Examining the Effectiveness of Education Based on Social Learning Theory in Fostering Self-care and Social Skills

Abstract Purpose: This study was conducted to examine the effectiveness of a training program prepared on the basis of the Social Learning Theory for teaching self-care and social competence behaviors in preschool children.

Design and method: The sample of the study consisted of 41 in the intervention and 41 in the control group. Data were collected using the Demographic Assessment Form, the Self-Care Skills Assessment Scale and the Social Competence and Behavior Evaluation-30 Scale. Using five animated films created on the basis of the Social Learning Theory for fostering children self-care and social competence behaviors, a total of 20 training sessions were conducted with intervention group over a period of four months. Self-care and social competence scales were administered at the end of each month. Ultimately, children were assessed a total of five times.

Preschool is a period in the life of children when they experience rapid cognitive and social development, and their capacity for learning is at its greatest. In this period, children have a natural curiosity and a desire to learn everything they can, make observations and duplicate the behaviors of others.

Preschool is an important time of life when behaviors are shaped, habits are formed and basic health-related behaviors are acquired, with self-care being one of the most important acquired behaviors in this period for personal health. Self-care skills can be defined as the daily life skills required for a child to be able to meet their basic needs on their own, without the help of an adult, at home, at school or in other settings. The self-care skills that children acquire as they develop, such as those related to eating, dressing, personal care and toileting, are vital components of a bio-psycho-socially healthy life. Self-care plays an important role in the development of positive health behaviors and quality of life.

The healthy self-care behaviors expected from preschool children include an ability to wash oneself without wetting one's clothes, brushing teeth at least twice a day without help, toilet hygiene, healthy eating and nutritional habits, dressing skills, separating clean and dirty clothes, dressing for the weather, covering one's mouth when sneezing or coughing, using a tissue to wipe a runny nose and combing one' hair without help. Social learning refers to learning in a social environment. Social learning theory argues that human behaviors are shaped by the interactions between cognitive, behavioral and environmental factors. According to social learning theory, learning takes place via reactions and modeling. Bandura, a leading proponent of social learning theory, claims that many behaviors are learned through the observation and modeling of the behaviors of others.

Positive peer relationships in preschool help children adapt to school and acquire emotional control, conflict resolution and self-regulation skills, while also improving their social competencies, and contributing to their psychosocial, cognitive, affective and moral development. In this period, peers function as sources of information, models and interlocutors, and facilitate the learning of new knowledge, skills and behaviors.

Contemporary media, including smartphones, tablets, PCs and television, in particular, play an undeniable role in observation- and modeling-based learning among children. Children have at their disposal a wealth of technological devices through which they can interact with others at all hours of the day, providing them with easy access to information and other content that can shape their individual behaviors. The important role played by the media in social learning should not be underestimated.

Social learning theory is based on the fact that children identify with characters in TV shows, and cartoons in particular, and adopt the behaviors and attitudes displayed by those characters by making a conscious effort to copy them. Cartoon characters on TV play an important role both in shaping the characters of children, and can aid them in the acquisition of health-related behaviors.

In order to create a healthy society in the future, the training to be given to children in the preschool period about self-care and social competence and the methods to be used in this training are of critical importance. There is, however, a need for effective intervention programs targeting the improvement of self-care skills and social competence levels in children. Given the long-term negative effects of deficiencies in social competence and emotional control skills, it is of great importance for school nurses to identify at-risk children as early as possible and provide guidance for proper counseling. It is very important for nurses to implement health-promoting nursing interventions in order to ensure that the child is best prepared for life and has the chance to realize himself throughout his life. School nurses can thus play an important role in training parents and preschool teachers on the acquisition of positive health behaviors by children.

A review of literature revealed a lack of training programs in Türkiye that use animated cartoon characters to improve the self-care and social competence skills of children. This research was conducted to examine the effectiveness of a training program based on social learning theory in teaching self-care (general body hygiene, nose and ear cleaning, dental health, hand hygiene) and social competence skills to children five and six years of age. The hypotheses tested in the study are presented in the following.

Hypotheses Hypothesis 1. Following the training based on social learning theory, the intervention group differs from the control group in terms of self-care behaviors.

Hypothesis 2. Following the training based on social learning theory, the intervention group differs from the control group in terms of social competence skills.

Methods Design and Sample A randomized controlled intervention design was used in this study. The population of the study consisted of official kindergartens affiliated with the Ministry of National Education in a province. The selected province had 25 districts, one of which was selected using simple random sampling. This district had 18 official kindergartens affiliated with the Ministry of National Education, and one was selected using simple random sampling.

Participants and randomization

The power analysis conducted using the software G\*Power 3.0.10 showed that in a study design with 5 repetitions and 2 groups (intervention and control), a sample size of 82 was required for an effect size of 0.7362, power of 95% power, and 5% margin of error. The two kindergartens included in the study had a total of 180 children five and six years of age. A list of these children was created, each child was given a number, and lots were drawn from a box containing pieces of paper with these numbers on them. The first number drawn was assigned to the intervention group, the second number to the control group, and so on, until the intervention and control group had 43 participants each. Thus, given the risk of attrition, a total of 86 children were included in the study, all of whom were five or six years of age, agreed to participate in the study, and had parents who gave their written consent for the study (Figure 1 CONSORT).

To test the comprehensibility of the cartoons prepared and the data collection forms, a pilot study was conducted with 10 children attending one of the schools sampled. G\*Power analysis was based on data from this pilot study. Children who participated in the pilot study were excluded from the main study.

Blinding It was not possible to blind the researchers to the intervention and control groups for randomization. However, the data collection process was blinded by using classroom teachers who work in the kindergarten included in the study. Self -care and social competence scales were administered by the teachers who were unaware of the intervention and control groups of the children.

Variables Mean scores of the intervention and control groups on the self-care, social competence and behavior evaluation scales were the dependent variables. Independent variables were the training program -which involved animated films on self-care and social competence skills- and sociodemographic variables.

Intervention Group Procedure Pretest: In this session, children in the intervention group, who met the inclusion criteria for the study and agreed to participate, were informed about the training they were to receive. Teachers were also informed about the self-care and social competence scales they were to administer to the children.

To have pretest measurements prior to the training program, the Self-Care Skills Assessment Scale and the Social Competence and Behavior Evaluation-30 Scale were distributed to the teachers to be filled out, while the parents were asked to fill out the Demographic Assessment Form.

Eligibility Criteria:
Inclusion Criteria:

* Children who were five or six years of age and did not have any cognitive or sensory issues were included in the study.

Exclusion Criteria:

* Children with cognitive or sensory issues requiring special education were not included in the study.