title: Development and validation of a social cognitive theory-based survey for elementary nutrition education program.
abstract: BACKGROUND
  The Social Cognitive Theory (SCT) is a widely used model for developing elementary nutrition education programs; however, few instruments are available to assess the impact of such programs on the main constructs of the SCT. The purposes of this study were: 1) to develop and validate a SCT-based survey instrument that focuses on knowledge, behavior, and self-efficacy for fifth grade students; 2) to assess the relationships between knowledge, behavior, and self-efficacy; and 3) to assess knowledge, behavior, and self-efficacy for healthy eating among the fifth grade students.
  
  
  METHODS
  A 40-item instrument was developed and validated using content validity and tested among 98 fifth grade students for internal consistency reliability. Relationships between knowledge, behavior, and self-efficacy were assessed using Pearson Correlation Coefficients. Differences in behavior and knowledge scores between children with high and low self-efficacy were examined using t-test.
  
  
  RESULTS
  Cronbach's alphas for self-efficacy (0.70) and behavior (0.71) subscales of the survey were acceptable, although lower for knowledge (0.56). Summary scores for self-efficacy and behaviors were positively correlated (r = 0.40, P = 0.0001); however, summary knowledge scores were not associated with self-efficacy (r = 0.02, P = 0.88) or behavior scores (r = 0.14, P = 0.23). Participants with high self-efficacy also had significantly higher scores on consuming fruits (P = 0.0009) and dairy products (P = 0.009), eating breakfast (P = 0.008), helping plan family meals (P = 0.0006) and total behaviors for healthy-eating (P = 0.001) compared to those with low self-efficacy. In addition, approximately two thirds of the fifth grade students reported that they did not eat any fruits or vegetables or ate them only once on a typical day.
  
  
  CONCLUSIONS
  The developed instrument is a reliable and useful tool to assess SCT-based elementary nutrition education programs, particularly for self-efficacy and behavior. Our results also indicated that strategic interventions are necessary to improve dietary behaviors regarding fruit and vegetable consumptions among elementary school students.
authors.affiliation: Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 110 Leverton Hall, Lincoln, NE, 68583, USA. elisha@huskers.unl.edu.
authors.forename: Elisha
authors.initials: E
authors.lastname: Hall
authors.affiliation: Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 110 Leverton Hall, Lincoln, NE, 68583, USA. wchai2@unl.edu.
authors.forename: Weiwen
authors.initials: W
authors.lastname: Chai
authors.affiliation: Nutrition and Dietetics, University of North Dakota, Grand Forks, USA. Wanda.koszewski@UND.edu.
authors.forename: Wanda
authors.initials: W
authors.lastname: Koszewski
authors.affiliation: Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, 110 Leverton Hall, Lincoln, NE, 68583, USA. jalbrecht1@unl.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Albrecht
mesh_terms: D002648:Child; D002652:Child Behavior / Q000523:psychology; D003071:Cognition; D004032:Diet; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009752:Nutritional Status; D015203:Reproducibility of Results; D020377:Self Efficacy; D066269:Social Theory; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires / Q000592:standards*