Questionnaire Development

The questionnaire was developed after considering the requirements of both the Health Belief Model and the Theory of Planned Behaviour, as well as points made in the focus groups and also the questions from the British study (Conner et al., 2001) were included. The variables included are attitudes to functional foods, perceived benefits and barriers of functional foods including belief in the efficacy of functional foods, the influences of the environment (subjective norm) and perceived behavioural control (theses constructs were mainly adaption of the constructs used by Conner et al. (2001) in their study on supplement use). Furthermore, general functional foods consumption intentions and the intention to consume functional foods designed to treat/prevent arthritis and coronary heart disease were also sought. Questions on the taste of real and imaginary products (arthritis functional foods) and cost were also sought. These last two constructs were added because the focus group members considered the parameters to be most important in functional food consumption. However, due to the length of the survey these factors were only included as uni-dimensional constructs and not multi-dimensional constructs as they clearly are.

The socio-demographic factors included gender, age, education, income, and having young children in the household. In addition, several health behaviour variables (taking dietary or herbal supplements, smoking, doing physical activities, and talking about functional foods), and variables related to current health condition were included.

A copy of the questionnaire, along with the introduction and information sheet, appear in Appendix C.

4.4.1Description of the Survey Instrument

The ten-paged questionnaire comprised seven sections of 83 questions. The first section explored participants’ views on food, health and their experience in using dietary

supplements and consuming functional foods, while the second section measured variables related to the participants’ concerns about arthritis and coronary heart disease. Section 3 measured respondents’ attitudes to functional foods, perceived benefits, and barriers to the consumption of functional foods.

The fourth section measured respondents’ assessment of the dependability of information from different sources. This was measured by asking respondents to rank the sources of functional food information including documentaries, advertisements, interviews with scientists, seminar/conferences, food manufacturers and pharmacists, from 1 = the most dependable to 6 = the least dependable. They were also asked dichotomous questions (yes and no) about various aspects of functional foods.

In Section 5, the influence of the subjective norm on participants’ intention to consume functional foods was measured. In the sixth section of the survey, the participants were asked a number of questions that related to their perceived behavioural control and also their direct attitudes to functional foods and their intentions to consume functional foods. A seven-point Likert scale was used to measure the above variables ranging from 1 = strongly disagree to 7 = strongly agree. In the final section, demographic information was collected. The questions included gender, age, education, ethnicity, income, health condition and also health habits (whether they smoked, exercised regularly etc.).

4.4.2Pre-test

The questionnaire was pre-tested to ensure that people understood the questions. The pre- test of the questionnaire was conducted before data collection. Twenty participants, who were not included in this study, were involved in this process. The pre-test questionnaire revealed unexpected mistakes such as inept expressions and leading questions. In addition, some questions in the questionnaire were removed to reduce unexpected problems in data processing and analysis so that the data obtained from this process could be coded, tabulated and analysed (Zikmund, 2000). Some wording revisions were made to the questionnaire after the pre-test. The wording of the questionnaire was further modified slightly after the initial postal survey in response to further pretesting.

4.4.3The Measurement of Constructs

This section explains the operation of the research model constructs based on the Theory of Planned Behaviour and the Health Belief model. Twelve constructs have been included in this study. Each construct consists of multiple indicator questions to better explain

construct was measured using a seven-point Likert scale and either a 7-point rating scale. The Each construct and associated questions is explained below.

Consumer’s direct attitudes to functional food consumption

This construct was adopted from the Theory of Planned Behaviour and it measures peoples’ attitudes to the consumption of functional foods. This construct asks about the participants’ overall thinking concerning the eating/drinking of functional foods. Seven items were used to measure this construct and these included:

- Worthless-Valuable; - Harmful-Beneficial; - Unenjoyable-Enjoyable; - Negative-Positive; - Bad-Good; - Unnatural-Natural; - Difficult-Convenient. Subjective norm

This too was adopted from the Theory of Planned Behaviour. This construct measures the influence that people in the respondent’s social environment have on their consumption of functional foods. Three items were used to measure this construct. These included:

- My family thinks I should eat/drink functional foods;

- My friends or colleagues think I should eat/drink functional foods; - My doctor thinks that I should eat/drink functional foods.

Perceived behavioural control

This construct was also adopted from the Theory of PlannedBehaviour(Ajzen, 2002) and the study of Conner et al. (Conner et al., 2001), and it measures whether the individual believes he/she has control over his/her actions with regards to the consumption of functional foods. Six items were used to measure this construct. These included:

- If I wanted to, I could easily eat/drink functional foods; - Eating/drinking functional foods does me no harm;

- Eating/drinking functional foods makes some people dependent; - I can afford to try new food products such as functional foods; - I feel confident to buy functional foods;

- I know where to buy functional foods.

Perceived susceptibility to arthritis

This construct has been adopted from the Health Belief Model (Champion and Scott, 1997; Green and Kelly, 2004; Kelly et al., 1987; Poss, 2001; Secginli and Nahcivan, 2006; Turner et al., 2004; Tussing and Chapman-Novakofski, 2005)and it measures the individual’s perceived susceptibility to arthritis. Four items were used to measure this construct. These included:

- I am worried about getting arthritis; - I will get arthritis sometime in my life;

- My family history suggests that I will get arthritis;

- My physical health makes it less likely that I will get arthritis (R)4.

