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2015 HSR&D/QUERI National Conference Abstract

3089 — Multilevel Correlates of Dietary Behavior among Veterans

Hoerster KD, VA Puget Sound Healthcare System, Seattle Division, Mental Health Service; Reiber GE, VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development; Nelson KM, VA Puget Sound Healthcare System, Seattle Division, Health Services Research and Development;

Chronic health conditions such as type 2 diabetes, obesity, and cardiovascular disease are common among Veterans. Dietary behavior is an important contributor to these lifestyle-related diseases. Little is known about what factors are associated with dietary behavior among Veterans, an important area of study for informing dietary behavior interventions in this population. This study therefore examined correlates of dietary behavior among a patient population of Veterans.

Data for this study come from a mailed survey completed by patients from a major VA medical center (N = 653; response rate = 40%). Participants completed Paxton et al.'s "Starting the Conversation", an 8-item measure developed by the Center for Health Promotion and Disease Prevention to be administered in primary care and health promotion settings. Participants also completed a wide range of measures on potential correlates including socio-demographic characteristics (i.e., age, sex, race/ethnicity, marital status, employment status, educational history, and income), chronic pain, health-related quality of life (SF-12), post-traumatic stress disorder and depression symptom severity, general social support, social support for healthy eating, and neighborhood resources for healthy foods and healthy behaviors. Correlates at multiple levels of influence were examined, consistent with ecological models of health behavior. The ten variables associated in bivariate analyses (p < .05) were included in a multivariate linear regression model.

Participants scored an average of 6.5 on the diet measure (range: 0-16; higher scores reflect worse diet). In a multivariate linear regression analysis, three variables were significantly associated with better dietary behavior: lower depression symptom severity, receiving ideas from others about healthy eating, and reporting good availability of low-fat foods in neighborhood stores.

Consistent with the ecological model of health behavior, factors at the individual, social, and neighborhood levels were associated with dietary behavior among Veterans. All identified correlates are modifiable, making them viable targets for dietary behavior interventions.

Improving dietary behavior among Veterans should be an important public health target for VA. This is an essential step toward addressing the high burden of chronic health conditions in this population. Ensuring that mental health, social support, and neighborhood context are addressed will enhance the likelihood of future interventions' effectiveness.