Date of Graduation


Document Type


Degree Type



School of Nursing


Community Practice

Committee Chair

Tara Hulsey

Committee Co-Chair

Mary Jane Smith

Committee Member

Mary Jane Smith

Committee Member

Suzy Walter

Committee Member

Usha Sambamoorthi


The Association of Attitude, Perceived Behavioral Control, and Intention with Fruit and Vegetable Intake among Rural West Virginian Residents in Mineral and Hampshire Counties with Pre-diabetes

Introduction: Pre-diabetes affects approximately 84.1 million adults in the United States. Pre-diabetes is one of the leading predictors of type 2 diabetes. West Virginia ranks number one in the prevalence of diabetes. Fruit and vegetable intake may assist in reducing risk for pre-diabetes. However, most adults do not consume the recommended daily amount. There are no studies investigating the fruit and vegetable intake (FVI) of rural West Virginian residents with pre-diabetes.

Method: After IRB approval and informed consent, 74 participants from two counties in West Virginia were recruited over three weeks for the study. Data were collected using a demographic survey, a Theory of Planned Behavior (TPB) Questionnaire, the Behavioral Risk Factor Surveillance Survey (BRFSS) Fruit and Vegetable Module, and the CDC Pre-diabetes Screening Risk Test. Data were analyzed using SPSS 25, with alpha set at .05. Sample frequencies and descriptives were analyzed. Statistical analyses to answer the research questions included t-tests and multiple linear regressions.

Results: Participants were mainly white (94%), middle aged (M=48.8, SD=17.5), married (55.4%), women (63.5%) with college/technical education (56.8%) and household income greater than $40,000 (55.4%). Participants with less than college/technical education had significantly lower FVI (p = 0.004). Two TPB variables - perceived behavioral control (PBC) and intention - were highly correlated ( r= 0.45, p = 0.001). Attitude was not associated with FVI. After adjusting for education, the regression model explained 11.8% of FVI associated with attitude, 15.9% of FVI associated with PBC, and 18.2% of FVI associated with intention.

Conclusion: Higher PBC and intention toward FVI were associated with increased FVI. Increased FVI may play a role in preventing diabetes as well as other chronic conditions. Interventions to increase FVI in individuals with pre-diabetes aimed at targeting an individual’s PBC and intention may assist in stopping or delaying the progression of pre-diabetes to diabetes. Consideration should also be given to the individual’s educational level and the impact it may have on fruit and vegetable intention and actual intake.