Conceptualizing university students’ food choices based on theory of planned behavior

Introduction

Several students use hostel facilities offered by their colleges and universities while pursuing higher education. During their stay, their lifestyle undergoes a significant transformation from what they are used to at homes. A crucial change is witnessed in their food habits.⁴ Rather than eat at the campus, they prefer to eat out at the relatively cheaper options around the campus. This lack of nutritional food is one of the top six causes of health-risk behaviors reported among university students.⁵

A report by WHO (2015a) states that ‘Healthy diets optimize growth and development over the short- and long-term. They are characterized by being sufficient and balanced in quantity and quality, containing a diversity of nutrient-dense foods including vegetables, fruits, whole grain cereals, fish, legumes, nuts, modest amounts of animal-source foods, limited in foods and drinks high in saturated and trans fats, added sugars and salt”.¹ A past study² has reported that WHO guidelines in respect to dietary habits are rarely practiced by students during their stay at the campus. A study conducted in Kansas in the USA found that a majority of the university students were obese and that their dietary habits needed to be changed to include more nutritional foods rich in fruits, vegetables, and fiber³ Further, the study also recommended physical activity for the students. Consumption of a low proportion of fruits and vegetables and a high proportion of food having high calories, saturated fats, alcohols, and added sugar was reported among large number of university students.⁶ Many studies in the past have pointed out that university students don’t follow nutritional-rich lifestyles.⁷ Further, students find process of choosing food challenging,⁴ hence, they gradually move away from healthy food habits.⁵ Studies also show that only 4% of students consume 30% or less of energy from fat and 10% or less from sugar per day.³ Hence, there is pressing need to inculcate healthy eating habits amongst the students especially in the face of the upsurge in lifestyle diseases. There is an urgent need to inspire nutrient-rich food behaviors amongst the students such that they select whole grains over processed food, include of fruits and vegetables in their daily diet and avoid health-compromising food choices.⁹

A review study in the Indian context revealed that a substantial percentage of young people have unhealthy food habits that affect their overall progress. The issues of failure in achieving academic goals are on a rise, mostly interconnected to unhealthy food habits and are likely to intensify in the future. This study considers prime unhealthy habits as “under and over nutrition, common mental issues, non-communicable diseases (NCDs), and stress and anxiety commonly associated with current “nutrition and epidemiological transition”.¹⁰

The present study attempts to apply Ajzen’s (1991) theory of planned behavior to understand and conceptualize how students can transition their food choices to the more healthy options in the university campus. The theory of planned behavior (TPB) was proposed by Icek Ajzen in 1985 and is one of the most applied models to study the intentions and consumer behavior in various setting including food consumption.¹¹ The TPB states that behavior is influenced by intention to participate in that specific behavior (consuming healthy food) and perceived control behavior (PCB), for instance, practicing healthy food consumption at the campus irrespective of the environment. Intentions drive people to take conscious steps to perform a behavior. PCB is the ability of a person to control their behavior, in line with Bandurs’ concept of self-efficacy.¹² Terry et al., conducted a study among 146 undergraduate students using regression analysis and found that past behavior experiences (feedback) considerably foretell both, intentions and actual behavior.¹³ In the present qualitative study, participants had to compulsorily subscribe to UDF during their first year of undergraduate program as per university policy. The same policy was not applicable to postgraduate students. The duration for which students practiced process of choosing food (food choices) from first year onwards and development of feedback initiating repeat behavior was adopted as an approach to study past behaviors (experiences). This study is unique in that it applies the qualitative approach to the subject. In contrast, existing research has only applied the quantitative approach to study food consumption behaviors.¹⁴

Methods

A private university in Udupi was selected as basis for this study since it has four UDFs on its campus. This university attracts students from all over the country with varied food habits. Second, it was compulsory for first year students to dine at the UDF. This one-year period and the consecutive years thereafter were considered as integral to develop feedback on UDF food. Accordingly, the first-year and post-graduate students of the university formed part of this study. This research employed the qualitative research method and interpretive phenomenologic approach to analyze data and glean insights. The snowball sampling method was applied to recruit participants. An in-depth interview method was used to gather data and glean more subjective views. The interviewer did not know the participants personally. Students of the engineering college were contacted first and requested to participate in study. As the inclusion criteria, they had to be residents of the university accommodation, with their age ranging from 18 to 24 years and pursuing year II through year IV of their study programs. The first year students pursuing undergraduate programs were excluded from the study. First, a few participants were selected by purposive sampling who then recommended other potential participants from their WhatsApp groups. Undergraduate students from years II through IV and post-graduate from years I and II of their study program were invited to participate in the study via their WhatsApp groups. Their participation was voluntary, their verbal consent was taken for participation, and the interview time was confirmed in advance. The participants were not involved in the study beyond data collection and transcripts were only discussed with the research team.

