Intention to adopt a healthy diet among women with and without a history of gestational diabetes: Constructs and beliefs from the theory of planned behavior

Women with a history of gestational diabetes (GDM) have difficulty maintaining a healthy diet after delivery. The theory of planned behavior (TPB) is effective in identifying the determinants of adopting a healthy diet. The objectives were to identify the determinants of the intention to adopt a healthy diet among the TPB constructs in women with (GDM+) and without (GDM−) a history of GDM, and to identify the beliefs associated with these constructs. The study was conducted in Québec (Canada) between 2009 and 2017. Data from 213 GDM+ and 91 GDM− women were analyzed. Women completed a questionnaire on the determinants of intention to adopt a healthy diet, defined as adherence to 2007 Canada's Food Guide. The subjective norm and perceived behavioral control (PBC) constructs were associated with the intention to adopt a healthy diet among GDM+ women (β = 2.21 and β = 4.37, respectively, p < 0.0001), whereas among GDM− women, PBC was the only construct associated with intention (β = 0.78; p < 0.0001). More specifically among GDM+ women, the disapproval of a family member other than the partner (β = 1.49; p = 0.0005), not feeling capable of adopting a healthy diet with access to food treats (β = 1.58; p < 0.0001), lack of free time (β = 1.31; p = 0.002), lack of information about healthy eating (β = 1.02; p = 0.015) or lack of easy recipes to prepare (β = 0.84; p = 0.042) was associated with a lower intention to adopt a healthy diet. Overall, among GDM+ women, different beliefs related to the subjective norm and PBC could be targeted to improve the eating habits of this specific population.