The Effect of Social Cognitive Theory-Based Interventions on Dietary Behavior within Children

Abstract

Background and Objective: According to the World Health Organization (WHO), childhood obesity is one of the most serious public health challenges of the 21st century. Both behavioral and environmental factors have been shown to contribute to children’s eating behavior. Furthermore, researchers propose that personal factors such as self-esteem and self-efficacy are also key influences. Findings suggests that nutrition education programs may be more effective if it is derived from theoretically sound information. Bandura’s Social Cognitive Theory (SCT) is an interpersonal theory that emphasizes how environmental and personal characteristics influence behavior. SCT is one of the most commonly used theoretical frameworks underlying interventions to promote physical activity and healthy eating and prevent obesity in youth, however, no review of the literature examines the efficacy of individual SCT strategies on obesity prevention and dietary behavior modification within children and adolescents. Therefore, the purpose of this review was to test the effectiveness of SCT strategies in explaining health behavior to prevent childhood obesity around the world. Methods: A total of 16 studies that focused on health behavior change and/or physical activity within children were reviewed. Articles were categorized based on research design, individual SCT principles, including, Environmental, Cognitive, Behavioral, in addition to behavior change and/or BMI outcome effects. Results: Results: All of the articles reported at least one SCT principle. However, methods and procedures varied vastly among the studies. There was a total of nine randomized control studies, three case-control studies and four cross- sectional studies. The studies revealed consistent significant correlations between behavioral factors and dietary behavior within children, such as reports of high self-efficacy being related to increased intake of fruits and vegetables and lower intake of fat, sugar and sodium. Significant correlations also existed between environmental factors (Socio Economic Status (SES), parental influence and school cafeteria) and dietary behavior within children, including low SES being related to poorer nutrition knowledge and higher BMIs and parental influence effecting the accessibility of fruits and vegetables. Results also showed that cognitive factors played a role in influencing dietary behavior by increasing one’s nutrition knowledge and self-efficacy to choose healthier foods. Conclusion: Although methods and procedures are varied, current literature suggests that environmental, cognitive and behavioral factors act together to influence children’s nutrition knowledge, self-efficacy and healthy lifestyle choices. It is important to note that not one factor alone influences dietary behavior change, but instead a continuum of factors working together. Future research needs to define and practice the same methods and procedures in order to gain consistent results and better control for confounding variables.