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Background
Adolescents with autism spectrum disorder (ASD) demonstrate more problematic eating behaviors and unhealthy dietary patterns than their neurotypical peers. As the COVID-19 pandemic has resulted in a continued need for virtual interventions, a tailored framework to guide virtual nutrition education programs for this population is warranted.
Objective
To optimize a theoretical framework based on empirical data from a virtual nutrition education intervention study for adolescents with ASD.
Study Design, Setting, Participants
This is a secondary analysis of qualitative data collected from a pre-post intervention study with 27 adolescents with ASD aged 12-21 years. Six adolescent focus groups (n = 12) and 21 parent interviews were conducted after the intervention.
Measurable Outcome/Analysis
The initial framework based on social cognitive theory (SCT) was applied to a virtual nutrition education intervention, BALANCE (Bringing Adolescent Learners Nutrition and Culinary Education), that consisted of eight weekly sessions. The framework had 6 domains (ASD-related Barriers, SCT Constructs, Environmental Context, Eating Habits, Other Lifestyle Behaviors, and Health Outcomes) and 21 constructs. Focus group and interview data were analyzed for emergent themes, and the framework was refined based on key findings.
Results
Emergent themes that were overlooked in the initial framework development included that adolescents improved ‘Self-regulation’; parents particularly liked that children's ‘Autonomy and independence’ were encouraged; and ‘Family support’ for healthy eating increased, e.g., parents teaching their children how to prepare food themselves, after participating in BALANCE. The optimized framework included 3 new constructs based on these results: Self-regulation, Autonomy, and Supportive Social Environment, which can be well-explained with self-determination theory (SDT).
Conclusions
The findings suggest that future versions of the BALANCE intervention should incorporate SDT constructs to improve adolescents’ intrinsic motivation to make healthy food choices. The optimized framework can be used to inform future virtual nutrition education programs for this population.
Funding
University of South Florida College of Public Health.
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Copyright
© 2022 Published by Elsevier Inc.
