There is an increasing emphasis on designing health promotion interventions for low-socioeconomic-status (SES) individuals.

However, many previously developed behavior change tools have not been tested in this population.

Self-efficacy was measured at pre-and postintervention as part of a randomized clinical trial to reduce cholesterol levels in rural low-SES Southern adults.

A 22-item scale was designed and validated to measure subjects'confidence in their abilities to make dietary changes.

High mean self-efficacy was noted in both control and intervention subjects at pre-and postintervention.

Mean self-efficacy score was a significant predictor of dietary change at both preintervention and postintervention.

This study demonstrates that self-efficacy is a predictor of ability to make dietary changes in a low-SES rural population.

This finding is of significance to researchers and practitioners wishing to design theory-based health promotion interventions in this population.