Intervention design: An 18-week,
individually-based intervention was provided for
children in experimental group that emphasized the
modification of children’s behaviors based on a TPB
framework. This included: attitudes toward eating
behaviors for weight control; subjective norms
regarding eating behaviors for weight control;
perceived behavioral control toward eating behaviors;
and increased intention to perform eating behavior for
weight control. The main component comprised
nutritional education based around four modules with
different objectives. Module A emphasized modifying
attitudes toward eating behaviors for weight control.
Information was provided through media such as a
computer game, cartoon animation, a box game, and
a comic book in order to raise awareness about the
health impact of being overweight and healthy eating
behavior. Module B focused on modifying subjective
norms regarding eating behaviors for weight control.
The influence of normative beliefs and motivation was
provided through the opinions of influential people in
close relationships with the child such as the father,
mother, grandfather, grandmother, teachers, and
friends. Module C aimed to modify perceived
behavioral control toward eating behaviors. The
children were asked to consider their opinions about
their ability to perform healthy eating behaviors.
Finally, Module D involved setting goals to achieve
eating behaviors for weight control. The assumption
here was that once children understood their capabilities
and the underlying normative values, they can
confidently set their own goals to perform effective
eating behaviors and follow through with their plan.
It is also important that the children not only set goals
and make a plan but also that they monitor themselves
as they carry out their plan. In this way, the individual
commits to follow a plan of their choosing and observes
their own progress.
The intervention contents were approved by
five experts: a pediatric doctor; a nursing faculty
member expert in children and TPB; two nursing
faculty members, experts in nutrition and overweight
in children; and a behavioral science faculty member
expert in health behaviors. These experts were
requested to review the content in the manual to clarify,
and assess its adequacy in terms of construct validity
and appropriateness. Their suggestions were used to
make revisions to the program. Content validity was
determined in a pilot test with ten children to evaluate
the readability and understandability of the materials.
The recommendations of children were used to make
revisions during implementation