Health Education Research

Psychosocial predictors of fruit and vegetable consumption among elementary school children
S.B. Domel, W.O. Thompson, H.C. Davis, T. Baranowski, S.B. Leonard and J. Baranowski
Health Educ. Res. 11:299-308, 1996.
doi:10.1093/her/11.3.299

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 HEALTH EDUCATION RESEARCH Vol.11 no.3 1996
Theory & Practice Pages 299-308

Psychosocial predictors of fruit and vegetable

consumption among elementary school children

S.B.Domel, W.O.Thompson1, H.C.Davis1, T.Baranowski2, S.B.Leonard3 and

J.Baranowski2

Abstract F&V consumption among elementary school

children than programs which target self-
A self-efficacy questionnaire for fruit and veget- efficacy and outcome expectations. However,
able (F&V) consumption among fourth and fifth since preferences accounted for only small pro-
grade students was developed, pilot tested with portions of the variances, further research
140 students from one school and field tested should consider other issues such as availability.
with 252 students from two schools. The ques-
tionnaire included 34 items generated by invent-
Introduction
orying behaviors targeted for change in the
F&V school curriculum. The four subscales
Increased fruit and vegetable (F&V) consumption
derived from principal components analysis
is an aspect of eating which has received consider-
were labeled 'after-school F&V snacks'; 'break-
able attention recently in various nutrition guide-
fast and lunch F&V, and paying for F&V;
lines to decrease the risk of several chronic diseases
'independent shopping for F&V; and 'assisted
such as cardiovascular disease and certain cancers
shopping for F&V; they accounted for 43.8%
(American Heart Association, 1988; Butrum et al.,
of the total variance. Subscale test-re-test reliab-
1988; Surgeon General, 1988; Committee on Diet
ilities and internal consistencies were acceptable.
and Health, 1989; USDA and USDHHS, 1990).
Criterion validities against F&V consumption
One of the Nation's Year 2000 Health Goals
from food records were low. Relationships were
(USDHHS, 1991) specifies a minimum of five
stronger with preferences and outcome expecta-
daily servings of F&V; the Food Guide Pyramid
tions. Results from stepwise regression analyses
(USDA and HNIS, 1992) recommends two to four
indicated that preferences were the only signi-
daily servings of fruit (F) and three to five daily
ficant predictors of fruit and total F&V con-
servings of vegetables (V). A national program
sumption, as well as the main predictor of
entitled '5 A Day For Better Health' (Subar et al,
vegetable consumption; however, the models
1992; Havas et al., 1995) was recently initiated to
accounted for less than 13% of the variance.
help Americans eat more F&V since most adults
Nutrition education programs which target
and children consume much less than the recom-
preferences may be more effective in increasing
mended levels (Patterson et al., 1990; Block, 1991;
Subar et al., 1992; Wolfe and Campbell, 1993;
Georgia Prevention Institute, Department of Pediatrics, DOmel et al., 1994a). Behaviors initiated during
Medical College of Georgia, Augusta, GA 30912-3710, childhood may last into adulthood and thereby
'Office or Biostatistics, Medical College of Georgia, impact the risk of chronic diseases (Kelder et al.,
Augusta, GA 30912-4900, 'Department or Behavioral 1994).
Science, University of Texas MJXAnderson Cancer
Center, Houston, TX 77030 and ^Section of Endocrinology Eating is a behavior. According to Bandura's
and Nutrition, Department of Medidne, Medical College Social Cognitive Theory (1986), behavior may be
of Georgia, Augusta, GA 30912-3102, USA explained and predicted by several key concepts

