Fast-Food Consumption Intention among High School Students in Bangladesh

doi:10.21203/rs.3.rs-3993956/v1

Background: Intention to Fast Food Consumption among children and adolescents has been recognized as a serious health concerns globally.

Objective: The objective of the study was to identify factors influencing student’s intentions toward fast food consumption.

Methods: A correlational study was conducted using a convenience sampling technique. Participants included high school students in grades 9th to 10th from two selected schools. Data were collected through a self-administered questionnaire. Descriptive and inferential statistics were used for data analysis.

Results: The average age of the students was 15.32 years. The intention to consume fast food was negatively correlated with the students' age (r=-.281, p<.001) and female students had a higher intention to consume fast food (t =-5.386, p<.001). The results showed a statistically significant relationship that the higher scores of attitudes, subjective norms, and perceived behavioral control were positively correlated with higher intention to fast food consumption (p<.05) respectively. Further analysis showed that attitude and perceived behavioral control were the significant predictors of intention to consume fast food (ꞵ=.296, p<.001), and (ꞵ=.478, p<.001) together explained 42% of the variance in the intention to consume fast food among students.

Conclusion: The findings of this study provide baseline information for policymakers to develop strategies following effective health education programs to raise awareness of attitudes among students. Further studies should examine the constructive ways of changing attitudes and reasonable alternatives to alter perceived behavioral control regarding the intention to fast food consumption.

Fast Food Consumption

Intention

Students

Adolescents

Theory of Planned Behavior (TPB)

Background of the study: Fast food is an easily accessible form of processed food that is prepared quickly and served to the customer easily in a packaged form for take-out or take-away (Parikh, Shree, & Shree, 2020; Sumaedi & Yarmen, 2015). Foods made with lower nutritional value are classified as such by Seo, Lee, and Nam (2011). Fast-Food Consumption is linked to unsatisfactory nutrients intake and unhealthy dietary behaviors that increased the incidence of non-communicable diseases in the worldwide (Didarloo, Khalili, Aghapour, Moghaddam, & Mousavi, 2022). Globally, the consumption of fast food has significantly increased among people of different ages (AlTamimi et al., 2023). With globalization and urbanization, radical trends have had an effect on adolescent’s consumption of unhealthy foods (Shetu, 2022). In 2016, over 124 million children and adolescents, of whom 14% were obese (World Health Organization: WHO, 2021), and the figure is predicted to reach 2.7 billion by 2025 according to the WHO (Shori, Albaik, & Bokhari, 2017). In a study conducted in the United States on adolescents between the ages of 13 and 17, a significant relationship was found between overweight and processed foods (Didarloo et al., 2022).

Fast-food consumption has been recognized as a serious health concern among adolescents in developing nations like Bangladesh (Banik, Naher, Pervez, & Hossain, 2019). In Bangladesh, with a population exceeding 160 million, adolescents account for 20.5% of fast-food consumption due to taste, pleasure, and convenience (Banik et al., 2020; Maternal and Child Health: MCH, 2016). According to a joint study by the Bangladesh Bureau of Statistics, 17.9% of children in South Asia are obese, while the prevalence among early adolescents is 23.6% (Kamruzzaman, 2022). Consuming fast food more frequently than twice a week has been linked to higher body weight and detrimental health impacts. Specifically, fast food was consumed by 72.5% of overweight or obese school children four times per week (Almuhanna, Alsaif, Alsaadi, & Almajwal, 2014). The study by Hossain, Luies, & Biswas (2020) found a high prevalence of overweight among boys (67.1%), with a mean age of 11.6 years.

