Adolescent Self-Efficacy for Diet and Exercise Following a School-Based Multicomponent Lifestyle Intervention

Abstract

Self-efficacy is perhaps the most important parameter associated with behavioral changes. The main aim of this study was to provide insight into the diet and exercise self-efficacy of Greek adolescents and how they could be modified via a multilevel multicomponent school-based lifestyle intervention. Secondary aims were to study the associations of students’ dietary and exercise self-efficacy indices with their anthropometric and sociodemographic parameters. A representative sample of the adolescent population in Attica, consisting of 1610 adolescents aged 12–17 years, recruited from 23 public high schools in three municipalities of the Attica area in Greece, received a three-component lifestyle educational intervention for health promotion and underwent screening for characteristics of metabolic syndrome with the use of portable telemedicine. All assessments and anthropometric measurements were performed at baseline and after the 6-month intervention. Anthropometric measurements included body mass index, waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR). Assessment tools included the Self-efficacy for Diet and the Self-efficacy for Exercise questionnaires, as well as the Mediterranean Diet Quality Index in Children and Adolescents (KIDMED). Analysis included 1020 adolescent students (421 males and 599 females), who completed the self-efficacy questionnaires pre- and post-intervention. Overall, the dietary (p < 0.001) and exercise (p < 0.001) self-efficacy increased significantly post-intervention. Post-intervention, all adolescents decreased their abdominal obesity indices (WC, WHtR, WHR), and this improvement was even more pronounced and significant (p = 0.019, p = 0.019, p = 0.023 respectively) in the adolescents with overweight/obesity. Post-intervention, the proportion of adolescents with normal weight increased from 73.9% to 78.6%, whereas the proportion of adolescents with overweight and obesity decreased from 20.4% to 15.9% and from 5.7% to 5.5%, respectively. Abdominal obesity also decreased from 10.4% to 9.0%. Female adolescents achieved significantly (p = 0.010) higher changes in diet self-efficacy than males. Other sociodemographic characteristics such as family structure, parental age, parental educational level and family income showed non-significant differences. Adolescents with higher KIDMED scores manifested significantly higher dietary and exercise self-efficacy than those with lower KIDMED scores. Both adolescents with normal weight and overweight/obesity manifested a reciprocal relation between diet and exercise self-efficacy. Multicomponent lifestyle interventions in the school environment may provide a first step in students’ behavior changes and provide grounds for future prevention programs in youth.

Perception and Awareness of Diabetes Risk and Reported Risk-Reducing Behaviors in Adolescents

“…Our sensitivity analysis suggests that the association of this indirect measurement was minimal, but future studies may find even stronger associations between risk perception and health behaviors if adolescents are asked directly. Our finding that youth with lower rates of physical activity perceive themselves to be at higher risk of diabetes suggests that the failure to engage in healthy lifestyle behaviors is not a knowledge gap, but perhaps the result of limited self-efficacy 21 or other barriers to health behavior change that were not measurable via NHANES. Further exploration of how risk perception emerges and its causal role in health behaviors may also inform future intervention design, as traditional motivational interviewing alone has not been demonstrated to be effective for treating adolescents with overweight and obesity.…”

Effects of Online Nutrition Training Program About Mediterranean Diet on Anthropometric Measurements and Diet Quality in Overweight and Obese Adolescent Girls

“…Multicomponent lifestyle interventions to adolescents in the school environment may provide a first step in behavior changes and provide grounds for future prevention programs in adolescent (48). In addition, it is also emphasized that it is important to maintain individual nutrition programs in order for a significant change in BMI in obese adolescents (29,49).…”

Association Between Physical Activity and Sedentary Behavior With Depressive Symptoms Among US High School Students, 2019

“…For example, many physical activity programs and sports necessitate a healthy diet. Combining regular physical activity and a self-regulated healthy PREVENTING CHRONIC DISEASE diet may increase self-efficacy and resiliency, which may in turn reduce the likelihood of developing depressive symptoms (29,30). Moreover, physical activity and related health behaviors may be associated with well-being through beneficial physiological mechanisms such as increases in hormones and growth factors (eg, endorphins, brain-derived neurotrophic factor), immune function, and anti-inflammatory effects (31).…”