Social cognitive theory in an after-school nutrition intervention for urban Native American youth

Objective: To improve dietary self-efficacy through a 7-month nutrition intervention for Native American children (5 to 10 years) and adolescents (11 to 18 years). Design: Single-group pretest, posttest design. Setting: An after-school program in a local community center for urban Native American youth. Participants: 104 urban Native American youth (65 children and 39 adolescents). Intervention(s): A 9-month project with pre-post evaluation and a 7-month intervention. Main Outcomes Measure(s): Dietary self-efficacy and 24-hour recalls. Analysis: Descriptive statistics were computed for comparability analysis of dietary self-efficacy and diet at baseline. For the normally distributed data, independent t tests were used for gender comparisons, whereas 1-way analysis of variance with post hoc Tukey adjustment was used to compare responses among body mass index (BMI) categories. Non-normally distributed data were analyzed with Kruskal-Wallis tests with post hoc pairwise Mann-Whitney analyses. For non-normally distributed data, the Bonferroni correction was used, and the P values were set at .025 for gender comparisons and .016 for BMI comparisons. Wilcoxon signed rank tests determined whether fat and sugar intake changed significantly between pre- and postintervention time points among adolescents. Results: Both children and adolescents exhibited moderate levels of dietary self-efficacy at baseline, with no variation by BMI. The nutrition intervention significantly improved the self-efficacy of children. Overweight children significantly improved their dietary self-efficacy. The intervention was not successful among adolescents. Conclusions and Implications: Social Cognitive Theory is an effective model from which to explore influential constructs of health behavior. This project demonstrates that a nutrition intervention provided at monthly intervals is an effective way to significantly improve dietary self-efficacy among urban Native American children. The lack of intervention effect anion, adolescents reiterates the need for greater comprehension of personal, environmental, and behavioral constraints, influencing dietary self-efficacy and behavior.