The ethics clearance certificate was obtained from Kasturba Medical College and Kasturba Hospital Institutional Ethics committee before recruiting the participants for the study. An in-depth interview guide was prepared and validated by doctoral committee for PhD study and experts from nutrition, culinary arts, and qualitative research fields. A pilot study was conducted to test the interview guide and based on the findings, the necessary modifications were incorporated. Participants’ consent was verbal as they were interviewed online via the MS Teams platform and the interaction was audio-recorded based on their consent. Online interviews were conducted with twenty-six students belonging to various regions of India and living on the campus. Data was collected until saturation. Two students couldn’t participate because they had to appear for their examinations. Only, the research team was present during the online interviews with students who were at their own place of residence due to the pandemic lockdown.

The interviews were conducted in English and then transcribed. Using deductive approach, the codes were identified and grouped under code families. The data were coded manually¹⁵ and analyzed by thematic analysis using the Atlas.ti data management software. Coding was performed by the primary researcher and one other research team member. Following this, the codes were reviewed by the research team. Coded data were grouped according to relevance to enlist categories. This helped us to create themes and sub-themes. The themes derived were discussed with the research team members and consistency between data and findings was established.

Results

The demographic profile of the participants revealed that students were pursuing courses in engineering, architecture, medicine, dental, pharmacy and forensic medicine. Their age ranged between 18 to 24 years and most belonged to Mumbai, Kolkata, Ahmadabad, Karkala, Ghaziabad, Bangalore and Kochi. Figure 1 shows the conceptual model of the food choices of the students that emerged after data analysis.

Figure 1. Conceptual model of food choice.

The conceptual model was developed by applying the theory of planned behavior. It included the following components 1. Individual behavior beliefs 2. Normative beliefs 3. Control beliefs 4. Actual controls, and 5. Feedback. The continuous interdependency and relationship of beliefs about UDF food by participants led to attitude development towards healthy food which, in turn, initiated the transition in intentions to opt for UDF food followed by actual behavior. This cyclic process was observed throughout their stay at campus including the effect of feedback on behavior (food choice) and, accordingly, transition in food choices. Each component of the conceptual model is described using examples from data.

Individual behavioral beliefs

Individual behavior beliefs were developed based on participants’ experience with respect to their food consumption routines, knowledge about healthy food, views on nutrients requirements, perceptions about the after-effects of adopting unhealthy food choices and their observations of food choices of their peers. Individual beliefs motivated the development of attitude and intention to adopt healthy food choices.

Normative beliefs

Participants’ normative beliefs of subjective norms to promote healthy food behavior on campus included university policy, parental influence, and environmental influence. The subjective norms were seen to have positive impact students’ favorable attitude towards the UDF.

Control beliefs

The preconceived notions about food greatly influenced the students’ transitional journey towards healthy food irrespective of peer pressure and their social circle during their stay at the campus.

Feedback on UDF (post-behavior)

The Theory of Planned Behavior (Ajzen, 1991) describes “Feedback” as the post-behavior understanding of the actions taken (Behavior). Studying the current problem from the lens of the theory of planned behavior, it was found that the students displayed their intention choose UDF over other sources to access healthy food based on feedback.

Discussion

The conceptual model developed for this study is in line with the theory of planned behavior (Ajzen, 1991), and grounded in the students’ perspectives about the UDF food and their own food choices. The model represents a comprehensive process of transition in food choices as they progressed through their stay at the campus. On an average, the students stay in the campus for two to four years and during this time their food habits undergo a change. Their behavioral beliefs, subjective norms and preconceived control beliefs impact their attitude towards UDF and their perceptions about the quality of the food it serves. In the first year, the students are required to dine at the UDF, post which they begin to explore outside options driven by several factors. This is substantiated by the respondents who expressed that they dined at the UDF during the first two years of their study after which many of them explored other options. Most respondents expressed their dissatisfaction with the taste, and this was one of the primary causes for their exploring other avenues even though they served unhealthy food.²¹ While the food lacked in nutrition it served as a source of relaxation. This finding was in line with another study.²² It was also found that taste was a major factor driving transitions in food habits. Further, the study also found that taste as a sensory experience varied from one person to another.²² Thus, taste is unique to each person and so it is difficult to identify which food has higher sensory attributes. Hence, sensory appreciation cannot be a means to predict acceptance of a certain food item.²³

