The Willingness to Adopt a Plant-Based Diet among Young Chinese Adults: A Mixed Method Study

Background: Chronic diseases have become a significant public health issue in China, accounting for nearly 88% of deaths and a considerable burden on healthcare resources. Among the various interventions to address this issue, adopting a plant-based diet (PBD) has gained attention for its potential health and non-health benefits. With its low intake of animal products, PBD has been associated with a lower risk of chronic diseases such as cardiovascular disease, type 2 diabetes, and certain cancers. In addition, PBD is also linked to benefits for the environment, animal welfare, and food security. Although young adults constitute a significant portion of the Chinese population, there is a research gap regarding their PBD consumption status and the factors that facilitate or impede their willingness to adopt this dietary pattern. Therefore, the goal of this study is to investigate the current PBD consumption status among young Chinese adults and the factors that influence their willingness to adopt this dietary pattern. Understanding these factors can help design effective interventions to promote PBD adoption among this population, potentially reducing the burden of chronic diseases in China. Methods: This study utilized a mixed methods approach, incorporating both quantitative and qualitative data collection methods. The study was grounded in two health behavior models, the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM). The study population consisted of young Chinese adults aged between 18 and 35 years in 2022. A convenience sampling technique was used to recruit participants from various regions in China. Quantitative data were collected by Wenjuanxing platform through a structured online survey, which aimed to describe the demographic characteristics of the participants, including age, sex, education level, income, and lifestyle. Additionally, the survey assessed participants' current PBD consumption status and willingness to adopt PBD. Qualitative data were collected through semi-structured interviews with a subset of the survey participants. The interviews aimed to explore in-depth the factors that influenced participants' willingness to adopt PBD, such as attitudes, subjective norms, perceived control beliefs, perceived benefits, perceived barriers, and cues to action. Results: The survey data were collected from 495 participants, and the qualitative data were obtained from in-depth interviews with 29 participants. The study sample were evenly distributed across five geographical regions of China. The mean age was 27.03. The mean score of PBD index was 85.09. There were 256 out of 495 participants who had high PBD adherence. There was 94.95% of participants who had the intention to adopt PBD. With the adjusted model, people with intention to adopt PBD were more likely to have high PBD adherence than those without intention. Education attainment, marital status, disposable income, smoking, weekly exercise time and three different types of residence and eating habit significantly influenced participants’ adherence to PBD. In terms of TPB and HBM, attitude, subjective norms are positively associated with participants’ intention to adopt PBD, while perceived control beliefs, perceived benefits, perceived barriers, and cues to action are factors that are highly related with an individual’s adherence to PBD. Conclusions: This study provides valuable insights into factors influencing individuals’