Perceived severity of arthritis

This construct was adopted from the Health Belief Model (Champion and Scott, 1997; Green and Kelly, 2004; Kelly et al., 1987; Poss, 2001; Secginli and Nahcivan, 2006; Turner et al., 2004; Tussing and Chapman-Novakofski, 2005) and it measures the perceived severity of the arthritis afflicting each individual. Four items were used to measure this construct. These included:

- If a doctor told me that I had arthritis, I would be; - If I had arthritis, it would change my life;

- If I had arthritis, it would limit my daily activities;

- The problems I would experience from arthritis would last a long time (R).

Perceived susceptibility to coronary heart disease

This construct is adopted from the Health Belief Model (Champion and Scott, 1997; Green and Kelly, 2004; Kelly et al., 1987; Poss, 2001; Secginli and Nahcivan, 2006; Turner et al., 2004; Tussing and Chapman-Novakofski, 2005) and it measures the individual’s perceived susceptibility to coronary heart disease. Four items were used to measure this construct. These included:

- I am worried about getting coronary heart disease; - I will get coronary heart disease sometime in my life;

- My family history suggests that I will get coronary heart disease;

- My physical health makes it less likely that I will get coronary heart disease.

Severity of coronary heart disease

This construct was adopted from the Health Belief Model (Champion and Scott, 1997; Green and Kelly, 2004; Kelly et al., 1987; Poss, 2001; Secginli and Nahcivan, 2006; Turner et al., 2004; Tussing and Chapman-Novakofski, 2005) and it measures the severity of the individual’s coronary heart disease. Four items were used to measure this construct. These included:

- If a doctor told me that I had coronary heart disease, I would be; - If I had coronary heart disease, it would change my life;

- If I had coronary heart disease, it would limit my daily activities;

- The problems I would experience from coronary heart disease would last a long time (R).

Perceived benefits of functional foods

This construct can be found in the Health Belief Model (HBM) (Champion and Scott, 1997; Green and Kelly, 2004; Kelly et al., 1987; Poss, 2001; Secginli and Nahcivan, 2006; Turner et al., 2004; Tussing and Chapman-Novakofski, 2005) and it measures the

individual’s perceived benefits from consuming functional foods. Nine items were used to measure this construct. These included:

- Eating/drinking functional foods would help prevent chronic disease; - Eating/drinking functional foods would help me to be healthy; - Eating/drinking functional foods would stop me from getting ill; - Functional foods make it easier for me to follow a healthy lifestyle;

- I get pleasure from eating/drinking functional foods;

- I don’t need to take dietary supplements if I eat/drink functional foods; - I can reduce taking medication if I eat/drink functional foods;

- I do not worry about eating a balanced diet, if I eat/drink functional foods.

Perceived barriers to the consumption of functional foods

This construct has been adopted from the HBM (Champion and Scott, 1997; Green and Kelly, 2004; Kelly et al., 1987; Poss, 2001; Secginli and Nahcivan, 2006; Turner et al., 2004; Tussing and Chapman-Novakofski, 2005) and also from the results of the focus group (Chapter 3). It measures the individual’s perceived barriers to the consumption of functional foods. Focus groups were conducted to explore the ideas of participants about the things (barriers) that were stopping them from consuming functional foods. Six items were used to measure this construct. These included:

- Eating/drinking functional foods would cause unpleasant side-effects; - Functional foods cost more than other foods;

- I am unsure of the dosage of active ingredients in functional foods; - It is difficult to see the benefits of functional foods;

- I do not have enough knowledge about functional foods;

- I trust the health claims made by food manufacturers about functional foods (R); - Functional foods do not taste good.

Intention to consume general functional foods

This construct has also been adopted from the Theory of Planned Behaviour(Ajzen and Madden, 1986; Chang, 1998; Conner and Armitage, 1998; Madden et al., 1992) and it measures the intention of participants to consume functional foods. Three items were included when measuring this construct. These included:

- I intend to eat/drink functional foods in the next few months; - I aim to eat/drink functional foods for my healthy lifestyle; - I want to eat/drink functional foods.

Intention to consume functional foods designed to treat/prevent arthritis

This construct was also adopted from the Theoryof Planned Behaviour(Ajzen and Madden, 1986; Chang, 1998; Conner and Armitage, 1998; Madden et al., 1992) and it measures the participants’ intentions to consume specific functional foods designed to prevent/treat arthritis. Four items were included in this construct. These included:

- I am likely to eat/drink functional foods to prevent me from getting arthritis; - If a new food product was developed that included compounds that have been

scientifically proven to treat the symptoms of some types of arthritis, I would purchase such a product;

- If a new food product was developed that included compounds that have been scientifically proven to prevent the symptoms of some types of arthritis, I would purchase such a product;

- Glucosamine has been scientifically proven to relieve the symptoms of some types of arthritis. If it were added to a food, I would purchase such a product.

Intention to consume functional foods designed to help treat/prevent coronary heart disease

This construct was also adopted from Theory of Planned Behaviour(Ajzen and Madden, 1986; Chang, 1998; Conner and Armitage, 1998; Madden et al., 1992) and it measures the participants’ intentions to consume specific functional foods designed to help prevent/treat coronary heart disease. Four items were included to measure this construct. These

included:

- I am likely to eat/drink functional foods to prevent me from getting coronary heart disease;

- If a new food product was developed that included compounds that have been scientifically proven to treat the symptoms of coronary heart disease, I would purchase such a product;

- If a new food product was developed that included compounds that have been scientifically proven to help prevent coronary heart disease, I would purchase such a product;

- Plant sterols have been scientifically proven to reduce cholesterol, which helps prevent heart disease, and if it were added into a food, I would purchase such a product.