Cross-cultural validity of the theory of planned behavior for predicting healthy food choice in secondary school students of Inner Mongolia

Aims Unhealthy eating behavior is a serious health concern among secondary school students in Inner Mongolia. To predict their healthy food choices and devise methods of correcting unhealthy choices, we sought to confirm the cross-cultural validity of the theory of planned behavior among Inner Mongolian students. Materials and methods A cross-sectional study, conducted between November and December 2014. Overall, 3047 students were enrolled. We devised a questionnaire based on the theory of planned behavior to measure its components (intentions, attitudes, subjective norms, and perceived behavioral control) in relation to healthy food choices; we also assessed their current engagement in healthy food choices. Results A principal component analysis revealed high contribution rates for the components (69.32%–88.77%). A confirmatory factor analysis indicated that the components of the questionnaire had adequate model fit (goodness of fit index = 0.997, adjusted goodness of fit index = 0.984, comparative fit index = 0.998, and root mean square error of approximation = 0.049). Notably, data from participants within the suburbs did not support the theory of planned behavior construction. Several paths did not predict the hypothesis variables. However, attitudes toward healthy food choices strongly predicted behavioral intention (path coefficients 0.49–0.77, p < 0.01), regardless of demographic characteristics. Conclusion Our results support that the theory of planned behavior can apply to secondary school students in urban areas. Furthermore, attitudes towards healthy food choices were the best predictor of behavioral intentions to engage in such choices in Inner Mongolian students.