© Oxford University Press 299

 S.B.Domel et al.
including self-efficacy and outcome expectations.
Within social cognitive theory, skills provide the
capability to perform the behavior, outcome
expectations provide the motivation for the
behavior and self-efficacy provides the confidence
that barriers can be overcome (Baranowski, 1990).
Self-efficacy concerns the beliefs a person has
about how capable s/he is of performing a particular
behavior in particular situations (Strecher et al.,
1986). Bandura (1982, 1986) proposed that
behavior change will occur only when the person
has a substantial level of self-efficacy for, or the
confidence that s/he can perform, the new behavior.
Since self-efficacy reflects beliefs about abilities,
the perceptions, not necessarily the 'true' abilities,
influence behavior (Strecher et al., 1986). Strong
relationships were reported between self-efficacy
and health behavior change and maintenance in a
review of studies regarding health practices such
as weight control and alcohol abuse (Strecher et al.,
1986). In the 'Go For Health' project, self-efficacy
for heart-healthy foods was studied among third
and fourth grade students through 18 items that
asked how sure students were of choosing a heart-
healthy alternative in a variety of scenarios; an a
coefficient of 0.76 was reported (Parcel et al,
1989).
Outcome expectations are the beliefs about
whether a certain behavior will lead to certain
outcomes (Strecher et al., 1986). Outcome expecta-
tions have been shown to relate to alcohol con-
sumption among adolescents and adults (see
Goldman et al., 1987 for a review), and to low-
and high-fat food consumption among college
students (Bowen et al, 1992).
Food preferences are also thought to be deter-
minants of eating behavior (Birch and Sullivan,
1991; Contento, 1991). Preference involves affect
or liking for something and/or choosing one thing
over something else (Birch and Sullivan, 1991).
Birch (1979) reported that preferences of nursery
school children for various sandwiches were effect-
ive predictors of consumption (r = 0.80, P <
0.01). Calfas etal. (1991) reported 66% agreement
between stated preferences and food choices from
300
pairs of photographed foods among 4- to 8-year-
old children.
Research regarding the reliability and validity
of questionnaires for preferences and outcome
expectations regarding F&V consumption among
fourth and fifth grade students has recently been
conducted (Domel et al., 1993a, 1995). The pur-
pose of this paper is two-fold: (1) to describe the
development, pilot testing and field application of
a self-efficacy questionnaire for F&V consumption
among fourth and fifth grade students, and to
discuss questionnaire subscales and assessment of
reliability and validity; and (2) to report psycho-
social predictors, specifically self-efficacy, out-
come expectations and preferences of F&V
consumption among fourth and fifth grade students.
This study was conducted with data collected for
a larger study which involved the development
and pilot testing of a 6 week, school-based curric-
ulum to increase F&V consumption among fourth
and fifth grade students (Domel et al., 1993b).
Methods
Overview
The self-efficacy questionnaire for F&V consump-
tion was developed and pilot tested at one school
and field tested at two schools in an intervention
trial; the three elementary schools were randomly
assigned to either the developmental or field
application conditions. Approximately half of the
students were eligible for free or reduced-price
lunches. The study received approval from the
institutional Human Assurance Committee;
informed consent forms were signed by each
participant and one of his/her parents.
Development of self-efficacy questionnaire
The self-efficacy questionnaire included 34 items
generated by inventorying behaviors targeted for
change in the F&V school curriculum; topics
included purchasing F&V, selecting F&V over
other items for after-school snacks, including F at
breakfast and adding F&V at lunch. The three
response options listed for each item included 'not

