The Relationship of Stage of Change for Smoking Cessation to Stage of Change for Fruit and Vegetable Consumption and Physical Activity in a Health Plan Population

Abstract

Purpose. The purpose of this study was to examine the relationship between stage of change for smoking cessation and stage of change for (1) fruit and vegetable consumption and (2) physical activity. Design. The data come from a cross-sectional telephone survey administered to a stratified random sample of health plan members (n = 9675). Setting. This study was conducted at a mixed-model health plan with approximately 1 million adult members. Subjects. Respondents were adults age 18 and older, who were randomly selected from five health plan product groups: commercial fully insured, commercial self-insured, two publicly subsidized plans, and Medicare supplemental insurance. Response rates ranged from 74.7% to 90.1% across these groups. Measures. The assessment included demographics and stage of change for smoking cessation, physical activity, and fruit and vegetable intake. Bivariate relationships among variables were analyzed with the use of contingency tables. Ordered logistic regression was used to examine the effects of stage of change for fruit and vegetable consumption and physical activity on stage of change for smoking while controlling for other factors. Results. Stage of change for smoking is more clearly related to stage of change for fruit and vegetable consumption (χ2 = 161.3, p < .001; Cramer's V = .11, p < .001) than to stage of change for physical activity (χ2 = 89.7, p < .001; Cramer's V = .08, p < .001). However, stage of change for fruit and vegetable consumption and physical activity are not strong predictors of stage of change for smoking. Conclusions. This study indicates that stage of change for both fruit and vegetable consumption and physical activity are independent constructs from stage of change for smoking cessation.