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Stage of Change, Self-Efficacy, and Barriers to Plant-Based Eating: A Secondary Analysis of Residential Program Data
David M Goldman1,2, Matthew Nagra3, Laurie Kortowich4
1Research and Development, Metabite, New York, USA.
Abstract:
Introduction Plant-based dietary patterns reduce cardiometabolic risk, yet sustained adoption remains limited. Psychosocial factors, including readiness for change and self-efficacy, are central to dietary behavior change, but their distribution among adults attending immersive lifestyle interventions has not been formally characterized. This study describes the stage of change, perceived barriers and facilitators, and self-efficacy among Plant Strong retreat attendees. Materials and methods Program evaluation surveys collected during routine operations were made available for secondary research analysis; 73 of 92 surveys were completed. Measures included the transtheoretical model (TTM) stage of change, self-reported dietary pattern, barriers and facilitators to whole-food, plant-based (WFPB) eating, and a two-item self-efficacy composite. One-way ANOVA with Tukey honestly significant difference (HSD) post-hoc analyses examined self-efficacy by TTM stage; chi-square tests assessed dietary pattern associations with barriers and facilitators. Results Nearly half (n = 35, 47.9%) of participants were in the maintenance stage. Self-efficacy was significantly higher among groups further along the TTM continuum (F(3, 69) = 7.34, p = 0.0002, η2 = 0.242), with the pre-action group scoring significantly lower than action (p = 0.013) or maintenance (p = 0.0002). Common barriers were food availability when eating out (n = 62, 84.9%) and meal preparation time (n = 54, 73.9%). Improving long-term health was universally endorsed as very helpful (n = 68, 93.2%). Dietary pattern showed nominally significant associations with barriers related to taste and texture, meal preparation knowledge, and preparation time (all p ≤ 0.032); none survived Benjamini-Hochberg correction across 12 simultaneous tests (false discovery rate-adjusted p ≥ 0.062). Conclusions Self-efficacy varied with TTM stage in a motivated retreat population, consistent with the dietary behavior change literature. The small pre-action subgroup and persistent barriers, particularly food availability away from home, suggest post-retreat support targeting eating-out contexts may strengthen sustained behavior change.
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