at all confident', 'a little confident' and 'very
confident'.
Pilot testing
Approximately 73% of the 246 students from all
fourth and fifth grade classes (five of each) from
school 1 participated in the pilot testing. Data
collectors followed a written protocol to classroom
administer the questionnaire two times about 14
days apart (to assess test-re-test reliability); the
procedure for classroom administration has been
described previously (Domel et al., 1993a).
Questionnaire revisions
Cronbach's a coefficients for the 34 items were
0.88 and 0.92 within the first and second adminis-
trations, respectively. Test-re-test reliability
(Pearson product-moment correlation) between the
first and second administrations was 0.70. Based
on these results and comments from the data
collectors, minor wording revisions were made in
two items, and the word 'confident' was changed
to 'sure' in the response options and group headings
before field application.
Field application
Approximately 92% of the 378 fourth and fifth
grade students from all fourth and fifth grade
classes (eight of each) from schools 2 and 3
participated in the field application. The revised
questionnaire was classroom administered in a
manner similar to that used during pilot testing.
Analyses
Responses were coded as 0 = not at all confident
(sure), 1 = a little confident (sure) and 2 = very
confident (sure). The few students of other racial-
ethnic groups (4.3%) were added to the white, non-
Hispanic group to form a 'non-African-American'
group since the vast majority of the sample was
white, non-Hispanic (40.3%) or African-
American (55.4%).
Principal components analysis was conducted to
identify subscales. Because only minor revisions
were made between pilot and field testing, the data
from all three schools were combined in order to
Psychosocial predictors of fruit and vegetable intake
use the largest possible data set A scree plot of
the eigenvalues was used to determine the number
of principal components to retain; varimax rotation
was then used to achieve simple structure. Data
were also randomly split in half and re-analyzed
to determine whether the items loaded similarly
on the same number of components. Items with
loadings of 0.4 or higher on more than one compon-
ent or with loadings of less than 0.4 on any
component were excluded from further analyses.
The items that loaded at 0.4 or higher for each of
the principal components were unit weighted and
averaged to compute self-efficacy subscale scores
for each subject
A multivariate analyses of variance (MANOVA)
was conducted on the set of self-efficacy subscales
by gender, grade (fourth, fifth), ethnicity (non-
African-American, African-American) and school
(1,2, 3). This was followed by univariate analyses
of variance (ANOVA) for each subscale separately.
Internal consistencies were calculated using Cron-
bach's a coefficient to assess reliability for each
subscale for schools 2 and 3. The pilot data
from school 1 were re-analyzed by subscale; this
included Pearson product—moment correlations to
determine test—re-test reliabilities and Cronbach's
a to assess internal consistencies. Test-re-test
reliabilities by subscale were also calculated for
school 3 over a 7 week period; they were not
calculated for school 2 since an educational inter-
vention had occurred.
To evaluate criterion validity between the ques-
tionnaire and F&V consumption (Contento, 1991)
for schools 2 and 3 combined (field sample),
Pearson product-moment correlations were com-
puted between the F&V self-efficacy subscales and
actual F&V consumption determined from daily
food records completed by students for 1 week
prior to completing the questionnaire; consumption
variables included servings of F (F and F&V
juices), V (V and legumes) and F&V combined
The food record procedure and validation through
school lunch observations have been described
previously (Domel et al., 1994b); Pearson correla-
tions between components of the school lunch
301
S.B.Domel et al.
portion of the food records and observations ranged
from 0.16 to 0.85 with a median of 0.66. The
procedure for coding F&V servings from the
food records has been described elsewhere (Domel
et al., 1993b).
To relate F&V self-efficacy with F&V prefer-
ences for the field sample, Pearson correlations
were computed between the self-efficacy subscales
and preferences for F, V and F&V snacks as
assessed through a F&V preferences questionnaire
administered 1 day prior to the self-efficacy ques-
tionnaire. The 31 items assessed how much the
students liked 10 common F and 10 common V,
and whether the students preferred F&V to 11 other
after-school snacks. Cronbach's a coefficients for
the three preference subscales (F, V and F&V
snacks) ranged from 0.55 to 0.77; Pearson correla-
tions for each of the three preference subscales
with F&V consumption ranged from 0.01 to 0.29
with a median of 0.17 (Domel et al., 1993a).
To relate F&V self-efficacy with F&V outcome
expectations, Pearson correlations were computed
between the F&V self-efficacy subscales and two
F&V outcome expectation subscales as assessed
through a F&V outcome expectations questionnaire
administered immediately after the self-efficacy
questionnaire. The 17 items were applied to F
and repeated for V. Principal components analysis
indicated two outcome expectation subscales:
social, and health and physical ability. Cronbach's
a coefficients for the subscales ranged from 0.79 to
0.89; Pearson correlations for each of the subscales
with F&V consumption ranged from 0.11 to 0.16
(Domel et al., 1995).
Correlations with the F&V self-efficacy sub-
scales were computed within cells and transformed
using Fisher's r to z transformation; a weighted
average was then taken and transformed back to r.
These transformations were required since mean
values differed by cell membership, which can
inflate correlation coefficients. Significance was
set at a of 0.05; significance tests were one-tailed
where applicable.
To determine psychosocial predictors of F&V
consumption among fourth and fifth grade students,
a stepwise regression was conducted with demo-
302
graphics (gender, ethnicity, grade), F&V prefer-
ences subscales, F&V outcome expectations
subscales and F&V self-efficacy subscales as the
independent variables, and F consumption as the
dependent variable. The analysis was then con-
ducted with V consumption as the dependent
variable-, and finally with total F&V consumption
as the dependent variable. F&V were analyzed
separately as well as combined for direct assess-
ment of the Year 2000 F&V health goal (USDHHS,
1991) and the '5 A Day For Better Health' program
goal (Subar et al., 1992) which combine F&V, and
the Food Guide Pyramid recommendations (USDA
and HNIS, 1992) which separate F from V.
Results
The sample consisted of 392 students (49% male,
54% fourth graders, 56% African-American) with
140, 164 and 88 students from schools 1, 2 and 3,
respectively. The samples by school were approxi-
mately evenly split by gender, grade and racial-
ethnic group except for at school 1 where 67%
were African-American and at school 3 where 64%
were fourth graders. Approximately 16% of the
students were absent from class during question-
naire administration. Approximately 7% of the
students were eliminated from analyses for not
answering all of the items and another 3% for
answering every item 'not at all confident/sure',
which suggested they were not paying attention to
the individual questions.
The four subscales derived from principal com-
ponents analysis were labeled 'after-school F&V
snacks'; 'breakfast and lunch F&V, and paying
for F & V ; 'independent shopping for F&V; and
'assisted shopping for F&V; they accounted for
43.8% of the total variance. Similar results were
indicated when principal components analysis with
varimax rotation was conducted on half of the
sample randomly selected and then repeated on
the remaining half.
Overall subscale means across items were 1.29
(SD = 0.55) for 'after school F&V snacks'; 1.30
(SD = 0.49) for 'breakfast and lunch F&V, and
paying for F&V; 1.17 (SD = 0.53) for 'independ-
 Psychosocial predictors of fruit and vegetable intake

