Graduation Year

2018

Document Type

Dissertation

Degree

D.P.H.

Degree Name

Doctor of Public Health (Dr.PH.)

Degree Granting Department

Community and Family Health

Major Professor

Cheryl Vamos, Ph.D.

Committee Member

Ellen Daley, Ph.D.

Committee Member

Wei Wang, Ph.D.

Committee Member

Lauri Wright, Ph.D.

Keywords

College students, Dietary practices, Health literacy, Integrated Model of Health Literacy

Abstract

Overweight and obesity continue to plague Americans and contribute to decreased quantity and quality of life. Americans of all ages experience overweight and obesity; however, increasing rates occur during young adulthood. Young adults develop dietary practice behaviors that persist into adulthood and can contribute to weight-related chronic diseases. Approximately half of all young adults are enrolled in college, and, approximately 38% of college students are either overweight or obese.

Dietary practices are health behaviors that can either increase or decrease risk for overweight and obesity. Much research has explored predictors of dietary practices among college students; however, there is a lack of consensus across studies. One significant predictor of health practices and outcomes is health literacy. Health literacy is people’s abilities to access, understand, appraise, and apply health information. Much research has explored the association between health literacy and dietary practice behaviors among adults. Few studies, though, have explored the association between health literacy and dietary practices among college students. Therefore, this study seeks to fill these gaps. First, this study seeks to understand the impact of health literacy on dietary practices among college students. Second, this study seeks to test the fit of the Integrated Model of Health Literacy in the context of dietary practices among college students.

College students (N = 436) at a large, southeastern university completed surveys to assess both study aims. Participants completed items based on constructs in the Integrated Model of Health Literacy: personal, situational, and societal and environmental determinants, health literacy skills and domains, and health behaviors. Individuals were eligible to participate in the study if they were 18-25 years old, undergraduate students enrolled in the southeastern university, and not pregnant or breastfeeding. Analyses included bivariate associations and path analyses.

There were significant associations between general, disease prevention, and health promotion health literacy and dietary practices among college students. Post-hoc analyses indicated that participants with excellent general, disease prevention, and health promotion health literacy consumed more servings of fruits and vegetables daily than did participants with limited general, disease prevention, and health promotion health literacy.

Approximately 63% of the variance in disease prevention and health promotion health literacy was explained by variables in each path model. However, there were few statistically significant pathways in each model. There was only one statistically significant pathway between health literacy determinants and disease prevention health literacy. Health majors had higher health literacy than did non-health majors (β = 0.15, SE = 0.05, p < .001). There were no statistically significant pathways between health literacy determinants and health promotion health literacy. And, health literacy did not serve as a mediator between health literacy determinants and dietary practices among college students. There were four statistically significant pathways between health literacy predictors and dietary practices: 1) BMI and dietary practices (β = -0.10, SE = 0.03, p < .005); 2) Food Environment-Physical and dietary practices (β = 0.09, SE = 0.03, p < .005), 3) race and dietary practices (β = 0.06, SE = 0.03, p < .05), and 4) Food Environment-Social and dietary practices (β = 0.08, SE = 0.04, p < .05).

Overall, findings from this study indicate an association between health literacy and dietary practices among college students. However, the Integrated Model of Health Literacy may not best explain the nature of the relationship between health literacy and dietary practices among college students. Instead, a more parsimonious model may be needed, as few variables in the model were significantly associated.

This study helps us to better understand the impact of health literacy on dietary practices among young adults, as few studies have explored this association. Future research can continue to explore factors that predict health literacy skill development among young adults. Public health practice can integrate health literacy skill development on college campuses to improve health-related decision-making and future health and well-being among this vulnerable population.

Download

Share

COinS