Application of an integrative approach to identify determinants of junk food consumption among female adolescents

The increasing consumption of junk foods by adolescents is associated with adverse health consequences. The purpose of this study was to identify determinants of unhealthy snack consumption among female adolescents using an integrative method based on the theory of planned behavior. The sample included 90 female adolescents aged 12-15 years, from 2 guidance schools in Tehran, selected by systematic sampling. In the qualitative phase of the study, which was of a phenomenology type, the data were collected through 9 focus group discussions. After obtaining parental consent, in each discussion session a moderator followed a topic outline developed based on the theory of planned behavior (TPB). Data analysis was done using the framework method. The quantitative phase consisted of a cross-sectional study on 790 female adolescents aged 12-15 years old from 10 schools, selected using a randomized stratified cluster sampling method. Data on social cognition (based on TPB) and food consumption (using a 48-item food frequency questionnaire) were collected and analyzed using the multiple regression method. In both phases of the study there was a broad range of factors, some of them contradicting each other, influencing selection of snacks by the adolescents. Taste was identified as the most important factor influencing their attitude towards junk foods consumption. The major predictors of behavior of the adolescents were found to be easy access to junk foods, personal taste preferences, peer pressure, media advertisements, and low price of unhealthy snacks (p<0.05). The most influential individuals in snack choice, based on the qualitative phase findings, were peers, while quantitative findings identified parents as the most influential. Applying an integrative approach provided a comprehensive insight into the underlying factors of junk food consumption by adolescents. Intervention programs with due consideration of these factors can help reduce unhealthy snack food consumption in this vulnerable group.