Table L Coefficient a for four F&V self-efficacy subscales by school (separately and combined)

F&V self-efficacy subscales

After school Breakfast and lunch F&V, Independent shopping Assisted shopping
F&V snacks and paying for F&V for F&V for F&V

School 1
1st administration 0.81 0.68 0.76 0.74
2nd administration 0.86 0.77 0.84 0.79
School 2 0.86 0.77 0.76 0.71
School 3 0.88 0.76 0.68 0.64
All three schools combined 0.87 0.78 0.74 0.72

Table II. Pearson product-moment correlations between four F&V self-efficacy subscales

Breakfast and lunch F&V, Independent shopping Assisted shopping

and paying for F&V for F&V for F&V

After school F&V snacks 0.57 0.21 0.44

Breakfast and lunch F&V, and paying for F&V 0.29 0.45
Independent shopping for F&V 0.34

ent shopping for F&V; and 1.69 (SD = 0.39)

Table m . Test-re-test reliabilities for four F&V self-efficacy
for 'assisted shopping for F&V. Means for the subscales for school I and school 3*
'assisted shopping for F&V subscale were higher
than those for the other three subscales regardless School l b School 3C
of gender, grade and ethnicity.
After school F&V snacki 0.62 0.51
Cronbach's a coefficients (Table I) for the four Breakfast and lunch F&V, and 0.67 0.63
subscales were high and ranged from 0.72 to 0.87 paying for F&V
for all three schools combined, which indicated Independent shopping for F&V 0.64 0.53
that the subscale items were measuring the same Assisted shopping for F&V 0.52 0.35
underlying constructs. Pearson product-moment Test-re-test reliabilities were not calculated for School 2
correlations (Table II) between the four subscales since an educational intervention occurred between the two
were low and ranged from 0.21 to 0.57, which administrations.
indicated that they were measuring four different 'Two weeks separated the two administrations.
c
constructs. Test-re-test reliabilities (Table HI) at Seven weeks separated the two administrations.
school 1 over a 2 week period were acceptable;
however, at school 3 over a 7 week period, they and 3 were the highest (1.46 and 1.44, respectively)
were lower than at school 1 over a 2 week period. and school 1 (0.99) the lowest.
Results from the MANOVA indicated an overall For the 'breakfast and lunch F&V, and paying
significant effect for the school by grade by ethni- for F&V subscale, ANOVA results indicated a
city by gender interaction (P < 0.03). Since this significant ethnicity effect (P < 0.004) and a
term included all of the independent variables, the significant school effect (P < 0.001) which were
univariate ANOVA's were conducted using the full subsumed within a significant gender by ethnicity
model with each of the four subscales as dependent by school interaction (P < 0.01). At school 1,
variables. Results from the ANOVA for the 'after African-American boys and non-African-American
school F&V snacks' subscale indicated a signific- girls scored the highest (1.11 and 1.10, respect-
ant school effect (P < 0.001). Means at schools 2 ively). At school 2, African-American boys scored

