Eileen S. Anderson

Social cognitive determinants of physical activity in young adults: A prospective structural equation analysis

This study used a prospective design to test a model of the relation between social cognitive variables and physical activity in a sample of 277 university students. Social support, self-efficacy, outcome expectations, and self-regulation were measured at baseline and used to predict physical activity 8 weeks later. Results of structural equation modeling indicated a good fit of the social cognitive model to the data. Within the model, self-efficacy had the greatest total effect on physical activity, mediated largely by self-regulation, which directly predicted physical activity. Social support indirectly predicted physical activity through its effect on self-efficacy. Outcome expectations had a small total effect on physical activity, which did not reach significance. The social cognitive model explained 55% of the variance observed in physical activity.

Weight Gain Prevention: Identifying Theory-Based Targets for Health Behavior Change in Young Adults

Young adults attending college are more vulnerable to weight gain than the general population. We sought to identify health behavior change targets related to weight management in college students. Based on the Social Cognitive Theory model for health behavior change, we investigated the health-related lifestyle behaviors and physiological characteristics of this population. Forty-three college students (18.3+/-0.1 years) completed a series of quantitative assessments (eg, body weight and composition, cardiorespiratory fitness, and diet and activity habits) and structured qualitative assessments (ie, structured interview or focus group). Participants were predominantly normal weight (mean body mass index 22.2+/-0.4) and fit (maximal oxygen consumption 50.5+/-1.5 mL/kg/minute). However, healthful eating and physical activity were not considered high priorities, despite having ample free time, high exercise self-efficacy, positive outcome expectations for exercise, and a desire to exercise more. Participants reported that regularly engaging in exercise was difficult. This may have been due to poor planning/time management, satisfaction with body image, lack of accountability, and feelings of laziness. Dietary patterns generally met recommendations but were low in fruits, vegetables, and whole grains. Social support for exercise and healthful dietary habits were important factors associated with health behaviors. Students reported a decline in exercise and dietary habits relative to high school, which may have contributed to college weight gain. Our results suggest that this population may not have adequate self-regulatory skills, such as planning and self-monitoring, to maintain healthful behaviors in the college environment. Food and nutrition professionals working with young adults attending college may use these findings to guide the behavioral therapy component of their weight management medical nutrition therapy goals and outcomes.

Guide to health: Nutrition and physical activity outcomes of a group-randomized trial of an internet-based intervention in churches

Background: Theory-based interventions accessible to large groups of people are needed to induce favorable shifts in health behaviors and body weight.Purpose: The aim was to assess nutrition; physical activity; and, secondarily, body weight in the tailored, social cognitive Guide to Health (GTH) Internet intervention delivered in churches.Methods: Participants (N=1,071; 33% male, 23% African American, 57% with body mass index ≥25, 60% sedentary, Mdn age=53 years) within 14 Baptist or United Methodist churches were randomized to the GTH intervention only (GTH-Only; 5 churches), with church-based supports (GTH-Plus; 5 churches), or to a waitlist (control; 4 churches). Verified pedometer step counts, measured body weight, fat, fiber, and fruit and vegetable (F&V) servings from food frequency and supermarket receipts were collected at pretest, posttest (7 months after pretest), and follow-up (16 months after pretest).Results: Participants in GTH-Only increased F&V at post (∼1.50 servings) compared to control (∼0.50 servings; p=.005) and at follow-up (∼1.20 vs. ∼0.50 servings; p=.038) and increased fiber at post (∼3.00 g) compared to control (∼1.5 g; p=.006) and follow-up (∼3.00 g vs. ∼2.00 g; p=.040). GTH-Plus participants compared to control increased steps at post (∼1,500 steps/day vs. ∼400 steps/day; p=.050) and follow-up (∼1,000 steps/day vs. ∼−50 steps/day; p=.010), increased F&V at post (∼1.5 servings; p=.007) and follow-up (∼1.3 servings; p=.014), increased fiber at post (∼3.00 g; p=.013), and follow-up (∼3.00; p=.050) and decreased weight at post (∼−0.30 kg vs. ∼+0.60 kg; p=.030).Conclusions: Compared to control, both GTH treatments improved nutrition at posttest, but church supports improved physical activity and nutrition at posttest and follow-up, suggesting environmental supports may improve Internet-based interventions.

