All ETDs from UAB

Advisory Committee Chair

David Macrina

Advisory Committee Members

Harriet Cloud

Connie Kohler

Bonnie Spear

Scott Snyder

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Education


This study developed and validated the Youth-Directed Obesity Counseling Self-efficacy (Y-DOCS) Scale to evaluate the self-efficacy of registered dietitians (RDs) working with childhood overweight. The specific purpose of this study was to create an evaluation instrument that can measure the effectiveness of continuing education (CE) that provides behavioral counseling training. Two research questions guided this investigation into measuring the self-efficacy of RD’s: (a) Is the Y-DOCS scale for dietitians a reliable instrument for assessing self-efficacy among dietitians who receive training? (b) Is the Y-DOCS scale for dietitians a valid instrument for assessing self-efficacy among dietitians who receive training? The population for the study consisted of a convenience sample of 132 RDs who volunteered to take part in the survey. Analysis revealed the Y-DOCS Scale to be a reliable and valid scale. Reliability was measured by paired sample t-tests on individual items and the entire scale, and by Cronbach’s alpha. There was no significant difference in the total item scale and the pretest-posttest correlation of the scale was .939. Cronbach’s alpha was .963 (p < 0.01). Validity was determined by expert panel review, exploratory factor analysis (EFA), and iii ANOVA. EFA revealed a four-factor solution yielding a 19-item scale that accounted for 76% of the variance in scores. Comparison of reduced items with total item scores produced similar results with ANOVA. EFA using orthogonal rotation suggested a four-factor solution based on Kaiser criterion and scree plot. The four identified factors were external influences, client motivation, BMI-for-age, and counseling time (Factor 1: seven items, variance = 28%, alpha = .964; Factor 2: five items, variance = 18%, alpha = .957; Factor 3: four items, variance = 16%, alpha = .955; and Factor 4: three items, variance = 13%, alpha = .955). Each factor retained high inter-item correlation. Recommendations for use and future research are presented. Training should be designed to strengthen behavioral counseling skills by targeting the four factors identified. Future research might include confirmatory factor analysis with a sample of 500-1000 participants and validation with a different cohort of health care professionals such as physicians or nurse practitioners.

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