Doctoral Dissertations

Date of Award

12-1998

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Sandra P. Thomas

Committee Members

Jeff Aper, Mitzi Davis, Pat Droppleman, Janet Secrest

Abstract

It is widely accepted that health is influenced by one’s behavior and lifestyle. The development of health attitudes and behaviors begins at an early age. During childhood the individual develops self-perceptions, health beliefs, a sense of control over health, and health behaviors. Habits established in childhood are enduring, and a health-enhancing lifestyle acquired during childhood can influence later health behaviors.

In an effort to incorporate each client’s individual differences into a systematic and comprehensive structure which examines the multiple determinants of health behaviors, the Interaction Model of Client Health Behavior (IMCHB) was developed by Cox (1982). The IMCHB refocuses nursing’s attention away from traditional disease models toward a model of multidimensional health. It is based on a multidisciplinary perspective and was proposed as a prescriptive nursing framework. The framework emphasizes the process by which the singular position of the client (on many variables) is translated into health outcomes. The IMCHB incorporates an extensive set of variables that address psychological, sociological, and environmental determinants of health behavior, as well as short-term behavioral determinants that arise during the client-professional interaction.

The purpose of this study was to identify those variables that influence the school-age child’s enactment of diet and physical activity. Specific objectives were: (1) to use the IMCHB as a conceptual guide in explaining the correlates of children’s diet and physical activity, (2) to determine the relative and cumulative contributions of socio-demographic variables, health experiences, family influence, intrinsic motivation, cognitive appraisal and affective response to children’s diet and physical activity, and (3) to use the empirical base developed to propose nursing interventions that may potentially optimize the performance and retention of preventive diet and physical activity behaviors in school-age children.

The research question was: What elements of client singularity (uniqueness) are related to the diet and physical activity of the school-age child? Gender was the single most contributory background variable to health behavior in the only previous study of children based on the IMCHB. Therefore, a subsidiary question addressed was: What is the relationship of gender to diet and physical activity of the school-age child? A sample of fifth-graders (N = 371) and their parents (N = 371) participated in the study. There were 176 boys and 195 girls. Information on the family’s demographics. health experience, social influence and environmental resources was collected. Data on the children’s intrinsic motivation, cognitive appraisal, and affective response to food/physical activity were gathered. Finally, the children’s self-reports on diet and physical activity were collected, as were parents’ self-reports on health habits.

A descriptive correlational study was conducted on these 371 fifth-grade students and their parents to identify those variables that influence the child’s enactment of diet and physical activity. Significant differences were observed between girls and boys on several major study variables. Girls scored higher (healthier) on food preferences and diet self-efficacy than did boys, but no difference was detected in their actual diet behavior. Girls also participated in more low-intensity physical activity, but boys participated in more high-intensity physical activity than did girls. No statistically significant gender differences were observed on the child’s perceived health status, feelings toward exercise, and/or physical activity self-efficacy.

Significant relationships were observed among most of the variables. Food preferences and diet self-efficacy explained the most variance in diet behavior for both girls and boys. A parent’s self-rated health was significant in explaining the boy’s participation in low-intensity physical activity; the lower a parent rated his/her health. the more likely that the boy participated in low-intensity physical activities. However, the boy’s self-rated health status contributed the most to his high-intensity physical activity participation; boys who perceived themselves in better health were more likely to participate. For a girl, her feelings toward exercise and her parent’s marital status were important in explaining her high-intensity physical activity participation; the more positive her feelings toward exercise, and if she lived in a single-parent home, the greater the likelihood of the girl’s participation.

The findings of this study provide strong support for the use of the IMCHB to explain children’s diet, but weak support for the explanation of children’s physical activity. Regression analysis revealed that 46.2% of the variance in diet was explained. Although only 10.2% of the variance in physical activity was explained. this is comparable to the amount of explained variance found in many other children’s exercise studies. Clearly, further study exploring additional factors predictive of exercise is indicated.

Download
Files over 3MB may be slow to open. For best results, right-click and select "save as..."

Share

COinS