Fast food consumption is influenced by various factors, including its good taste, easy availability, affordable cost, local production of packaged food, choices, flavor, peer pressure, family and friends, relative to more traditional home-style restaurants (Lestari, Fakhira, Ismiana, & Annisa, 2021). Multiple studies have shown an increased frequency of takeaway and fast-food consumption among adolescents (Jahan, Karmakar, Hossain, Jahan, & Islam, 2020). In a study by Seo et al. (2011), it was found that Fast-Food Consumption Intention represents the amount of effort one is willing to exert to consume fast food as a future goal and action. The performance or non-performance of fast-food consumption behavior by an individual is a function of several factors based on the theory of planned behavior (Didarloo et al., 2022). Another study demonstrated that fast-food consumption intention was affected by subjective norms and perceived behavioral control (Mirkarimi et al., 2016). Fast food consumption behavior, using a 95% confidence level, indicated that subjective norms and behavioral intention are predictors of fast-food consumption behavior (Ebadi, Rakhshanderou, & Ghaffari, 2018). In a different study, among the TPB constructs, subjective norm and perceived behavioral control were identified as important predictors of fast-food consumption intention, and these relationships were statistically significant (Didarloo et al., 2022). A study conducted in Romania found that only cognitive attitudes and subjective norms are statistically significant toward intention to fast-food consumption (Bîlbîie et al., 2021).

In developing countries like Bangladesh, both malnutrition and overnutrition, as well as chronic diseases, result from high-calorie intake. The theory of planned behavior served as the theoretical framework for this study. According to the theory of planned behavior (TPB), there is a substantial body of research. To our knowledge, studies on Fast-Food Consumption Intention are predominantly conducted in developed countries, with limited research conducted among high school students in developing countries. Additionally, inconsistent findings have been reported in prior research. Most of the studies were conducted in different cultural contexts. Thus, it is essential to conduct studies on fast-food intention among school students in Bangladesh.

This chapter described the methodology part includes a description of the study design, study students, instruments, data collection methods, and data analysis. These are as following.

Study Design: A correlational study. This study was conducted from January 2023 to December 2023.

Study Participants: The population of this study comprised all high school students studying at Hazrat Shahjamal (R:) School and College in Pathalia, Jamalpur, and Bangabandhu Ideal School and College in Dewanpara, Jamalpur, Bangladesh. The sample for this study was drawn from 9th and 10th-grade high school students in two selected schools using the convenient sampling technique. The research aimed to gather information from high school adolescents who met specific criteria: (1) students aged 15-16 years, and (2) students in grades 9th and 10th. Exclusion criteria encompassed students with any severe illness during data collection.

The required sample size was determined using G*Power (Version 3.1.9.4) analysis. The correlation-based sample size, with a priori -r and a medium effect size (γ) of 0.25, a significance level (α) of 0.05, and an expected power of 0.80 (1-β), resulted in an estimated sample size of 120. Considering an attrition rate of 20%, the final estimated sample size was 144.

Instruments: Data were collected using the following five sets of questionnaires: (1) Socio-Demographic Data Questionnaire, (2) Attitude Questionnaire toward Fast-Food Consumption, (3) Subjective Norm Questionnaire toward Fast-Food Consumption, (4) Perceived Behavioral Control Questionnaire toward Fast-Food Consumption, and (5) Intention Questionnaire toward Fast-Food Consumption.

Socio- Demographic Data Questionnaire of Students: The Socio- Demographic Data Questionnaire of the study was developed by the researcher based on the literature review. A total of 11 items such as age, height-weight, gender, parents' education, parents' working status, family financial status, consume fast food regularly, take fast food for what, and place for fast food consumption.

Attitude Questionnaire toward Fast-Food Consumption: Attitude Questionnaire toward Fast-Food Consumption was used to measure students' attitudes regarding fast food consumption. It was developed by Seo et al. (2011) and consisted of 12 items, ranged from 1 (strongly disagree) to 5 (strongly agree). The total score ranged from 12 to 60, with a higher score indicating a more positive attitude toward fast-food consumption.

Subjective Norm Questionnaire toward Fast-Food Consumption: Subjective Norm Questionnaire (SNQ) toward Fast-Food Consumption was used to measure students' subjective norms regarding fast food consumption. It was developed by Seo et al. (2011) and comprised 6 items, ranged from 1 (strongly disagree) to 5 (strongly agree), with a total score ranging from 6 to 30. A higher score indicated stronger subjective norms toward fast-food consumption.

