Food for thought: A social cognitive approach to assessing children's food environments

Objective: Fruit and vegetable (F/V) intake among U.S. children from low-income families and minority subgroups remains below daily recommendations. Children who do not receive adequate nutrients are at greater risk for poor health outcomes, including childhood obesity. The Social Cognitive Theory (SCT) is a successful framework for child F/V interventions; however, current SCT-based measures are dated, lengthy, not theoretically comprehensive, and were not designed for low-income, minority children. Our objective was to develop SCT-F/V scales appropriate for and describe SCT-F/V constructs within this underserved population.

Methods: A three-stage process was conducted to develop SCT-F/V scales appropriate for low-income, minority children: (1) a comprehensive literature review was conducted to identify SCT-F/V items and modifications, (2) an expert panel reviewed items to ensure cultural appropriateness and establish content validity, and (3) a pilot test and focus group discussion (n=8) were conducted. Children ages 8-12 (n=42; 43% African American, 17% Hispanic, 19% multiple race/ethnicities) were then administered a computer-based questionnaire during after-school programs. Descriptive statistics and bivariate correlations were calculated. 

Results: Seven F/V-SCT-construct scales (64-items) were developed or modified (behavioral capability, F/V consumption, self-efficacy, observational learning, environment/situation [social and physical], outcome expectations, and self-regulation). Children’s overall F/V intake met daily recommendations of five servings (M=5.17; SD=3.43). Self-efficacy for eating, preparing, and asking for F/V was the SCT-construct most strongly associated with F/V consumption (r=0.50; p=0.01).

Conclusions: These scales provide a robust, theoretically comprehensive assessment of F/V intake for low-income and minority children. Future research needs to structurally-validate these SCT-based scales.