Social Cognitive Theory Caroline Mc Naughton Tittel Nutrition

Social Cognitive Theory Caroline Mc. Naughton Tittel Nutrition Education May 22, 2000

Social Cognitive Theory Mischel & Bandura • SCT addresses – Psychosocial dynamics influencing health behavior – Methods of promoting behavior change • Self-efficacy, self-confidence, and outcome expectations • Reciprocal determinism – Behavior, personal factors & environment all interact

Reciprocal Determinism Bandura Person Environment Behavior

Relevance of SCT to Health Education • Comprehensive – Cognitive, emotional & behavioral explanations of behavior • Constructs provide avenues for behavioral research & health education practice • Application of theoretical ideas developed in other areas of psychology to health behaviors & behavior

Constructs of SCT Mischel & Bandura • Environment • Situation • Behavioral capability • Expectations • Expectancies • Self-control • Observational learning • Reinforcements • Self-efficacy • Emotional coping responses • Reciprocal determinism

Use of SCT in Nutrition • Predicting Influences – “Social cognitive model of fruit and vegetable consumption in elementary school children” -Resnicow K et al – “Social-cognitive predictors of fruit and vegetable intake in children” -Reynolds KD et al – “Examination of specific nutrition/health behaviors using a social cognitive model” -Lewis CJ et al • Interventions – “Gimme 5 fruit, juice, and vegetables for fun and health: Outcome evaluation” -Baranowski T et al – “Development and evaluation of an intervention program: “Control on campus” -Wdowik MJ et al – “Changing fruit and vegetable consumption among children: The 5 -a-Day Power Plus program in St. Paul, Minnesota” Perry CL et al

Beverage Consumption • Extent to which milk & soda consumption behaviors are influenced by SC variables has not been examined • Justification – Current health concerns – consumption behaviors can be measured accurately – comparisons b/t whole/low-fat/skim & regular/diet soda Lewis et al (1989) J Am Diet Assoc; 89: 194 -202

Study Design Lewis et al • Written questionnaire mailed in 2 phases – Phase 1: 39 items frequency of consumption, knowledge, attitudes & behavior as well as demog – Phase 2: 59 items differential association, social and non-social reinforcement, behavior modeling • 457 adults mean age of 47 y, 58% female • 709 college students mean age 21 y, 50% female

Model for Food Frequency Consumption Behavior modeling Frequency of food consumption behavior Differential Association Evaluative Definitions Social Reinforcement Non-social reinforcemen Lewis et al

SCT Variables Lewis et al • Differential association – perceptions of family, friends, health experts, media • Attitude – “milk is important” & “soda is acceptable” • Social reinforcement – positive feelings, belonging, pleasing others • Nutrition knowledge – “true” & “false” & “don’t know”

SCT Variables Lewis et al • Behavior modeling – frequency by mother, father, other adult, significant other, friend, & favorite media star • Behavioral commitment – selection of beverages low in fat & sugar • Taste enjoyment – “not at all” (1) to “very much” (5)

Results Lewis et al • For both groups and for all 4 beverages, neither social reinforcement nor behavior modeling directly influence FOBC • Milk – taste enjoyment, commitment, attitudes toward importance directly related to FOBC for both groups & both whole & low-fat/skim – taste enjoyment related to commitment & attitude

Results Lewis et al • Soda – more variable than milk for consumption b/t groups & type of beverage – taste enjoyment & commitment were directly related to FOBC for both groups & both regular & diet

Conclusions Lewis et al “Best predictor of behavior is the person’s intention to perform the behavior” “Nutrition knowledge. . . may help to create an intervening variable, ‘behavioral intention, ’ which in turn leads to the actual behavior” “. . . social beverages. . . more variable & easily changed. . . healthful beverages. . . steady & deeply rooted”

Gimme 5! • Multi-component randomized school intervention in 4 th and 5 th graders to FJV consumption • Levels of FJV consumption in children range from 1. 9 to 2. 5 servings – thru the elementary school years • Focus groups conducted to determine environmental, personal & behavioral factors Baranowski et al (2000) Health Education & Behavior;

Gimme 5! Baranowski et al • 8 matched elementary school pairs • 6 -week intervention (12 sessions) – conducted by trained teacher – transparencies, handouts, worksheets, posters & weekly newsletters – Taste testing of snacks prepared by FSP – MTV-like video – Role-playing skits – Point-of-Purchase education

SCT Variables Baranowski et al • Environment – availability & accessibility • Behavioral capability – asking skills, Fa. SST recipes • Outcome expectancies – performance w/o acceptance by peers • Self-control – Goals for FJV at meals & snacks

SCT Variables Baranowski et al • Observational Learning – teacher, parents (? ) • Reinforcement – prizing for completing assignments, congratulations • Self-efficacy – Role-play to bolster asking & shopping skills • Reciprocal determinism

Results Baranowski et al • 1, 172 students provided 7 -d food records for 3 y – 15% African American, 85% Euro-American • Curriculum implementation was 47% for all activities, w/ only 22% of crucial activities performed • participation in video & POP education activities • Effect size of 0. 2 servings comparable to other interventions

Results Baranowski et al

Future Directions Baranowski et al • Better understanding of food choice • More effectively impact mediating variables & processes • Explorations of alternatives channels • Teacher training which results in higher curriculum fidelity • Higher dose of several intervention components

Control on Campus Abstract from Wdowik et al (2000) Diabetes Educ; 26(1): 95 -104 • Based on SCT and EHBM • Type I Diabetes knowledge, attitudes & behaviors assessed pre-, post- & at followup – 3 intervention cohorts, 1 control – Reporting of Hb. A 1 C & knowledge significantly for intervention groups – More support on campus, overcame fears associated with BG testing, frequency of BG testing, testing when BG felt to be low

Limitations of SCT • Too many constructs • Limited in its ability to predict behavior • No significant behavior seen in large intervention studies • Applied to a single behavior or not • Additional influences • Fails to address nonlinearities

References • Baranowski T et al. (2000) Health Education and Behavior; 27(1): 96 -111. • Elder JP. Motivating Health Behavior. New York: Delmar, 1994. • Glanz K. Health Behavior and Health Education: Theory, Research and Practice. San Francisco: Jossey-Bass, 1997. • Lewis CJ et al. (1989) J Am Diet Assoc; 89: 194 -202. • Perry CL et al. (1998) Am J Pub Health; 88(4): 603609. • Resnicow K et al. (1997) Health Psychology; 16(3): 272 -276. • Reynolds KD et al. J of Nutr Edu; 31(1): 23 -30.