Interactions among perceived norms and attitudes about health-related behaviors in U.S. adolescents.

Objective: Prior research has documented the influence of social norms on health-related behaviors, though social norms may affect behaviors in more complex ways than have conventionally been modeled. The present research evaluates parent norms and teens' own attitudes as moderators of associations between perceived peer norms and diet and physical activity behaviors (both health-promoting and health-impairing) in a national sample of U.S. adolescents. Methods: Adolescent participants (N = 1,859; ages 12-17) from the 2014 Family Life, Activity, Sun, Health, and Eating study reported on the extent to which their friends eat fruits and vegetables; eat junk food or drink sugary drinks; exercise; and watch TV, play on the computer, or play electronic games most days of the week. They also reported on their own attitudes and behaviors as well as their parents' corresponding behaviors and rules. Results: Perceived peer norms were associated with teens' own health-promoting behaviors such as fruit and vegetable consumption and physical activity as well as health-impairing behaviors such as junk food consumption and sedentary habits. Teens who reported liking fruits and vegetables or physical activity or perceiving congruent descriptive parental norms demonstrated the strongest positive associations between peer norms and their own behavior. Conclusions: Perceived social norms may play a significant role in both health-impairing and health-promoting behaviors, particularly when congruent with attitudes or descriptive parental norms about those behaviors. The findings may inform interventions such as social norms marketing campaigns that aim to change perceptions of peer norms for health-promoting behavior.