Perceived Benefits and Barriers of Increased Fruit and Vegetable Consumption: Validation of a Decisional Balance Scale

Objective

To develop and validate scales to assess perceived benefits and barriers (decisional balance) for increasing fruit and vegetable consumption.

Design

A cross-sectional mail and telephone survey was conducted.

Subjects/Settings

A total of 1200 Chinese households were randomly selected from the Singapore residential telephone listings, and 71% responded to the mail survey; 390 males and 406 females participated (mean age = 39.3).

Main Outcome Measures

Decisional balance, stage of change, and fruit and vegetable consumption were measured.

Statistical Analyses Performed

Using a split-half sample approach, developmental sample responses were analyzed by principal-components analysis and validation sample responses by confirmatory factor analysis. Analyses of variance were used to examine stage differences in decisional balance.

Results

Principal-components analysis indicated two components representing benefits (or pros) (Cronbach's α = 0.86) and barriers (or cons) (α 0.79) of change. Confirmatory factor analysis strongly supported the two-component structure (Goodness of Fit Index = 0.97). There was a shift from cons to pros being more important across the stages. The increase in pros across the stages of change (p < .0001) corresponded to a medium effect size, and the decrease in cons (p < .01) corresponded to a small effect size.

Implications

Decisional balance scales may be used to guide interventions to influence fruit and vegetable consumption.