Background: Child obesity is one of the main health problems all across the world, which leads to mental and physical health problems. Various models are used in designing intervention to prevent child obesity, one of which is social-cognitive theory (SCT). The constructs of social-cognitive theory are commonly used for designing preventive interventions. However, there is no specific tool based on the constructs of social-cognitive theory to assess the factors associated with child obesity. Aim: The aim of this study was to investigate the validity and confirmatory factor analysis of a SCT-based questionnaire for assessing obesity preventing behaviors among 4-6 years old children. Method: A cross-sectional study was first conducted in 2016 on 240 preschool children aged 4-6 years in Behbahan city (a city in southwest Iran) to assess the obesity prevention behaviors among them using a SCT-based questionnaire. To investigate the validity and confirmatory factor analysis of the SCT-based questionnaire, content and face validity as well as forward-backward translation method were used. Reliability of the questionnaire was also measured by Cronbach’s alpha coefficient and Intra-class Correlation Coefficient (ICC). Construct validity was assured by confirmatory factor analysis. To measure the obesity prevention behaviors in 4-6 years old children, the construct of SCT, including environment, emotional coping, outcome expectations, goal setting and self-efficacy were used. Also, the obesity prevention behaviors used in the model included physical activity, consumption of fruit and vegetable, consumption of sugar-free drinks, and screen. Results: Results of this study confirmed the acceptable content and face validity of the SCT-based questionnaire. The results of confirmatory factor analysis also confirmed the factor loading of more than 0.3 for all variables; therefore, the SCT-based questionnaire had an acceptable validity and reliability. Conclusions: Since the SCT-based questionnaire had an acceptable validity and reliability, it can be used to assess the obesity prevention behaviors in 4-6 year old children, and also to design relevant educational interventions. Keywords: Validation, Social-Cognitive Theory, Behavior, Childhood obesity, Preschool, Prevention

Introduction: The development of effective prevention and intervention programs in preschool period is an essential step in the fight against the obesity epidemic throughout life. The aim of this study was to prioritize the factors affecting the obesity prevention behaviors in 4-6 years old children from the perspective of mothers based on social-cognitive theory. Materials and Methods: This cross-sectional and analytical study was conducted on 240 children aged 4-6 years in Behbahan city, Iran in 2016. The random multi-stage sampling method was used in this study. Data collection tools included a demographic information questionnaire and a questionnaire based on cognitive-social theory (constructs of environment, outcome expectation, emotional coping, self-control and self-efficacy), which its validity and reliability have been evaluated and confirmed (α> 0.7). The questionnaire which was based on cognitive-social theory included 4 obesity prevention behaviors in children (physical activity, consumption of fruits and vegetables, consumption of sugar-free drinks and screen), which were completed by the mothers of these children. SPSS-23 software and Friedman’s test were used to analyze the data. Results: The results of this study suggest that from the mothers' point of view, the constructs of cognitive-social theory affecting obesity prevention behaviors in 4-6 years old children do not have the same priority (p <0.01). Also, considering the mean ratings obtained in this study, the outcome expectation construct in all 4 behaviors of obesity prevention are of primary importance. The average ranking of the outcome expectation construct was 4.38, 4.39, 4.25 and 4.49 in the behaviors of physical activity, consumption of fruits and vegetables, consumption of sugar-free drinks, and the screen, respectively. Conclusion: In designing maternal-centered educational interventions that prevent obesity in 4-6 years old children, the construct of outcome expectation should be given the highest priority. Keywords: Obesity, Pediatric, Lifestyle, Behavior, Health Priorities, Health Planning