Perceived Behavioral Control Questionnaire toward Fast-Food Consumption: Perceived Behavioral Control Questionnaires (PBCQ) toward Fast-Food Consumption was used to measure the student’s perceived behavioral control regarding fast food consumption. It was developed by Seo et al. (2011). It consisted of 14 items from 1: strongly disagree to 5: strongly agree. The total score was 14 to 70. The higher score indicated lower perceived behavioral control toward fast food consumption.

Intention Questionnaire toward Fast-Food Consumption: Intention to consume fast food was used to measure the student’s intention regarding fast food consumption. It was developed by Seo et al. (2011). It consisted of 5 items regarding structural attributes of Fast-Food Consumption based on their cultural perspectives (Seo et al., 2011; Mirkarimi et al., 2016). One item “hamburger” is unrelated to the Bangladeshi cultural context. As a result, the researcher adjusted “hamburger” as “cheeseburger” and developed three new items about the intention to consume fast food. There were 8 items from 1: strongly disagree to 5: strongly agree. The total score was 8 to 40. Higher score indicated higher intention toward fast food consumption. In this study, content validity of the instruments was checked and verified by three experts from NIANER who are knowledgeable and experienced in the field of conducting nursing research. The reliability of the instruments (attitude, subjective norms, perceived behavioral control, and intention) was assessed using Cronbach's Alpha, yielding a score of .75. The original instruments were developed in the English language and then translated into Bengali using the bilingual translation method (Brislin, 1970).

Data Collection Methods: The data collection process consisted of two phases: In the first phase, the preparation phase, approval of the research proposal was granted by the Institutional Review Board (IRB No. Exp.NIA-S-226) of NIANER. Informed consent was obtained prior to the interview from study participants. Privacy and confidentiality of the participants were maintained.

In the implementation phase (2nd phase), data were collected using the following five sets of questionnaires. Data collection was carried out by the researcher with the assistance of teachers from the participating school. The total number of questions was 51, and it took approximately 20-25 minutes to complete the interview session.

Data Analysis: After completing the data collection, the data were analyzed using the Statistical Package for Social Sciences (SPSS) for both descriptive and inferential statistics. Descriptive statistics, including frequency, percentage, mean, and standard deviation (SD), were utilized to describe the socio-demographic characteristics of the students. Inferential statistics, such as t-test and ANOVA, were employed to examine whether group means differed from one another. Additionally, a Pearson correlation test was used to explore the relationships among the concepts of the Theory of Planned Behavior (TPB) regarding intention to fast-food consumption. Multiple regression was used for further analysis.

The Table 1 shows the sociodemographic characteristics of the students. The results found that the mean age of schools’ students was 15 years (SD= .468) old. Among them, more than half of students (54.2%) were male and remaining were female. Fathers of students had primary educational level (38.9%), secondary (29.2%), higher secondary (21.5%) and only honors (10.4%). Most of the student’s mother were housewives (75.7%), businesswomen (9.0%), service holders (12.5%) and others (2.8%) like tailoring, garments worker, and day labor etc. Mothers of students had primary educational level (42.5%), secondary (33.3%), higher secondary (20.7%) and only honors (3.5%). Majority students (81.3%) took at least one type of the fast foods regularly in recent month and recent week, respectively. Students who took fast-food regularly, among them, more than half of students (51.3%) took fast-food as a meal and remaining of them took as a snack. In addition, more than half of students (53.8%) took fast food from hotel and restaurants.

Table 1. Distribution of Socio- Demographic Characteristics of the Students (N=144)

Variables	Frequency (f)	Percentage (%)	M ± SD
Age (in years)			15.32±.47 (Min=15, Max=16)
Gender
Male	78	54.2
Female	66	45.8
Body Mass Index (BMI)			21.31±3.05 (Min=15, Max=32)
Father’s Education
Primary	56	38.9
Secondary	42	29.2
Higher Secondary	31	21.5
Honors	15	10.4
Mother’s Education
Primary	61	42.5
Secondary	48	33.3
Higher Secondary	30	20.7
Honors	5	3.5
Father’s Occupation
Farmer	33	22.9
Business	65	45.1
Service Holder	23	16.0
Others	23	16.0
Mother’s Occupation
Housewife	109	75.7
Business	13	9.0
Service Holder	18	12.5
Others	4	2.8
Monthly family income (in taka)		18888.89±8143.05 (Min=5000, Max=50000)
Take fast food regularly
Yes	117	81.3
No	27	18.7
Fast-Food consumption
As a meal	60	51.3
As a snack	57	48.7
Place for Fast-Food consumption
Home	29	24.8
School Canteen	25	21.4
Hotel & Restaurants	63	53.8

