Factors associated with unhealthy snacks consumption among adolescents in Iran’s schools

Abstract

Background: Well-informed interventions are needed if school-based health promotion is to be effective. Among other aims, the Iranian Health Promoting School (IHPS) program that was launched in 2011, has an important aim of promoting dietary behaviors of adolescents. The present study, therefore, aimed to investigate the factors affecting unhealthy snacking of adolescents and provide evidence for a more effective IHPS program. Methods: In a cross-sectional study design, 1320 students from 40 schools in Kerman city were selected using a proportional stratified random sampling method. A modified qualitative Food Frequency Questionnaire (FFQ) was used to gather data about unhealthy snacking behavior. Data about intrapersonal and environmental factors were obtained using a validated and reliable questionnaire. A mixed-effects negative-binomial regression model was used to analyze the data. Results: Taste and sensory perception (prevalence rate ratio [PRR] = 1.18; 95% CI: 1.09-1.27), being a male (PRR = 1.20; 95% CI: 1.05-1.38) and lower nutritional knowledge (PRR = 0.96; 95% CI: 0.91-0.99) were associated with higher weekly unhealthy snaking. Perceived self-efficacy (PRR = 0.95; 95% CI: 0.91-1.00) negatively influenced the frequency of unhealthy snaking, with this approaching significance (P