303
S.B.Domel et al.

Tame IV. Weighted Pearson correlations (one-tailed) between four F&.V self-efficacy subscaUs, F and V consumption, F and V
preferences, and two F and V outcome expectation subscaUs for field sample (n = 206)

F and V self-efficacy subscales

After school Breakfast and lunch F&V, Independent shopping Assisted shopping
F and V snacks and paying for F and V for F and V for F and V

Consumption
fruits 0.06 0.07 0.09 -0.02
vegetables 0.06 0.17* 0.06 0.08
F&V 0.06 0.13* 0.08 0.04
Preferences
fruits 0.20** 0.23*** 0.12 0.18**
vegetables 0.23*** 0.19** 0.03 0.22**
F&V snacks 0.49*«* 0.12 0.15* 0.26***
Outcome expectation subscales
social 0.06 0.14* 0.20** 0.02
health/physical ability 0.24*** 0.25*** 0.13* 0.24***

*P < 0.05; **P < 0.01; •••/> < 0.001.

the highest (1.65), followed by African-American

Tabte V. Pearson correlations (unweighted) between
girls (1.55). At school 3, African-American girls demographic and psychosocial variables and F&V
scored the highest (1.58), followed by African- consumption
American boys (1.44). Means for all groups at
school 1 were lower than those at schools 2 and 3. Consumption variables
Results from the ANOVA for the 'independent Fruit Vegetable F&V
shopping for F&V subscale indicated only a
significant ethnicity effect (P < 0.04); means Demographic variables
gender 0.05 0.01 0.04
for African-Americans were higher than for non-
grade -0.05 0.10 0.04
African-Americans (1.24 versus 1.08). Results ethnicity 0.06 0.07 0.09
from ANOVA for the 'assisted shopping for F&V Preference subscales
subscale were non-significant fruit 0.20** 021***
Pearson correlations between the F&V self- vegetables 0.27*** 032***
F&V snacks 0.15*
efficacy subscales and F&V consumption, F&V Self-efficacy subscales
preferences and F&V outcome expectations for the after school F&V snacks 0.08 0.08 0.10
field sample are found in Table IV. Of the 252 breakfast and lunch F&V,
students in the field sample, 206 (137 and 69 from and paying for F&V 0.09 0.20** 0.18**
schools 2 and 3, respectively) completed all three independent shopping for
F&V 0.11 0.06 0.10
of the questionnaires and the food record. This assisted shopping for F&V 0.00 0.08 0.05
sample was fairly evenly split by gender, grade and Outcome expectation subscales
ethnicity. Correlations between the self-efficacy social 0.08 0.15* 0.15*
subscales and F&V consumption ranged from health/physical ability 0.14* 0.14* 0.18**
-0.02 to 0.17. Between the self-efficacy subscales
*P < 0.05; **P < 0.01; ***P < 0.001.
and preferences, correlations ranged from 0.03 to
0.49; the highest correlation coefficient was tions between the self-efficacy subscales and out-
between preferences for F&V snacks and self- come expectations ranged from 0.02 to 0.25.
efficacy for 'after school F&V snacks'. Correla- Table V includes correlations between each

