Explaining the Correlates of Eating Outside-of-Home Behavior in a Nationally Representative US Sample Using the Multi-Theory Model of Health Behavior Change: A Cross-Sectional Study

Manoj Sharma, Christopher Johansen, Ravi Batra, Chia-Liang Dai, Sidath Kapukotuwa, Bertille Assoumou () and Kavita Batra ()
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Manoj Sharma: Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
Christopher Johansen: Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
Ravi Batra: Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
Chia-Liang Dai: Department of Teaching and Learning, College of Education, University of Nevada, Las Vegas, NV 89154, USA
Sidath Kapukotuwa: Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
Bertille Assoumou: Department of Surgery, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA
Kavita Batra: Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA

IJERPH, 2024, vol. 21, issue 1, 1-25

Abstract: Eating outside-of-home (EOH) is one of the main changes in lifestyle that occurred worldwide in the past few decades. Given that EOH behavior is influenced by individual and contextual factors, the utilization of a theory seems to be suitable in analyzing this health behavior. The fourth-generation theory multi-theory model (MTM) is designed exclusively for health behavior change at the individual and community levels. Therefore, the purpose of this analytical cross-sectional study was to investigate EOH behavior by using the MTM among a nationally representative sample in the United States (US). Data for this study were collected from April–May 2023 via a 61-item psychometric valid, web-based, structured survey disseminated via Qualtrics. Chi-square/Fisher’s exact tests were used to compare categorical data, whereas the independent-samples t -test was used to compare the mean scores of MTM constructs across groups. Pearson correlation analysis was performed for the intercorrelation matrix between the MTM constructs and hierarchical regression models were built to predict the variance in the initiation and sustenance by certain predictor variables beyond demographic characteristics. The p values in the multiple comparisons were calculated by using adjusted residuals. Among a total of 532 survey respondents, 397 (74.6%) indicated being engaged in EOH at least twice a week, whereas 135 (25.4%) reported not being engaged in EOH. People who were engaged in EOH were younger (mean age = 42.25 ± 17.78 years vs. 55.89 ± 19.43 years) African American, (15.9% vs. 6.7%, p = 0.01), single or never married, (34.0% vs. 23.0%, p = 0.02), had a graduate degree (9.6% vs. 3.7%, p = 0.03), and were employed (72.0% vs. 34.8%, p < 0.001) as opposed to those who reported not being engaged in eating outside the home. Among the MTM constructs of initiation, “behavioral confidence” and “changes in the physical environment” were the significant predictors of initiating a reduction in EOH behavior and explained 48% of the variance in initiation. Among the MTM constructs of sustenance, “emotional transformation” and “changes in the social environment” were the significant predictors of sustaining a reduction in EOH behavior and explained 50% of the variance in sustenance. This study highlights a need to design MTM-based educational interventions that promote in-home eating instead of frequent EOH for health, family bonding, economic, and other reasons.

Keywords: multi-theory model; screening; eating outside home behavior; eating away from home meals (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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