A computerized social cognitive intervention for nutrition behavior: Direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers

This study examined the direct and mediated impact of a self-administered, computer-based intervention on nutrition behavior, self-efficacy, and outcome expectations among supermarket food shoppers. The intervention, housed in kiosks in supermarkets and based on social cognitive theory, used tailored information and self-regulation strategies delivered in 15 brief weekly segments. The study sample (N = 277), stratified and randomly assigned to treatment or control, was 96% female, was 92% White, had a median annual income of about

Social-cognitive determinants of nutrition behavior among supermarket food shoppers: a structural equation analysis.

35,000, and had a mean education of 14.78 ±2.11 years. About 12% of the sample reported incomes of

Social cognitive mediators of change in a group randomized nutrition and physical activity intervention: social support, self-efficacy, outcome expectations and self-regulation in the guide-to-health trial.

20,000 or less, and about 20% reported 12 years or fewer of education. Analysis of covariance immediately after intervention and at a 4- to 6-month follow-up found that treatment led to improved levels of fat, fiber, and fruits and vegetables. Treatment also led to higher levels of nutrition-related self-efficacy, physical outcome expectations, and social outcome expectations. Logistic regression analysis determined that the treatment group was more likely than the control group to attain goals for fat, fiber, and fruits and vegetables at posttest and to attain goals for fat at follow-up. Latent variable structural equation analysis revealed self-efficacy and physical outcome expectations mediated treatment effects on nutrition. In addition, physical outcome expectations mediated the effect of self-efficacy on nutrition outcomes. Implications for future computer-based health promotion interventions are discussed.

Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments.

A social-cognitive model of nutrition behavior (A. Bandura, 1997) was tested using structural equation modeling of data from 307 food shoppers recruited from 5 supermarkets in Southwest Virginia. The shoppers were participating in the baseline phase of an ongoing nutrition promotion program. As part of the evaluation, data were collected on the self-efficacy and outcome-expectations components of social-cognitive theory as well as on food purchases and intake. The structural analyses presented here support the social-cognitive model. Self-efficacy, physical outcome expectations, age, socioeconomic status, and number of children were important predictors of nutrition behavior among shoppers. Implications for interventions using social-cognitive variables to improve the nutritional content of food purchases and intake are discussed.

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention

In an evaluation of the theoretical foundations of behavior change, the current study examined whether social cognitive (SCT) variables mediated treatment effects on physical activity and nutrition in the recently reported Guide-to-Health trial (GTH). Adults (N = 661) were assessed at baseline, seven months and 16 months to examine whether treatment-related changes in SCT variables at seven months mediated change in nutrition and physical activity at 16 months. GTH treatment effects were mediated by self-efficacy, self-regulation and social support; self-regulation mediated self-efficacy. Social-cognitive variables explained only part of the treatment effects suggesting future investigations evaluate the environmental-selection and affective processes of behavior change.

Web-Based Nutrition Education Intervention Improves Self-Efficacy and Self-Regulation Related to Increased Dairy Intake in College Students

Objectives:Youth are increasingly at risk for contracting HIV infection, and community-level interventions are needed to reduce behavioral risk. Design:A randomized, controlled, multi-site community-level intervention trial was undertaken with adolescents living in 15 low-income housing developments in five US cities. Methods:Baseline (n = 1172), short-term follow-up (n = 865), and long-term follow-up (n = 763) risk assessments were conducted among adolescents, ages 12–17, in all 15 housing developments. The developments were randomly assigned in equal numbers to each of three conditions: experimental community-level intervention (five developments); ‘state-of-the-science’ skills training workshops (five developments); and, education-only delayed control intervention (five developments). Results:At long-term follow-up, adolescents living in the housing developments receiving the community-level intervention were more likely to delay onset of first intercourse (85%) than those in the control developments (76%), while those in the workshop developments (78%) did not differ from control condition adolescents. Adolescents in both the community-level intervention (77%) and workshop (76%) developments were more likely to use a condom at last intercourse than those in control (62%) developments. Conclusions:Community-level interventions that include skills training and engage adolescents in neighborhood-based HIV prevention activities can produce and maintain reductions in sexual risk behavior, including delaying sexual debut and increasing condom use.

Food Purchase Patterns at the Supermarket and their Relationship to Family Characteristics

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.