In line with past studies, the current study also found that the factors that impacted food choices were taste,^27,28 price,¹⁶ time availability,^17,18 convenience, academic stress,¹⁸ lack of knowledge about nutrition,^19,30 absence of display boards notifying nutrient content of each meal,³¹ and cheap cost of unhealthy food¹⁷ compared to healthy foods.⁶ However, the study adds new factors to the literature, namely, the concern expressed by the respondents in terms of lack of nutritionist at the UDF to guide and advice about the food served at the UDF, and their lack of knowledge on how the food was actually prepared at the facility. The students also expressed their concerns on the lack of other outlets selling healthy food at the campus. The reasons for deviation from healthy food choices were uniform irrespective of their year of study, education stream, and gender.⁶ Further, the study also finds that the UDF needs to evolve its services, guided by the administration, and develop a healthy food culture on the campus that is appreciated by the students.²⁰ This recommendation is in line with past research, which emphasized the role of UDF as, “responding to young adult’s food preferences, food service cost-effectiveness, efficiency, and student’s health considerations”.³²

The participants expressed their concerns about the UDF which prompted them to explore other eating options. The theory of planned behavior (Ajzen 1991) states that feedback is necessary to bring about the necessary behavioral changes based on current behavior.¹¹ The conceptual model aptly illustrates the transition in food choices. According to this theory, “background factors,” such as age, education, religion, income, general attitude and emotions etc. indirectly influence a person’s intentions and behavior by effecting behavioral, normative and control beliefs. The data analysis draws insights on study program duration as one of the background factors which stimulated participants’ intentions and behavior towards food choices. The study finds that the respondents were positively disposed toward changing their attitudes and adopting healthy food habits. This is in line with other studies that have found that intentions are a precursor for accomplishing a particular behavior. Success in accomplishing behavior will not be impacted by the will or intention to perform the behavior but also by other control factors, such as requisite chances and means. These requisite chances, means and intention to perform behavior influence a successful transition towards the desired behavior.²⁷ This is well-illustrated in the conceptual model in which these controls are in the form of volitional controls and budgetary constraints affecting students’ intentions and behavior.

The study establishes a relationship between a healthy environment and healthy food choices²⁴ in which the environment facilitates the accessibility and consumption of fruits, vegetables and nutrient-rich food.²⁵ Students could be made aware of the need to consume healthy foods and display the nutritive value chart of the foods served in the UDF in the facility itself. Further, affirmative messages can be shared regularly in the form of posters, charts, digital boards flashing PPTs through social media and other messaging platforms, and other outreach activities.²⁶ Similar findings were noted in other studies also.³³

The model was conceptualized developed based on the in-depth understanding achieved through the study and not the scale of sample. To achieve this, specific university students from diverse regions and studying at same university campus were invited to share their food experiences. The sample did not aim to represent the students’ population; rather, it was aimed to identify the factors that motivated them to change their food choices over the period of their stay at the campus. Our study sample included students from varied social backgrounds and exposed to different food cultures, with the aim to understand their food transition journeys. The model components display food events held throughout the duration of their stay and the role of feedback in developing an attitude. Future works can consider participants belonging to different universities, geographical locations, and educational streams. An insight on significance of UDF and its role in a students’ transitional food journey was not exclusively objective-oriented but emerged through food events or actions experienced by participants. However, the role of UDF may vary depending on the geographical location of the university.

Conclusion

The conceptual model developed to understand food choices focuses on food actions undertaken by individual participants, the interaction of actions with one another and their impact on formation of an individual’s attitude towards healthy food consumption. The developed model offers insights to decision-makers in universities on how they can motivate students towards healthy foods, thereby improving their academic performance. Further, the UDF also needs to evolve its services in tune with the nutritional needs of the students without compromising on taste or adding to their costs. Past studies have shown that a conducive environment promotes healthy food habits. The universities can ensure an ideal environment by ensuring easy availability and accessibility to healthy foods.^6,25 The conceptualized model projected in the paper is a first of its kind attempt to understand what governs students’ food choices. Further, research can consider diverse participants in diverse settings.

Data availability

Figshare. DataPerceptions.docx. DOI: https://doi.org/10.6084/m9.figshare.20766088.v1³⁵

This project contains the following underlying data:

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).