The table 2 shows the attitude toward fast food consumption among high school students. The total mean score of attitudes was 41.89 (SD= 13.80) on a 5- point Likert Scale (Table 2). The table 3 shows the subjective norm toward fast food consumption among high school students. The total mean score of subjective norms was 21.54 (SD= 6.62) on a 5- point Likert Scale (Table 3). The table 4 shows the perceived behavioral control toward fast food consumption among high school students. The total mean score of perceived behavioral control was 44.14 (SD= 16.91) on a 5- point Likert Scale (Table 4). The table 5 shows the intention to fast food consumption among high school students. The total mean score of intention was 24.83 (SD= 9.69) on a 5- point Likert Scale (Table 5).

Table 2: Distribution of Attitude of the Students toward Fast Food Consumption (N=144)

S/N

Items

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Mean± SD

n (%)

1.

Fast food is familiar to me

7

(4.9)

10

(6.9)

18

(12.5)

52

(36.1)

57

(39.6)

3.99±1.12

2.

I think that fast food is not good for health

8

(5.6)

15

(10.4)

24

(16.7)

41

(28.5)

56

(38.8)

3.85±1.21

3.

I think that fast food can provide all necessary nutrients of a meal

34

(23.6)

30

(20.8)

55

(38.2)

16

(11.1)

9

(6.3)

2.56±1.15

4.

I think that fast food is delicious

6

(4.2)

8

(5.6)

22

(15.2)

59

(41.0)

49

(34.0)

3.95±1.05

5.

I think that fast food stores provide an attractive environment

4

(2.7)

26

(18.1)

44

(30.6)

42

(29.2)

28

(19.4)

3.44±1.08

6.

I think that fast food stores are clean

8

(5.6)

11

(7.6)

65

(45.1)

51

(35.4)

9

(6.3)

3.29±.91

7.

I think that fast food is clean and safe

15

(10.4)

28

(19.4)

51

(35.5)

40

(27.8)

10

(6.9)

3.01±1.08

8.

I think that fast food portions are large enough to feel full

19

(13.2)

18

(12.5)

47

(32.6)

44

(30.6)

16

(11.1)

3.14±1.18

9.

I think that fast food has a lot of salt

22

(15.3)

23

(16.0)

41

(28.5)

27

(18.8)

31

(21.4)

3.15±1.35

10.

I think that fast food has a lot of fat

9

(6.3)

7

(4.9)

11

(7.6)

52

(36.1)

65

(45.1)

4.09±1.13

11.

I think that consuming fast food will make me fat

7

(4.9)

13

(9.0)

10

(6.9)

41

(28.5)

73

(50.7)

4.11±1.17

12.

I think that fast food has a lot of calories

20

(13.8)

23

(16.0)

36

(25.0)

23

(16.0)

42

(29.2)

3.31±1.40

Total Mean

41.89±13.80

Table 3: Distribution of Subjective Norm of the Students toward Fast Food Consumption (N=144)

