Abstract

BackgroundSkipping breakfast and replacing it with non-nutritious snacks are progressively increasing among adolescents. This study aimed to develop an educational intervention based on the Social Marketing Model and evaluate its effects on healthy breakfast and snack consumption among female adolescent students.MethodsThis mixed-methods study was conducted in 2016–2019 in two phases. In the first phase, a qualitative study was conducted through directed content analysis in guidance schools in Khorramabad, Isfahan, and Tehran, Iran, to explore factors affecting breakfast consumption. The results of this phase were set in the benchmarks of the Social Marketing Model. In the second phase, a randomized controlled trial was conducted based on the benchmarks of the Social Marketing Model on 94 students randomly recruited from guidance schools in Khorramabad, Iran.ResultsThe findings of the qualitative phase were categorized into the benchmarks of the Social Marketing Model, namely the social marketing mix, the intended behavior, internal and external competing factors for behavior modification, theoretical concepts related to the behavior, and the role of supporters. In the quantitative phase, the univariate analysis showed significant between-group differences concerning the product, price, promotion, and behavior (p < 0.05).ConclusionHealthy breakfast and snack consumption can be promoted through making acceptable the tastes, costs, preparations, and consumption places of breakfast and snack.Trial registrationThe trial was registered in the Iranian Registry of Clinical Trials (code: IRCT20170201032347N1).The trial was registered in 11/07/2018 and is accessible on the Iranian Clinical Trial Registration website.

Highlights

  • Skipping breakfast and replacing it with non-nutritious snacks are progressively increasing among adolescents

  • Promoting perceived benefits and making prices acceptable through the theoretical concepts related to the behavior

  • Results of phase I: the qualitative study The results of the study included 201 first-level codes, successive classification of which resulted in the emergence of 18 subcategories, which were divided into five main categories, and led to the discovery of Social Marketing (SM) benchmarks about healthy breakfast and snack consumption including SM mix, identifying the intended behavior, internal and external competing factors for behavior modification, theoretical concepts related to the behavior, and the role of supporters

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Summary

Introduction

Skipping breakfast and replacing it with non-nutritious snacks are progressively increasing among adolescents. This study aimed to develop an educational intervention based on the Social Marketing Model and evaluate its effects on healthy breakfast and snack consumption among female adolescent students. Breakfast is a key component of healthy eating. It contributes to normal growth and development, among children and adolescents. The prevalence of irregular breakfast consumption among Iranian children is 8–30% [5,6,7]. Breakfast consumption improves cognitive and social functioning as well as mood [8,9,10], while its skipping is associated with limited intake of essential nutrients, inadequate physical development, impaired cognitive functioning, and behavioral problems among children. Mostafavi et al Journal of Health, Population and Nutrition (2021) 40:22 breakfast skipping and its subsequent increased rate of unhealthy snack consumption can increase the risks of obesity and chronic health conditions and may result in academic failure [11, 12]

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