Educational Nutritional Intervention Program for Adolescents Based on Social Cognitive Theory: Pilot Study of a Cluster Randomized Controlled Trial.

The eating habits of adolescents are often inadequate, with high consumption of unhealthy foods and low consumption of healthy foods. It is necessary to design and implement effective interventions to improve eating habits at this age and evaluate their feasibility, acceptability, and effectiveness. The use of theories for behavior change in health interventions favors the adoption of healthy behaviors. Due to this, the objective was set to determine the feasibility, acceptability, and effect on food consumption of a new educational nutritional intervention program for adolescents based on the Social Cognitive Theory (SCT) and supported by the Trans-theoretical Model (TTM) and identify areas of improvement in study design and intervention for future larger-scale studies. A pilot study of a cluster randomized controlled trial was conducted in adolescents of both sexes, 12 to 15 years of age, students from a public secondary school in Tonala, Jalisco, Mexico. The results show that a nutritional education intervention for adolescents, based on SCT and supported by the TTM, is feasible, acceptable, and with positive results in the modification of the consumption of ultra-processed foods, vegetables/fruits, and water. This pilot study identified some aspects that could be improved to enhance the effectiveness of the interventions in future studies.

A systematic review of educational nutrition interventions based on behavioral theories in school adolescents.

The purpose of this study was to summarize the evidence from studies conducted on adolescents, evaluating educational nutrition interventions for the modification of food consumption through controlled trials based on behavior change theories or models and implemented in school settings. A systematic search was carried out through PubMed and ERIC databases between November and December 2020, and updated in February 2023; English-language keywords were used, and no publication date limits were applied. Two authors independently performed the search, data extraction, data synthesis and risk of bias assessment. Twelve studies meeting the inclusion criteria were included. The interventions were based on different theories; the most used was the Social Cognitive Theory. Eleven of the twelve studies showed favorable modifications in the consumption of at least two of the food groups. Most studies were at low risk of bias, and only one was classified as high risk. It is concluded that educational nutrition interventions based on behavior change theories/models and implemented in the school setting influence positive changes in adolescents eating behavior.

Validation of a Spanish-Language Questionnaire on Adolescent Eating Behavior Based on Social Cognitive Theory.

OBJECTIVE: To validate a Spanish-language questionnaire on adolescent eating behavior based on Social Cognitive Theory. DESIGN: The validity (reliability and construct validity) of a self-administered questionnaire containing 28 questions with Likert scale-type response options was evaluated. SETTING: School located in Tonala, Jalisco, Mexico (a peri-urban area) with approximately 1,400 students enrolled. PARTICIPANTS: One hundred fifty-two adolescents enrolled in the second year of a middle school in Tonalá, Jalisco, Mexico (mean age, 13.7 years; SD, 0.5 years; 64% female). The retest was completed by 70 adolescents chosen at random. OUTCOME MEASURES AND ANALYSIS: The questionnaire's reliability was measured through internal consistency (Cronbach α) and reproducibility (intraclass correlation coefficient [ICC]). Construct validity was assessed using exploratory factor analysis. RESULTS: Five questions were eliminated from the questionnaire because of a lack of temporal stability (ICC ≤0.4). The exploratory factor analysis was satisfactory for 3 factors (41.89% of variance): environmental facilitators and social support, self-efficacy and self-regulation, and outcome expectations and outcome expectations value. The questionnaire had good internal consistency (α = 0.824) and excellent temporal stability (ICC = 0.849). CONCLUSIONS AND IMPLICATIONS: The results substantiate the reliability and construct validity of this questionnaire. The questionnaire has the potential to use the assessment of Social Cognitive Theory constructs in clinical practice or in nutrition interventions aimed at modifying the eating habits of Spanish-speaking adolescents.

Validación de un cuestionario autocompletado de hábitos alimentarios para adolescentes, en Jalisco, México / Validation of a questionnaire self-completed of food habits for adolescents, in Jalisco, México

Fundamentos: La evaluación de la calidad de la alimentación en la adolescencia es imprescindible. Existen diferentes métodos, sin embargo, la mayoría son útiles en la práctica clínica y se complica su uso en poblaciones. El objetivo de este estudio fue validar un cuestionario autocompletado de hábitos alimentarios para adolescentes, mediante su aplicación en una población de Jalisco, México. Métodos: El cuestionario fue autocompletado en dos ocasiones por 64 adolescentes de educación secundaria. Se realizó un análisis factorial exploratorio; se evalúo consistencia interna con coeficiente Alfa de Cronbach; se midió la concordancia entre las puntuaciones test-retest por medio de coeficiente de Pearson y coeficiente de Correlación Intraclase; la concordancia entre la clasificación de los hábitos test-retest se evalúo con coeficiente de Spearman y Kappa. Resultados: Todas las variables presentaron carga factorial significativa en sus respectivos componentes. La consistencia interna fue buena para la mayoría de las secciones. Se obtuvieron correlaciones de Pearson razonables y los valores del CCI fueron en su mayoría excelentes. La correlación de Spearman fue moderada y el coeficiente kappa aceptable. Conclusiones: La validación del cuestionario fue satisfactoria. Su utilización en adolescentes permitirá obtener resultados validos y evaluar poblaciones grandes sin invertir excesivos recursos humanos y temporales (AU)

Background: The evaluation of the quality of feeding in adolescence is essential. There are different methods, however, are most useful in clinical practice and use in populations is complicated. The objective of this study was to validate a food habits self-completion questionnaire for adolescents, through its application in a population of Jalisco, Mexico. Methods: The questionnaire was self-completed twice for 64 high school adolescents. Exploratory factor analysis was performed; internal consistency was assessed with Cronbach's Alpha coefficient; the correlation between test-retest scores by Pearson coefficient and intraclass correlation coefficient was measured; the correlation between the classifications of the test-retest habits was assessed with Spearman and Kappa coefficient. Results: All variables presented significant factor loadings in their respective components. Internal consistency was good for most sections. Pearson correlations were obtained fair and ICC values were mostly almost perfect. Spearman correlation was moderate and kappa coefficient was substantial. Conclusions: Validation of the questionnaire was satisfactory. Its use in adolescents will allow obtain valid results and evaluate large populations without investing excessive human and time resources (AU)