S/N	Items	Strongly disagree	Disagree	Neutral	Agree	Strongly agree	Mean± SD
S/N	Items	n (%)	n (%)	n (%)	n (%)	n (%)	Mean± SD
1.	I follow my family’s beliefs	3 (2.1)	13 (9.0)	22 (15.3)	45 (31.3)	61 (42.3)	4.03±1.06
2.	I follow my teacher’s beliefs	3 (2.1)	14 (9.7)	32 (22.2)	30 (20.8)	65 (45.2)	3.97±1.12
3.	I follow my friend’s beliefs	7 (4.9)	7 (4.9)	59 (41.0)	45 (31.2)	26 (18.0)	3.53±1.00
4.	I think that my family members (parents, siblings) would like to consume fast-food	15 (10.4)	23 (16.0)	54 (37.5)	31 (21.5)	21 (14.6)	3.14±1.17
5.	I think that my teachers would like to consume fast-food	13 (9.0)	31 (21.5)	51 (35.4)	24 (16.7)	25 (17.4)	3.12±1.19
6.	I think that my friends would like to consume fast-food	6 (4.2)	6 (4.2)	49 (34.0)	40 (27.8)	43 (29.8)	3.75±1.06
	Total Mean						21.54±6.62

Table 4: Distribution of Perceived Behavioral Control of the Students toward Fast Food Consumption (N=144)

S/N

Items

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

Mean± SD

n (%)

1.

I can eat fast food even if fewer fast-food stores are around.

15

(10.4)

21

(14.6)

51

(35.4)

42

(29.2)

15

(10.4)

3.15±1.12

2.

I can eat fast food even while I am on diet.

19

(13.2)

26

(18.1)

56

(38.9)

28

(19.4)

15

(10.4)

2.96±1.15

3.

I can eat fast food even if I have to wait for a long time.

17

(11.8)

15

(10.4)

54

(37.5)

44

(30.6)

14

(9.7)

3.16±1.12

4.

I can eat fast food even if fewer advertisement of fast food is on TV, internet and etc.

13

(9.0)

11

(7.6)

57

(39.6)

49

(34.0)

14

(9.8)

3.28±1.05

5.

I can eat fast food even if they offer few sale promotions.

13

(9.0)

26

(18.1)

50

(34.7)

46

(31.9)

9

(6.3)

3.08±1.05

6.

I think that changing my fast-food consumption behaviors for health would be difficult.

13

(9.0)

17

(11.9)

46

(31.9)

46

(31.9)

22

(15.3)

3.33±1.15

7.

I think that meeting friends at places other than fast food stores would be difficult.

26

(18.1)

23

(16.0)

37

(25.7)

37

(25.7)

21

(14.5)

3.03±1.32

8.

I think that using places other than fast food stores for special occasions such as birthday would be difficult.

15

(10.4)

21

(14.6)

39

(27.1)

41

(28.5)

28

(19.4)

3.32±1.24

9.

I think that changing my fast-food consumption behavior is difficult because I have eaten them from very young ages

17

(11.8)

26

(18.1)

33

(22.9)

38

(26.4)

30

(20.8)

3.26±1.30

10.

I can eat fast food even if i get nutrition education using multimedia.

9

(6.3)

23

(16.0)

44

(30.5)

43

(29.8)

25

(17.4)

3.36±1.13

11.

I can eat fast food even if I get continued nutrition education.

23

(16.0)

26

(18.1)

29

(20.1)

30

(20.8)

36

(25.0)

3.21±1.41

12.

I can eat fast food even if I learn how to quickly prepare a simple meal.

21

(14.6)

32

(22.2)

48

(33.3)

26

(18.1)

17

(11.8)

2.90±1.21

13.

I can eat fast food even if I get nutrition education about impact of fast food on health (e.g. calories, nutrient content)

13

(9.0)

33

(22.9)

40

(27.8)

44

(30.6)

14

(9.7)

3.09±1.13

14.

I can eat fast food even while I have less money in my pocket.

35

(24.3)

24

(16.6)

26

(18.1)

23

(16.0)

36

(25.0)

3.01±1.52

Total Mean

44.14±16.91

Table 5: Distribution of Intention of the Students toward Fast Food Consumption (N=144)

