Qom University of Medical Sciences Journal

Introduction
In recent years, obesity has been increased in developing countries including Iran, especially among adolescents. Various measures have not been successful to prevent it. Obesity in adolescence is a strong predictor of obesity in adulthood. Obesity affects self-confidence and has negative effects on social behavior. High daily intake of energy, protein and carbohydrates, daily activity, parents’ education, birth season, high/low birth weight, type of milk consumed during infancy, length of breastfeeding, frequency of consumption of fast foods and carbonated drinks, the time spent watching TV and using computers, and eating fast are related to obesity.
According to the social cognitive theory (SCT), nutritional behaviors are affected by individual and environmental factors, and predictive factors and effective principles in the formation of behavior as well as strategies to change the behavior are discussed. In this theory, three main factors including self-efficacy, goals and outcome expectations, affect the possibility of changing health-related behaviors. This study aims to investigate the factors related to the preventive behaviors of obesity based on the SCT in female high school students in Iran.
Methods
This descriptive study was conducted on 104 high school girls who were randomly selected from two schools in Qom city. To collect the data, a six-part questionnaire was used which surveys demographic characteristics, behaviors based on the constructs of the SCT, tendency to consume fast foods, consumption of snacks, food frequency, and physical activity using the international physical activity questionnaire-short form was used. All questionnaires had acceptable validity and reliability. Due to the COVID-19 pandemic, the questionnaires were sent to the students on the “Shad” application and then were completed online. After data collection, the data were analyzed in SPSS V.20 statistical software using descriptive statistics, independent t-test, and paired T-test. The significance level was set at 0.05.
Finding
The mean age, weight, and height of the students were 16.68 years, 73.89 kg, and 163.22 cm, respectively. Their fathers’ educational level was lower than high school education in 26 cases (25%), high school diploma in 32 cases (30.8%), and university education in 46 cases (44.2%). Their mothers’ education level was lower than high school education in 28 cases (26.9%), high school diploma in 54 cases (51.9%), and university education in 22 cases (21.2%). Regarding fast food consumption, 30 students (28.8%) had no consumption, 65 (62.5%) had consumption once a week, 4 (3.8%) had twice a week, one (1%) had three times a week, and 4 (3.8%) had four times a week (high consumption rate). In terms of the SCT constructs, the mean score of awareness was 13.98 out of 24; the mean score of outcome expectations was 13.05 out of 20 (65.25%); the mean score of outcome evaluation was 47.27 out of 30 (91.56%); the mean score of observational learning was 26.08 out of 30 (55%); the mean score of reinforcement was 3.23 out of 25 (56.96%); the mean score of self-efficacy was 18.52 out of 25 (74.08%); and the mean score of self-control was 13.05 out of 25 (52.2%). The scores of the SCT constructs had a significant relationship with nutritional behaviors and physical activity. The results of analysis of variance showed that the mean scores of the constructs of outcome expectations, self-efficacy and self-control were significantly related to the physical activity of students.
Discussion
The SCT constructs can be good predictors for obesity prevention behaviors in female high school students. Planning and implementing interventions based on these constructs can be effective in improving their lifestyle and nutritional patterns.
Ethical Considerations
Compliance with ethical guidelines
Informed consent was obtained from all participants. The study was approved by the ethics committee of Qom University of Medical Sciences (Code: IR.MUQ.REC.1400.045).
Funding
This study was extracted from the thesis of Atefeh Zolfaghari. This study was not funded by any organizations.
Authors contributions
Conceptualization, Methodology, Investigation, Editing & review: Zabihollah Qarlipour, Mohammad Aligol, Atefeh Zolfaqari; Statistical analysis: Abolfazl Mohammad Beigi; Initial draft preparation: Mohammad Aligol.
Conflicts of interest
The authors declare no conflict of interest.
Acknowledgements
The authors wish to thank the study participants for their contribution to the research, as well as current and past investigators and staff. The authors would specifically like to thank research deputy of Qom university of medical science.