RESEARCH Research and Professional Briefs Knowledge, Attitudes, and Label Use among College Students RANJITA MISRA, PhD ABSTRACT This study examined the relationships among nutrition education, knowledge, attitude, use of nutritional supple- ments, and label reading behavior among 537 randomly selected college students using a conceptual model. The majority of the respondents were women, undergraduate students, and nonsmokers. The mean age was 236.1 years. A higher percentage of undergraduate students and women had prior exposure to nutrition education, a positive attitude, and greater knowledge of food labels as compared to their graduate and male peers. The struc- tural equation model indicated nutrition education, age, sex, and attitude predicted label use; prior nutrition ed- ucation and a positive attitude exhibited the strongest (direct) effects on label reading behavior. Attitude medi- ated the relationship between knowledge and label read- ing behavior. The indexes of fit for the tested model indi- cated a good fit; the predictors accounted for 44% of the variance in label usage. J Am Diet Assoc. 2007;107:2130-2134. N utrition labeling is mandatory for most packaged food (1,2) and is designed to help consumers make informed dietary choices (3-7). The 2004 Shopping for Health Survey showed 83% of consumers check the Nutrition Facts panel when buying foods for the first time, 48% use it to purchase healthful foods, and 23% to lose weight (8). Label users report diets lower in fat and cholesterol and higher in fruits and vegetables (9,10) and have a positive attitude and greater nutrition knowledge of diet-disease relationship compared to nonusers (11,12). Both sex and educational level of respondents influence label reading behavior (13,14). However, many consum- ers do not understand or correctly use the information (4,13,15), desire labels to be easier to understand without utilizing quantitative skills (6,16,17), and are willing to pay extra for nutrition information provided the benefit outweighs the cost (18). Although there are several studies on adults (3,7,9,11,13,19,20), few are focused on adolescents and young adults (12,21-23). Often their knowledge of nutri- tion information is limited (22,23). Hence, it is important that adolescents and young adults understand and prac- tice appropriate label reading behaviors for healthful eat- ing practices. This research sought to comprehensively examine attitudes, knowledge, and label reading behav- iors using a path model. MODEL A model, based on the theoretical domains in the litera- ture (knowledge, attitude, label reading behaviors, label use, sex, and nutrition education) (8,12,13,15,18,24) and Theory of Planned Behavior (attitude and behavior), was developed to examine label reading behaviors among col- lege students (Figure 1). The model seeks to assess the relationships among the predictor variables (ie, age, sex, and prior nutrition education), moderating variable (ie, attitude toward food labels and knowledge), and outcome variable (label reading behavior). As represented in Fig- ure 1, the variables in the model included both measured variables and latent variables and represented as rectan- gle and ellipse in the model respectively. Directional re- lationships are implied by single-headed arrows. Label reading behavior is the only latent variable in the model and was measured by two subscales or indicators. Knowl- edge and attitude were the two measured constructs. We hypothesized that higher levels of nutrition knowl- edge and positive attitude would increase label reading behavior. Prior exposure to nutrition education directly increases nutrition knowledge and improves attitude to- ward food labels. Individuals who use nutritional supple- ments are more likely to use food label information due to a greater interest in nutritional status. METHODOLOGY Study Design and Participants A cross-sectional survey of 1,000 undergraduate and 500 graduate students was conducted at two midwestern uni- versities. Subjects were randomly selected from the uni- versity registrars’ student directories by a computer pro- gram. The instrument was pilot tested (10 students) for clarity and content validity and data were gathered using a self-administered, voluntary, and anonymous question- naire via mail. This study received approval from the Institutional Review Board of Ohio University and Tru- man State University. Data were collected in 2004. Five R. Misra is an associate professor, Department of Health and Kinesiology, Texas A&M University, College Sta- tion. Address correspondence to: Ranjita Misra, PhD, CHES, Associate Professor, Department of Health and Kinesiology, 4243 TAMU, 158P Read Bldg, Texas A&M University, College Station, TX 77843-4243. E-mail: misra@hlkn.tamu.edu Copyright © 2007 by the American Dietetic Association. 0002-8223/07/10712-0011$32.00/0 doi: 10.1016/j.jada.2007.09.001 2130 Journal of the AMERICAN DIETETIC ASSOCIATION © 2007 by the American Dietetic Association