S/N	Items	Strongly disagree	Disagree	Neutral	Agree	Strongly agree	Mean± SD
S/N	Items	n (%)	n (%)	n (%)	n (%)	n (%)	Mean± SD
1.	I intend to consume a fried chicken in the next week	36 (25.0)	44 (30.6)	30 (20.8)	14 (9.7)	20 (13.9)	2.57±1.34
2.	I intend to consume a fried fish in the next week	6 (4.2)	23 (16.0)	57 (39.6)	38 (26.4)	20 (13.8)	3.30±1.03
3.	I intend to consume a pizza in the next week	27 (18.8)	19 (13.2)	57 (39.6)	33 (22.8)	8 (5.6)	2.83±1.15
4.	I intend to consume a sandwich in the next week	10 (6.9)	17 (11.8)	64 (44.5)	42 (29.2)	11 (7.6)	3.19±.98
5.	I intend to consume a French fry/fried potatoes in the next week	10 (6.9)	17 (11.8)	50 (34.7)	42 (29.2)	25 (17.4)	3.38±1.12
6.	I intend to consume a doughnut in the next week	13 (9.0)	14 (9.7)	44 (30.6)	45 (31.3)	28 (19.4)	3.42±1.17
7.	I intend to consume a hotdog in the next week	28 (19.4)	28 (19.4)	30 (20.9)	30 (20.9)	28 (19.4)	3.01±1.40
8.	I intend to consume a cheeseburger in the next week	29 (20.1)	26 (18.1)	27 (18.8)	21 (14.6)	41 (28.4)	3.13±1.51
	Total Mean				24.83±9.69

Table 6 showed that there was a statistically significant negative results between students age and intention to fast food consumption (r=-.281, p<.001); gender and intention to fast food consumption (t=-5.386, p<.001); mothers’ education and intention to fast food consumption (F= 2.907, p=.037); fathers’ occupation and intention to fast food consumption (F= 2.785, p=.043) and monthly family income and intention to fast food consumption (r=.173, p=.038) respectively.

Table 6. The Relationship between Socio-Demographic Characteristics and Intention to Fast Food Consumption (N=144)

Variables	M ± SD	r/t/F	p
Age (in years)		-.281	<.001
Gender
Male	23.32±3.81	-5.386	<.001
Female	26.64±3.52	-5.386	<.001
Body Mass Index (BMI)		.148	.076
Father’s Education
Primary	23.77±3.64	2.537	.059
Secondary	25.21±4.72
Above	25.67±3.48
Mother’s Education
Primary ^a	23.89±3.97	2.907	.037 (b> c & a)
Secondary ^b	25.83 ±4.55
Above ^c	25.14±2.92
Father’s Occupation
Farmer ^a	23.76±4.78	2.785	.043 (b> c, d & a)
Business ^b	25.88±3.66
Service Holder ^c	24.22±3.54
Others ^d	24.09±3.84
Mother’s Occupation
Housewife	24.53±4.22	2.220	.088

Table 6. Continued

Variables	M ± SD	r/t/F	p
Business	27.15±3.56
Others	24.14±1.68
Monthly family income (in taka)		.173	.038
Take fast food regularly
Yes	24.97±3.93	.778	.438
No	24.30±4.47	.778	.438
Fast-Food consumption
As a meal	24.58±3.774	-1.082	.282
As a snack	25.39±4.074	-1.082	.282
Place for Fast-Food consumption
Home	24.10±4.169	.731	.536
School Canteen	25.61±5.050
Hotel & Restaurants	25.10±3.453

Table 7 shows the relationship among the concepts of theory of planned behavior regarding intention to fast food consumption. The result showed a statistically significant relationship between attitude and intention to fast food consumption (r= .487, p< .001); subjective norm and intention to fast food consumption (r=.177, p< .05); perceived behavioral control and intention to fast food consumption (r=.594, p< .001) respectively.

Table 7: Pearson’s Product Moment Correlation between Attitude, Subjective Norm, Perceived Behavioral Control and Intention to Fast Food Consumption (N=144)

Variables	Attitude	Subjective Norm	Perceived Behavioral Control	Intention
Attitude toward Fast Food Consumption	1
Subjective Norm toward Fast Food Consumption	.292^**	1
Perceived Behavioral Control toward Fast Food Consumption	.419^**	.259^**	1
Intention to Fast Food Consumption	.487^**	.177^*	.594^**	1

