Factors Associated With Self-Efficacy Toward Healthy Eating and Physical Activity Among Kuwaiti Adolescent Girls

Abstract Background: The factors that may influence adolescents’ health-related behaviors in Kuwait are unclear. We hypothesized that girls’ self-efficacy would be negatively associated with their weight statuses and positively associated with healthy eating-related behaviors. This study aimed to measure healthy eating-related parameters, including self-efficacy, dietary habits, dietary beliefs, nutrition knowledge, and physical activity, in a sample of Kuwaiti adolescent girls and assess the correlates of self-efficacy, including weight status and dietary and health behaviors. Methods: In this cross-sectional, self-administered survey at the school level, we evaluated students of three schools in different governorate locations in Kuwait. The participants were adolescent girls (n=301; mean age, 16.6±1.2 years) who attended secondary schools. The main outcome measures were self-efficacy, dietary habits, dietary beliefs, nutrition knowledge, physical activity, and weight status per body mass index (BMI) categories. Pearson’s correlation analysis was performed to determine the associations among the healthy behavior related parameter scores. The independent samples t-test was used to examine the differences in scores between participants’ characteristics and self-efficacy scores (SES). Multivariate regression analysis was used to determine the final independent correlates of SES.Results: Only 19.9% of the participants had high self-efficacy toward healthy eating behaviors, 20.9% had “satisfactory eating habits,” 11.3% had a good comprehension of the meanings of healthy and unhealthy dietary habits and food, 16.3% had good nutrition knowledge, and 29.2% had an active lifestyle. SES was negatively correlated with BMI (r=-0.074, P=0.03) and positively correlated with all domains of healthy eating and physical activity. However, SES was not associated with nutritional knowledge. The independent correlates of SES in the multivariate regression analysis were governorate, eating beliefs, healthy eating score, and physical activity (R2=38.3%).Conclusions: Adolescent girls in Kuwait demonstrated a high level of self-efficacy toward healthy eating and behaviors and had firm nutritional beliefs; however, they failed to translate their beliefs into good nutritional habits. It is necessary to develop interventional nutrition programs at the school level that aim at improving healthy behaviors among adolescents.