Compared to students attending regular high schools, alternative high schools (AHS) students are more likely to be racial/ethnic minorities, have higher levels of poverty, and higher rates of risky and poor health behaviors, including weight-related behaviors, such as limited fruit/vegetable intake. However, little is known about fruit/vegetable intake among AHS students. This study examined whether perceived barriers to healthy eating mediated association between self-efficacy to eat healthy foods and fruit/vegetable consumption among AHS students. The cross-sectional study population consisted of students (n=145) attending 6 alternative high schools in the St. Paul/Minneapolis, MN area who were participants in an obesity prevention pilot study and completed a baseline survey in Fall 2006. Mixed model linear regression, adjusting for sociodemographic characteristics was used to test a series of regression models performed according to mediation analysis procedures. Students' mean age was 17.3 years, 52% were male, 63% were low-income, and 61% were from racial/ethnic minorities. Students reported a mean fruit/vegetable intake of 3.6 servings per day, mean self-efficacy to eat healthy score of 22.2 (range 3-35), and mean barriers to eating healthy score of 6.9 (range 3-13). Perceived barriers to healthy eating fully mediated the relationship between self-efficacy and fruit/vegetable consumption (Sobel test statistic=2.7, p=0.007). Interventions targeting the dietary practices of AHS students should include components to decrease perceived barriers as a way to increase self-efficacy and ultimately fruit/vegetable intake.
Keywords: fruit and vegetable consumption, adolescents, alternative high schools, mediation analysis