Background: Fasting school and increasing
consumption of low-value meals among children is associated with adverse health
consequences and chronic diseases in adulthood. Since most bad hygienic
behaviors are rooted in childhood experiences, the present study examined the
effectiveness of educational interventions based on application of the theory
of planned behavior (TPB) in improving the breakfast and healthy snacks in
elementary school students in the second half of 2011 in Qazvin.
Methods: Randomly, 150 students, in case
and control group, from six schools participated in a quasi randomized
controlled experimental study. Variables were evaluated before and 3 months
after intervention. In treatment group, the educational program was conducted
with targeted educational pamphlets. The program included five 30-minute
sessions that developed regarding the beliefs and structures extracted from the
qualitative study and constructs of theory of planned behavior. Data regarding
TPB were collected using valid and reliable questionnaire with 40 items by self
report method. The food frequency checklist was used to assess students'
nutritional habits. Finally, the data were entered into SPSS 17.0 software and
statistical tests such as chi square, independent and pooled t test, McNemar
and one-way ANOVA with Scheffe post hoc test were used for data analysis.
Results: Student’s
average age was 8.43 ± 0.83 years old and their sex ratio was equal. Before
educational intervention, 57.3 % in the intervention group and 53.3 % in the
control group did not use the breakfast. After educational intervention,
significant improvement of about 12.6% was seen regarding breakfast eating (p
< 0.001). However, significant changes weren’t seen in the control group.
There were no significant differences between two group regarding constructs of
TPB in the pretest period, however after intervention significant changes in
attitude (from 53.26±25.7 to 74.72±28.18) (p<0.001), subjective norms (from
56.97±26.6 to 68.07±26.28) (p<0.001), perceived behavioral control (from
32.57±19.6 to 57.66±35.7) (p<0.001) and intention (from 8.5±3.3 to
11.37±3.11) (p<0.001) was seen in case group. Moreover, results showed that
consumption of soft drinks and junk food such as chips, etc. decreased from
74.6 % to 58.3% in case group after education (p<0.05).
Conclusions: The finding of this study
demonstrates the high prevalence of inappropriate eating behavior in this
sensitive period. Educational intervention with the appropriate application of
psychological theory correct behaviors associated with a healthy breakfast and
snacks at the elementary school. According to appropriate educational field and
cost-effective educational intervention in schools, generalization of such training
programs in other areas seems critical.
