Exploring the gap between healthy eating intentions and healthy eating behaviours using qualitative in-depth interviews Paul Naughton, UCC, TFRC Ashtown Dr Sinéad McCarthy, TFRC Ashtown Dr Mary McCarthy, UCC
Presentation Outline Study Background Research approach Qualitative in-depth interviews Qualitative findings informed the design of the quantitative study
Research Objective Research Question When people are motivated to pursue a healthy diet, what are the barriers and facilitating factors underlying healthy eating behaviour? Motivation Behaviour The transition of healthy motivations/intentions into healthy behaviour
Research Approach Mixed Methods (Bryman and Bell, 2007) Triangulation Qualitative Research Facilitates Quantitative Research Quantitative Research Facilitates Qualitative Research Qualitative Research Quantitative Research Qualitative Research Quantitative Research Quantitative Research Qualitative Research Conclusion Conclusion Conclusion Research hypotheses Self-completion questionnaire
Study Background Healthy eating behaviour is a process of self-regulation Motivational phase Volitional phase
Study Background Motivational Models of Health Behaviour (Armitage and Conner, 2000) Theory of Planned Behaviour, Health Belief Model, Protection Motivation Theory, Social Cognitive Theory. Intention behaviour gap Strong behavioural intentions do not always lead to corresponding behaviour (Armitage and Conner, 2001) Motivational Phase Barriers to intention implementation Volitional Phase Motivating factors Intention Behaviour Volitional/Post-Intentional Models of Health Behaviour Health Action Process Approach (HAPA)
Qualitative in-depth interviews: Sample To identify the factors that support and/or impede healthy dietary change and maintenance in an Irish population National Adult Nutrition Survey (NANS) qualitative study (n=80) Identify the determinants of dietary behaviour and food choices over the life course Qualitative in-depth interviews with 12 Irish Adults The discourse related to successful/failed attempts to make and maintain healthy dietary changes Undertaken in 2009 and early 2010
Qualitative in-depth interviews: Sample Female (pseudonym) Bodyweight Age Social class Anna Normal 18-35 3 Deirdre Normal 36-50 2 Michelle Normal 36-50 2 Mary Normal 51-64 2 Ciara Overweight 18-35 3 Sarah Overweight 51-64 4 Siobhan Obese 36-50 1 Elizabeth Obese 51-64 2 Male (pseudonym) David Normal 18-35 3 Jim Obese 36-50 1 Michael Obese 36-50 1 Patrick Obese 36-50 1
Qualitative in-depth interviews: Methodology In-depth interviews 12 transcripts 200 pages Exploratory study NVivo 8 software Systematic classification Themes & Categories Quotations Purposefully mined Qualitative content analysis Directed content analysis Findings
Qualitative in-depth interviews: what are the issues? Unconscious patterns of behaviour Eating habits Patrick if I was watching a DVD or watching something on TV, a film, I would feel maybe a couple of packets of crisps would be would just set the thing off right [laughs], and I m probably heading up to bed and saying ah jeez why did I eat that stuff, you know, but I d still do it again, you know Hedonic hunger Mary I mean I literally love chocolate and if I had one it s very dangerous someone came visiting and they bought a dairybox, I literally couldn t wait for them to go out the door and I ate the whole box of them when they were gone, so I would have that [laughs].
Qualitative in-depth interviews: what are the issues? Dietary self-efficacy Elizabeth For instance now I do quite a lot of walking and there s a new Italian ice cream shop and I only allow myself one scoop of that beautiful ice cream I don t take anymore than the one scoop and I even say to the girl I m only allowing myself one scoop. Perceived need David I am kind of conscious that I am sitting down all the time as well. I suppose it s just a mental thing like, if I am sitting at home watching the television I feel like I am kind of cheating myself, that I kind of need to be doing something to earn the right to be sitting down so I try to make up for it in terms of going to the gym and eating healthy.
Qualitative in-depth interviews: what are the issues? Self-regulation activities Dietary Planning Siobhan when we do a major shop we don t buy sweet stuff per se I would prefer that if I m really really hungry enough that I want something sweet that I actually have to go out, I have to be hungry enough to go out and buy it as opposed to having it sitting here in the house. Goal setting Ciara Self-Monitoring I am trying to lose a bit of weight at the moment, so I am trying to eat a bit healthier; We re getting married in October; I have that wedding dress thing in my mind. So, that s a big goal at the moment. Mary And then I just found during the summer that I lost a half a stone it kind of gave me a bit of motivation to stick with it and keep doing what I m doing and not vary too much.
Qualitative in-depth interviews: what are the issues? Unhealthy Dietary Habits Hedonic Hunger Automatic behaviour Dietary Intentions Deliberate behaviour Post-intentional Phase Dietary Behaviour Perceived Need Dietary Self-efficacy Self-regulation activities Self-Monitoring Planning Behaviour Goal setting
Qualitative in-depth interviews: what are the issues? Many observations fit with the thinking of others: Self-efficacy/PBC (Bandura, 1977; Ajzen & Madden, 1986) Lifestyle goal (Bagozzi, 1992; Bagozzi & Edwards, 1998; Abraham & Sheeran, 2003) Implementation intentions (Gollwitzer, 1993, 1999) Action planning and coping planning (Schwarzer, 2008, 2010) Self-monitoring (Sniehotta et al., 2005; Scholz et al., 2009) Habit (Verplanken and Aarts, 1999; Verplanken and Orbell, 2003) Some observations emerged: Hedonic Hunger (Lowe and Butryn, 2007) Perceived need (Paisley and Sparks; 1998; Payne et al., 2004) How important are these issues?
Quantitative study Self-completion questionnaire A representative sample of 509 Irish adults Target behaviour: Sugar consumption Avoidance behaviour Research hypotheses put forward
Quantitative study Sugar consumption 9 items Sugar consumption change 4 items Intention to change Binary variable From the interviews and literature review Confectionery habit 13 items Hedonic hunger 15 items Self-efficacy 5 items Dietary goal Binary variable Dietary Planning 7 items Goal satisfaction 2 items Self- Monitoring 3 items Perceived need 3 items Gender, age, education, Social class, BMI Self-completion questionnaire administered in 2011
Conclusion Qualitative research is most often used to explore an area when the theory base is not well developed Provide a deeper understanding of social phenomena than would be obtained from purely quantitative data It may lead to surprising findings or findings that appear surprising if a largely external/quantitative stance is taken Mixed methods: inform hypothesis and quantitative study design
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