People tend to avoid activities that they believe exceed their coping
capabilities, but they readily undertake activities and select social
environments they judge themselves capable of handling.
A school nurse was also involved in classroom activities related to
promoting healthy lifestyles. The nutritionist and school nurse were in
charge of answering questions related to diet control and the exercise
program. Social skills for interpersonal relationships and psychological
counseling due to weight control and body image change were also
provided as part of the classroom activity. Various play activities and
games were designed to encourage interactive sharing; positive feedback
and reward systems were also provided to enhance self-efficacy as shown
in figure 1. For example, adolescents learned how to select healthy
meals and got involved in practice sessions about options and choices
related to low-sugar and low-fat foods. In addition, each adolescent was
also encouraged before the interventions to set realistic goals to help
improve their dietary behavior and physical activity levels; they then
wrote these down and sealed them in an envelope. The submission of
the weekly dietary log book and participation in the daily after-school
planned physical activity served as a tracking system to monitor each
adolescent’s progress. The log book enabled the researchers to track
the frequency and usage duration of different sessions. These would be
used in future analyses to validate the relations between self-regulatory
skills and changes in self-efficacy after the expected behavioral change.
The individual and group behavior change initiatives aimed to
promote the adoption of healthy behaviors and incorporate them into
various behavior modification strategies: self monitoring, goal setting,
group competition, and reinforcement through social recognition and
rewards. Self monitoring and goal setting occurred throughout in order
to reinforce and encourage adolescents to learn self-regulatory skills
that are essential for behaviour change in social environments. During
each social activity, the adolescents were asked to refer back to prior
goal-setting and self-monitoring activities so as to reinforce these skills
and foster repeated practice. Targeted behaviors were reinforced by a
special recognition and reward system during regular gatherings in the
support group.