Dietary Outcomes

In terms of fruit and vegetable intake or dietary patterns, most SCT-based interventions have been shown to be effective. In several Eat Well and Keep Moving studies conducted with fourth and fifth grade elementary students, interventions that used explicit goal setting and targeted incentives to enhance student and staff self-efficacy resulted in students who had significantly higher fruit and vegetable intake following the completion of the intervention (Cheung et al., 2016; Gort-maker et al., 1999a; Hermann, 2001). CATCH, the longitudinal study mentioned earlier, resulted in significantly lower energy' intake for the intervention group than children in the control group by using goal setting and targeting children’s self-efficacy to eat more fruits and vegetables (Nader et al., 1999; Rice et al., 2014).

Be Smart is another example of a school-based intervention involving families of primary school children from three schools that used elements of SCT (Warren, Henry, Lighttowler, Bradshaw, & Perwaiz, 2003). During lunch, interactive and age-appropriate nutrition and/or physical activity curricula were presented to the students over the course of 20 weeks. There were four groups: control, nutrition intervention group, physical activity intervention group, and combined nutrition and physical activity group. Outcomes showed a significant increase in fruit and vegetable consumption for all participants, particularly the control group and the nutrition intervention group (Warren et al., 2003). In Be Smart, the SCT guided the intervention components in a number of ways. First, Be Smart provided the opportunity for participants to taste preferred healthy foods and engage in desired physical activity; the intervention offered incentives such as verbal praise and tangible prizes while also developing self-efficacy by reaching targeted goals. Last, Be Smart collaborated with parents to overcome sociocultural barriers by improving perceived parental self-efficacy in helping their child attain their desired goals.

Substance Use

SCT has long been applied to the field of substance use through the examination of a number of different substance use related variables including: attitudes towards drugs, drug expectancies, and social learning (nonns) associated with attitudes and expectancies (Giovazolias & Themeli, 2014). Researchers have examined different prevention and intervention approaches using the aforementioned variables in an attempt to reduce adolescent substance use. For example, a study by Hansen and Graham (1991) examined two strategies for substance use prevention including teaching refusal skills and correcting false nonnative perceptions around peer use and acceptance of substance use in a sample of junior high students. Using an experimental design with students either receiving a placebo, refusal skills, nonnative education, or both, they found significant reductions in alcohol, marijuana, and cigarette use attributable to nonnative education. More recent research conducted by Faggiano et al. (2010) examined the impact of a 12-hour intervention (Unplugged) developed based on SCT on the substance use behavior of 7,079 youth aged 12-14. The program focused on nonnative education, knowledge, attitudes, and self-efficacy in the development refusal skills. Using a cluster randomized control trial, students were randomly assigned to treatment conditions. The results of the study found significant decreases in binge drinking and cannabis use for youth who participated in the intervention at the 18-month follow up. Thus, interventions for substance use based on SCT appear to be effective in reducing adolescent substance use.

Risky Sexual Behavior

SCT has been applied to the study of risky sexual behavior phenomenologically in ways that examine self-efficacy related to discussing sexual history with partners, self-efficacy and attitudes towards condom use, perceptions of risk, and social norms (O’leary, Goodhart, Jemmott, & Boccher-Lattimore, 1992). Interventions on risky sexual behavior with adults finds support for the use of SCT framed interventions in improving condom use and reducing sexually transmitted infections (STIs). Specifically, a study conducted by Warner et al. (2008) on the Safe in the City intervention found a reduction of 10 percent in new STIs post intervention. Safe in the City is a 23-minute video-based intervention shown to adults in clinic waiting rooms that focused on SCT principles such as increasing perceptions of STI/HIV risk, fostering positive attitudes around safe sex practices, and developing self-efficacy around safe sex practices (Warner et al., 2008).

While the majority of this research has been conducted in adults, researchers have begun investigating these phenomena and related interventions in adolescents. The BReady4it intervention developed by Starling et al. (2014) is a webbased intervention implemented in schools that focuses on attitudes towards sexual behavior, subjective norms, and perceived behavioral control. The intervention was implemented with 173 students in grades 9 and 10. Results indicated that post intervention both self-efficacy and behavioral intentions for condom use significantly increased. Another study focused on high risk adolescent females and implemented an interactive video intervention (Seventeen Days) based on SGT concepts including condom self-efficacy with 300 females (75 percent African American) who participated in the intervention study. Results indicated that youth assigned to the interactive video demonstrated higher rates of abstinence, fewer condom failures, and fewer STIs (Downs, Murray, de Bruin, Penrose, Palmgren, & Fischhoff, 2004). While the research on SCT interventions related to risky sexual behavior is limited, preliminary work is promising.

 
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