The role of improved social support for healthy eating in a lifestyle intervention: Texercise Select




Yoshikawa, Aya
Smith, Matthew Lee
Lee, Shinduk
Towne Jr., Samuel D.
Ory, Marcia G.

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Cambridge University Press


Objective: We examined the measurement and mediating role of social support in dietary intake among participants in Texercise Select, an intervention for improving lifestyle behaviours.

Design: Quasi-experimental study. Participants reported their dietary intake, level of social support measured by the new Social Support for Healthy Eating scale, sociodemographics and disease profile. We conducted exploratory factor analysis for scale evaluation and structural equation modelling for mediation analysis to test if changes in dietary-specific social support mediate the relationship between the intervention and changes in dietary intake.

Setting: Texas

Participants: Community-dwelling middle-aged and older adults completed a self-reported survey at baseline and 3-month follow-up (intervention group n 211, comparison group n 175).

Results: The majority of the sample was aged ≥70 years (mean 74·30, SD 8·54), female (82·1 %) and had at least two chronic conditions (63·5 %). The acceptable levels of reliability and validity of the dietary-specific social support scale were confirmed. Compared with the comparison group, the intervention group reported improved intake of fruit/vegetables and water, and improved dietary-specific social support. Improved dietary-specific social support mediated the association between intervention and change in fruit/vegetable intake, controlling for sociodemographics, number of chronic conditions and geographic residence. About 12 % of intervention effect was mediated by social support.

Conclusions: The current study confirms positive intervention effects on healthy eating, and highlights social support relating to dietary behaviours that may be helpful for healthy eating. Future research should investigate additional social support for developing healthy eating behavioural skills.



Lifestyle intervention, Social support, Healthy lifestyle, Mediation analysis, Middle-aged and older adults


This is the published version of an article that is available at: Recommended citation: Yoshikawa, A., Smith, M. L., Lee, S., Towne, S. D., & Ory, M. G. (2020). The role of improved social support for healthy eating in a lifestyle intervention: Texercise Select. Public Health Nutrition, 24(1), 146–156. This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.