*p< .05, **p< .001

Table 8, According to the assumptions of regression analysis, dependent and independent variables were at the ratio level. Fast food consumption intention is the dependent variable in this model, as indicated by the total score of intention to consume fast food shown in Table 5. The dependent variable, intention to fast food consumption, was regressed relating to attitudes, subjective norms, and perceived behavioral control. The order and content of the steps were based on the theoretical framework of the TPB. The results indicated, the model was highly significant (P = 0.000) and showed that attitude, subjective norms and perceived behavioral control together explained 42% of the variance in the intention to fast food consumption among the students. Table 8 showed that the regression coefficient of attitude was .296 (t=4.094, p<.001) and perceived behavioral control was .478 (t=6.670, p<.001) whereas subjective norms was -.033(t=-.490, p=.625) (Table 8).

Table 8: A Multiple Regression of Attitude, Subjective Norm, Perceived Behavioral Control and Intention toward Fast Food Consumption (N=144)

Independent Variables	B	SE B	ꞵ	t	p
Constant	3.651	2.540		1.437	.153
Attitude	.239	.058	.296	4.094	<.001
Subjective Norm	-.042	.085	-.033	-.490	.625
Perceived Behavioral Control	.274	.041	.478	6.670	<.001

R²= .422, R² change = .422, ***p<0.001

A correlational study was conducted among high school students aged between 15 to 16 from Hazrat Shah Jamal (R:) School and College and Bangabandhu Ideal School and College in Jamalpur, Bangladesh. The present study aimed to examine the relationship between attitude, subjective norm, perceived behavioral control, and intention to consume fast food among high school students using the Theory of Planned Behavior (TPB).

In the present study, a statistically significant relationship was observed between students' age, gender, mothers’ education, monthly family income, and fathers’ occupation with the intention to consume fast food (p < .05) (Mirkarimi et al., 2016; Singh et al., 2020; Didarloo et al., 2022). The study showed a total mean score of 24.83 out of 40 for intention to consume fast food, indicating that students were more inclined towards fast-food consumption. This finding aligns with Seo et al. (2011) and Mirkarimi et al. (2016) studies, where the intention to consume fast food scored were 10.92 and 10.71 out of 20, respectively. Additionally, the study's results are consistent with Banik et al. (2020) finding that 68.1% of students consumed fast foods at least once in the previous week in Bangladesh.

According to the study's findings, stronger intentions to consume fast food were correlated with higher scores for attitudes, subjective norms, and perceived behavioral control. The results of the current study were consistent in showing that the intention to consume fast food was positively correlated with the correlation coefficients of attitude, subjective norms, and perceived behavioral control (Seo et al., 2011; Mirkarimi et al., 2016; Rouhani-Tonekaboni, N., Seyedi-Andi, S. J., & Haghi, M., 2018). On the other hand, according to Didarloo et al. (2022) the intention to consume fast food was positively correlated exclusively with subjective norms.

The present study found that the regression coefficient of attitude towards fast-food consumption intention was.296 (t=4.094, p<.001) and perceived behavioral control towards fast-food consumption intention was.478 (t=6.670, p<.001), with an explanatory power of 42%. In contrast, attitude toward fast food did not significantly affect behavioral intention (Seo et al., 2011; Mirkarimi et al., 2016). The current study's findings were in line with previous research (Seo et al., 2011; Mirkarimi et al., 2016), which found that perceived behavioral control was a major predictor of fast-food intake intention. Only subjective norms were found to be a significant predictor of intention to consume fast food in the studies by Didarloo et al. (2022) and Sajjad, Bhatti, & Hill (2023). Additionally, according to Bîlbîie et al. (2021) and Sharifirad et al. (2013), attitude and subjective norms were significant predictors of the intention to consume fast food.