304
 PsychosociaJ predictors of fruit and vegetable intake
Table VL Regression results predicting FA. V consumption using psychosocial and demographicvariables (n = 206)
Variables in equation Fruit consumption
2 2
R increase Significance
Vegetable preferences
Fruit preferences 0.04 0.01
Self-efficacy for breakfast and
lunch F&V, and paying for F&V
Adjusted R2 0.03
demographic (gender, grade and ethnicity) and
psychosocial predictor (subscales for preferences,
self-efficacy and outcome expectations) and each
of the dependent measures (consumption for F,
V and F&V combined) for stepwise regression
analyses. Table VI includes R2 change and respect-
ive P values from the stepwise regression. The
adjusted R2's for F, V and total F&V consumption
were 0.03, 0.09 and 0.12, respectively. The only
significant predictor for F consumption was F
preferences. The first significant predictor for V
consumption was V preferences; the second pre-
dictor, self-efficacy for 'breakfast and lunch F&V
and paying for F&V, increased the R2 by only
0.02. For total F&V consumption, V preferences
was the first significant predictor, the second pre-
dictor, F preferences, added only 0.02 to the R2.
The predictive value of the independent variables
was much stronger when V consumption, rather
than F consumption, was the dependent variable.
Discussion
While internal consistencies were high, test-re-test
reliability decreased as time increased from 2 to 7
weeks which indicates instability in the children's
response to F&V self-efficacy items. One possible
explanation would be that self-efficacy performs
much like a mood variable among children.
Means for the 'after school F&V snacks' sub-
scale were much lower at school 1 than schools 2
Vegetable consumption F&V consumption
R increase Significance R2 increase Significance
0.07 0.01 0.10 0.01
(Mepl) (step 1)
0.02 0.03
(step 2)
0.02 0.04
(step 2)
0.09 0.12
and 3. Investigation of individual items indicated
that means for the majority of items in this subscale
(15 of 17) were significantly lower (ANOVA,
P < 0.05) at school 1 than at schools 2 and 3.
Although means for all of the F&V self-efficacy
subscales indicated that the students reported being
somewhere between 'a little confident/sure' and
'very confident/ sure' that they could do the various
tasks concerning eating more F&V, overall F&V
consumption was low (Domel et ai, 1993b). In
addition, criterion validity for the F&V self-
efficacy subscales was low; while two of the 12
correlation coefficients with F&V consumption
were significantly greater than zero, they accounted
for only small proportions of the variance. One
possible explanation for the low correlations of
F&V self-efficacy to F&V consumption is that the
F&V available and served are not completely under
the children's control (Hearn et al., 1996), thereby
minimizing the possible effect of perceived self-
efficacy. Since there are numerous determinants of
eating (Michela and Contento, 1986), a second
explanation would be that self-efficacy may not be
a primary determinant of F&V consumption among
children. Alternatively, the instrument itself simply
may have low validity.
The relationships among F&V self-efficacy,
F&V preferences and F&V outcome expectations
were stronger than those with F&V consumption.
While 10 of the 12 correlation coefficients between
F&V self-efficacy and F&V preferences were sig-
305
S.B.Domel et al.
nificantly greater than zero, they were nevertheless
low; the highest correlation was between prefer-
ences for F&V snacks and the 'after school F&V
snacks' subscale. First, consistent with above theor-
izing, the child probably exerts more influence
over snacks than any of the meals. Alternatively,
it is possible that enhanced motivation for F&V,
as revealed through preferences, enhanced the
perceptions of self-efficacy (e.g. an enhanced will-
ingness to overcome more potential barriers); that
higher self-efficacy had a dissonance reduction
type effect on preferences (Scher and Cooper,
1989); or some third variable was affecting both
self-efficacy and preferences, e.g. exposure to F&V
(Domel et al., 1993a). Six of the eight correlation
coefficients between self-efficacy and outcome
expectations were significantly greater than zero;
however, they were also moderately low, thereby
accounting for only small proportions of the
variance.
The questionnaire might be improved by includ-
ing a more systematic sampling of question types.
For example, a matrix could be developed from
which questions could be sampled and systematic-
ally varied including different meals (breakfast,
lunch, dinner, snack), preparation method (frozen,
canned, raw), location (home, school, fast food
restaurant), identification of food type (favorite F
or V, specific F or V, favorite cookie or candy bar)
and position of food ('instead of or 'in addition
to'). We believe that the 'instead o f format (e.g.
selection of F&V items over an alternative) poses
more realistic choices in some situations while the
'in addition to' format poses more realistic choices
in other situations; thus, both types of formats
merit further research.
An issue which could impact the relationship
between F&V self-efficacy and F&V consumption
involves many teachers, parents and care-givers
who may unconsciously attempt to deactivate a
child's individual responsibility for changing eating
behaviors, e.g. by requiring the child to eat F&V
served. This conflicts with the self-efficacy model
which attempts to activate the person to assume
individual responsibility for changing (Strecher
et al., 1986). According to Satter (1983), a division
306
of feeding responsibility is needed in which the
adult is responsible for providing food that is
appropriate for the child and offering it in a positive
environment; the child is responsible for deciding
how much of, or even if, the food offered is eaten.
Perhaps more emphasis is needed concerning this
division of feeding responsibility in nutrition edu-
cation programs for adults who are involved in
feeding children. More emphasis may be needed
in school nutrition education programs to help
students assume age-appropriate responsibility for
changing eating behavior, as well as to differentiate
between feeling confident about what to do to
make the changes, increasing the desire to do so
and actually doing it
In the investigation of psychosocial predictors of
F&V consumption, preferences were consistently
related to F&V consumption among children; how-
ever, the variances accounted for were all less
than 13%. These findings are similar to those of
Resnicow et al. (19%). There are many determin-
ants of eating (Michela and Contento, 1986). Since
the foods served are not completely under the
children's control, availability may be a strong
predictor (Baranowski et al., 1993; Michela and
Contento, 1986; Heam et al., 1996). For example,
exposure to F&V has been related to children's
food preferences and to consumption (Birch, 1979;
Domel et al, 1993a). This emphasis on an environ-
mental determinant which may not be under the
children's control is consistent with the recent
efforts of Fishbein's theory of planned change
(Ajzen, 1985). An implication of these analyses is
that psychosocial variables should be more strongly
related to consumption when the foods are more
readily available.
Conclusions
Although reliability for the F&V self-efficacy ques-
tionnaire was acceptable, criterion validity against
F&V consumption was low. Stronger relationships
were found between F&V self-efficacy and F&V
preferences, and between F&V self-efficacy and
F&V outcome expectations, indicating that how
much children like F&V as well as what they

