One RCT, a positive-quality study, evaluated the effect of six telephone-delivered counseling sessions targeting increased self-efficacy outcome expectancy (Social Learning Theory constructs) in 65 hyperlipidemic patients not adherent to their cholesterol-lowering diet. The intervention involved goal-setting, self-monitoring, self-reinforcement and verbal persuasion. The intervention group significantly reduced saturated fat and cholesterol intake and had significantly decreased LDL-cholesterol levels relative to the control group. There was no increase in perceived self-efficacy in the intervention group vs. the usual care group. Outcome expectancy significantly increased in the intervention group, but was not correlated to the improvements in dietary adherence or decreased LDL-cholesterol. Despite positive behavioral and clinical outcomes, researchers failed to show a specific relationship between self-efficacy or outcome expectancy and change in behavior.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

One randomized controlled trial of neutral-quality evaluated a five-week nutrition education (NE) and a nutrition education plus social learning (NE+SL) intervention in 78 patients with type 2 diabetes. In addition to nutrition education, the social learning intervention group received information on goal-setting based on individual barriers to adherence, modeling of strategies used successfully by other individuals with type 2 diabetes and was taught a problem-solving method. This five-week study failed to show a significant advantage of social learning intervention over nutrition education alone. RCTs of longer duration are needed to further explore the effect of social learning theory on diabetes management.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.