Maternal-mediated social cognitive theory predictors of pediatric obesity

Background: The purpose of this study was to measure five, maternal-mediated social cognitive theory constructs (environment, expectations, emotional coping, self-control, and self-efficacy) for predicting four behavioral determinants (physical activity, fruit and vegetable consumption, sugar-free beverage consumption, and screen time) of childhood obesity. Methods: Instrumentation encompassed three stages of data collection and analysis. Stage 1 included evaluation of face and content validity of the instrument by a panel of six experts over two rounds as well as readability assessment by Flesch-Kincaid ease and grade level tests. Stage 2 assessed test-retest reliability of the instruments by having the same group of participants (n=30) complete the instruments two separate times with four weeks between administrations. Acceptable test-retest coefficient values were set a priori at 0.70. Stage 3 evaluated construct and predictive validity of the instruments through structural equation modeling. Each of the four behavioral determinants of childhood obesity (endogenous variables) was modeled separately according to the five social cognitive theory constructs (exogenous variables). Applying a participant-to-parameter ratio of 5:1, a sample size of 165 was required to build each model. Results: Each of the four models met the acceptable a priori Cronbach's alpha reliability values of > 0.70. The specified models met the a priori goodness-of-fit indices of chi-square value of p > 0.05, goodness-of-fit index > 0.90, root mean square error of approximation < 0.80, and normed fit index > 0.90. Conclusion: Social cognitive theory is a useful framework for measuring and predicting family and home determinants of pediatric obesity.