expect will happen as a result of eating F&V impact
the confidence they have in eating more F&V.
Preferences were consistent predictors of F&V
consumption, especially vegetable consumption,
among fourth and fifth grade children. Thus, it
appears that nutrition education programs which
target F&V preferences may be more effective at
increasing F&V consumption among elementary
school children than programs which target F&V
self-efficacy and F&V outcome expectations.
While preferences were consistent predictors of
F&V consumption, they accounted for only small
proportions of the variance. Research is needed to
clarify the role of F&V availability as a moderator
of F&V consumption. Further research should be
directed at making F&V more available to children
or exposing them to a larger variety of F&V
prepared a variety of ways to document the role
of availability and exposure in increasing F&V
preferences and F&V consumption among this
population.
Acknowledgements
The authors recognize the important contributions
of Drs Rebecca Mullis and Tim Byers, and thank
them for their encouragement and support of this
project. Sincere appreciation is also expressed to
Patricia Riley, Lisa Bryant and Sandra Young for
helping with data collection, and to Carrie B.
Harris for secretarial support. This study was part
of a collaborative project among the International
Apple Institute, Porter Novelli Omnicom PR
Network, the Centers for Disease Control—
Division of Nutrition, the Richmond County Board
of Education, and the Georgia Institute for the
Prevention of Human Disease and Accidents
(Georgia Prevention Institute) of the Medical
College of Georgia. This study was made possible
by funds from the International Apple Institute.
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Received on January I, 1995: accepted on December 30, 1995