dietary Behavior Scale, and a Social Support for Healthy Eating Questionnaire. The qualitative component entails six focus group discussions with purposively selected adolescents, parents, and school counselors to capture contextual insights and perceptions related to dietary choices. The reliability and validity of instruments are established through pilot testing and Cronbach’s alpha coefficients exceeding 0.80. Data analysis primarily utilizes structural equation modeling (SEM) to examine relationships among latent constructs such as behavioral intention, self-efficacy, social support, and environmental factors. The model specification draws on Bandura’s Social Cognitive Theory and Bronfenbrenner’s Ecological Systems Theory, aiming to delineate pathways through which personal, social, and environmental factors influence dietary behavior change. Thematic analysis, conducted with NVivo software, is employed to analyze qualitative data, providing contextual depth to quantitative findings. Expected findings include significant predictive relationships between adolescents’ self-efficacy, perceived social support, and their actual dietary behaviors, mediated by environmental accessibility to healthy foods. The integrated model is anticipated to demonstrate good fit indices (CFI > 0.90, RMSEA < 0.06), confirming its robustness and applicability. The study expects to identify key leverage points for intervention, such as enhancing self-efficacy through skill-building activities and fostering supportive peer and family environments. This research contributes to existing knowledge by proposing a novel holistic framework that synthesizes behavioral, social, and environmental determinants of dietary change among urban adolescents, addressing gaps in prior models that often focus narrowly on individual factors. It offers empirical evidence for a multidimensional approach in designing effective nutritional interventions within urban settings, emphasizing the importance of contextual influences. The main conclusion underscores the critical role of an integrated, multi-level approach in promoting sustainable dietary behavior change, with policy implications for school-based programs, community engagement, and urban planning that facilitates healthy food choices. Recommendations include implementing comprehensive school nutrition curricula, strengthening peer-led support initiatives, and improving access to affordable healthy foods in urban environments. Suggestions for further research involve longitudinal studies to assess the long-term impact of intervention models based on the developed framework, and evaluating the model’s applicability across diverse urban populations to enhance generalizability. Overall, this study aims to advance theoretical understanding and practical strategies for fostering healthier dietary habits among adolescents living in complex urban settings.