The constructing health study : factors influencing the dietary behaviours of men working in New Zealand construction : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Human Nutrition at Massey University, Palmerston North, New Zealand

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Background: The construction industry is a male dominated career group consisting largely of low to medium socioeconomic status (SES) workers. This population is known to be significantly impacted by non-communicable disease which shortens their life expectancy and negatively impacts their work ability. Currently in the sector a majority of health research has focused on musculoskeletal disorders with lifestyle behaviours such as diet and exercise being secondary considerations. Qualitative investigations surrounding dietary behaviours in this group have demonstrated that there are many factors that are perceived to influence behaviour which could be targeted to improve their long-term health outcomes. At this time there is no research in New Zealand surrounding this subject, resulting in a gap in knowledge. Aim: Using an ecological model this research seeks to identify barriers, motivators and demographic characteristics influencing the dietary behaviours of full-time male construction workers within New Zealand and present pathways to improve dietary profiles. Methods: Men who had worked in the construction sector for 2+ years and were currently working in the Manawatu – Whanganui regions were invited to participate. The investigation was broken down into 3 phases. Phase 1 was a brief dietary questionnaire administered as a hard copy or online via Qualtrics®. Phase 2 consisted of individual or group interviews of a purposive sample of participants from phase 1 with thematic analysis being carried out on transcripts using NVIVO 12 Pro. Emphasis was placed on carrying out and analysing interviews using the ecological framework, to ensure individual, organisational and societal variables were discussed by workers. Phase 3 provided a health screening available to all phase 1 participants. Participants were also given questions from phase 1 surrounding health belief model (HBM) constructs to assess changes in perceptions. Results: Phase 1 (n=20): Compared to the 2008/09 NZ Adult Nutrition Survey and Annual NZ health survey, this cohort had low fruit and vegetable intakes with 40% and 30% respectively meeting recommended daily intakes (RDI’s) while the majority exceeded RDI’s for meat. 7 were classified as hazardous drinkers according to New Zealand Ministry of Health (NZMoH) guidelines. Sweetened beverage and fast-food intakes were high while a majority of men in their 20’s did not eat breakfast or pack lunches regularly, resulting in poor eating behaviours at work. Phase 2 (n=13): The evidence supports previous investigations showing that men are interested in their long-term health. Prevalent themes discussed as impacting dietary behaviours included female partners, nutritional knowledge, body weight, cost, time, healthcare providers, work environment and mentalities of other staff and managers. Unlike previous investigations, these themes could not be labelled as predominantly motivators/facilitators or barriers to healthy eating with the exception of female partners, who had an overwhelmingly positive influence. Phase 3 (n=12): Body mass index (BMI) and body composition measures classified 8 and 7 participants respectively as overweight or obese. 5 participants had high TC/HDL ratios with a 6th unable to be recorded due to readings exceeding equipment capabilities. For the questionnaire, more participants perceived cardiovascular disease (CVD) and type 2 diabetes (T2D) as serious concerns. 5 participants were now happy with the way they were eating with another 5 believing their diet did not increase their risk of these diseases at the end of the study. Conclusions: This research presents multiple themes which are perceived by men to support or prevent healthy dietary behaviours. Many of these could be targeted to improve the health and wellbeing of men in the industry. There is evidence that the health of this group is being negatively being affected by dietary behaviours. However, there is a need for broad scale surveys of dietary behaviours and testing of health status within the sector to understand the breadth of the issue. Lifestyle interventions must also be trialled in this population in order to identify effective long-term strategies which involve all primary stakeholders.