title: Beverage Choices of Adolescents and Their Parents Using the Theory of Planned Behavior: A Mixed Methods Analysis.
abstract: BACKGROUND
  Added sugar intake in the form of sugar-sweetened beverages (SSBs) has been considered a contributor to weight gain and cardiometabolic dysfunction in adults and youth. Adolescents are some of the highest consumers of added sugars, taking in ∼16% of their total calories from added sugars with ∼40% of these calories coming from SSBs. Food preferences and self-regulation of dietary intake by youth can be influenced by parents.
  
  
  OBJECTIVE
  To evaluate the effectiveness of the Theory of Planned Behavior (TPB) in understanding and predicting adolescents' SSB consumption, identify which constructs are the most important when evaluating SSB consumption in adolescents, and determine whether and how adolescents' beverage choices are influenced by parents' reactions to their beverage choices.
  
  
  METHODS
  Measurements for this cross-sectional study included four record-assisted 24-hour dietary recalls and responses to an SSB-specific TPB questionnaire from 100 adolescents. Consenting parents completed a beverage intake questionnaire, a TPB questionnaire, and the Parent Response to Beverage Choice Questionnaire.
  
  
  RESULTS
  The TPB explained 34% of the variance in adolescents' and parents' intention to limit SSBs to <1cup/day. Parents' perceived behavioral control (b=1.35; P=0.002) and adolescents' subjective norms (b=0.57; P=0.001) were the strongest predictors of intention, and intention was the strongest predictor of SSB consumption in both adolescents and parents (b=-37 [P=0.026] and b=-49 [P=0.003], respectively). The TPB explained more variance in parent SSB consumption (R(2)=0.38) than adolescents (R(2)=0.22). Parents did more discouraging of SSBs and encouraging of non-SSBs. Adolescents' intention to limit SSB consumption moderated the relationship between parents' reactions encouraging SSBs and adolescents' predicted SSB consumption (P=0.021).
  
  
  CONCLUSIONS
  The TPB explained a small but significant amount of variance in adolescents' SSB consumption. When addressing adolescent SSB intake, people in addition to parents may influence their intentions and SSB consumption.
authors.forename: Shaun K
authors.initials: SK
authors.lastname: Riebl
authors.forename: Carly
authors.initials: C
authors.lastname: MacDougal
authors.forename: Catelyn
authors.initials: C
authors.lastname: Hill
authors.forename: Paul A
authors.initials: PA
authors.lastname: Estabrooks
authors.forename: Julie C
authors.initials: JC
authors.lastname: Dunsmore
authors.forename: Jyoti
authors.initials: J
authors.lastname: Savla
authors.forename: Madlyn I
authors.initials: MI
authors.lastname: Frisard
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Dietrich
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Davy
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001628:Beverages / Q000009:adverse effects; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D015930:Diet Records; D019422:Dietary Sucrose / Q000009:adverse effects*; D005260:Female; D005518:Food Preferences; D006801:Humans; D033182:Intention; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010287:Parent-Child Relations; D016487:Parenting; D010290:Parents; D010349:Patient Compliance; D011582:Psychological Theory; D012306:Risk; D057566:Self Report; D012938:Social Perception; D014768:Virginia / Q000453:epidemiology
chemical_list: D019422:Dietary Sucrose
keywords: Adolescents; Parents; Sugar-sweetened beverages; Sugary drinks; Theory of Planned Behavior