Socio-demographic Characteristics of Students on Intention to Fast Food Consumption

The study findings are consistent with the previous research that has explored various factors influencing the intention to fast-food consumption including student’s age (Mirkarimi et al., 2016; Singh et al.2020; Banik et al., 2020). The possible explanation may be that, young age serves as a strong predictor for the intention to consume fast food due to the great interest and excitement about something typically associated with this age group. Adolescents and young adults often exhibit a greater interest in fast food compared to other age groups (Askari et al., 2016). The study showed, more than half of students were male. The finding is similar to the study of Seo et al. (2011) but dissimilar to Didarloo et al. (2022). However, it is noteworthy that female students demonstrated a higher intention to consume fast food, contrary to the findings of previous studies (Seo et al., 2011; Mirkarimi et al., 2016; Banik et al., 2020). One plausible explanation may be that, despite spending considerable time away from home attending classes and school, female students traditionally lean towards maternal activities. Additionally, the increased participation of mothers in the labor market can have a significant impact on economic growth, leading to longer workdays and potentially influencing parents to opt for convenient but lower-quality food options (Nipun, Debnath, Miah, Kabir, & Hossain, 2017).

The findings of mother’s educational level regarding the intention to consume fast-food are consistent to previous study (Seo et al., 2011; Didarloo et al., 2022). A plausible explanation could be that the educational status of mothers plays a crucial role in shaping early childhood education on healthy and unhealthy dietary behaviors, particularly lower education, has a higher intention to the overall unhealthy dietary practices (Hidaka, 2018; Hupkens, Knibbe, VanOtterloo, & Drop, 1998).

The result concerning the father's job status regarding the intention to consume fast-food showed statistical significance, presenting an inconsistency with the findings of Didarloo et al. (2022). In this study, the average monthly family income demonstrated statistical significance, consistent with a study conducted in North West Iran (Didarloo, 2022). A possible explanation is that the findings suggest that fathers' occupation, particularly in business, has a substantial impact on the overall income of their families. This finding resonates with similar studies conducted in Bangladesh (Kabir et al., 2012).

The study found that majority of the students consumed at least one type of the fast foods regularly in recent month and week, respectively. The finding is nearly similar to the previous study (Seo et al., 2011; Mohammadbeigi et al., 2018; Singh et al., 2020). The study showed that about fifty percent students consumed fast food as a meal, presenting a discrepancy from earlier research (Seo et al., 2011; Banik et al., 2020; Tareq, Hasan, Billah, & Hasan,2022). Furthermore, the present study found that half of the students consumed fast food from hotels and restaurants, consistent with previous research (Seo et al., 2011; Banik et al., 2020). One possible explanation is that the rise in fast food consumption among adolescents may be attributed to the lack of recreational opportunities and entertainment in urban areas, as reported by Banik et al. (2020).

Relationship Among Attitude, Subjective Norm, and Perceived Behavioral Control on Intention to Fast-Food Consumption

Attitude and Intention to Fast Food Consumption

The study revealed a total mean score of attitudes at 41.89 out of 60, indicating a positive attitude among students toward fast-food consumption. This finding is consistent with previous studies by Seo et al. (2011) and Mirkarimi et al. (2016), which reported attitude scores of 24.55 out of 48 and 24.29 out of 48, respectively. The present study found a significant relationship between attitude and intention to fast food consumption. The findings showed the similar results on familiarity (Sajjad et al., 2023; Mirkarimi et al., 2016), taste, environments and saltiness of fast food (Mirkarimi et al., 2016). However, the present study found inconsistencies in attitudes related to the cleanliness and safety of fast food, the belief that consuming fast food would lead to fatty, and the perception of high-calorie content (Seo et al., 2011; Mirkarimi et al., 2016). Possible explanation, these variations in findings may be attributed by several reasons such as increasing number of fast-food restaurants, convenience, availability, affordable costs, menu choices, taste and marketing of food products are the main reasons for increased fast food consumption among adolescents. The majority of fast-food consumers are typically uneducated teens, young adults, and singles (Fazelpour, Hoseini, Farzaneh, & Shamsi, 2019). The rise in fast food consumption among adolescents could indicate a more positive attitude toward it, driven by these influencing factors.

Subjective Norms and Intention to Fast Food Consumption

The study showed the total mean score of subjective norms at 21.54 out of 30. indicating a positive influence on students' intention to consume fast food. This finding is consistent with previous studies by Seo et al. (2011) and Mirkarimi et al. (2016), which reported positive influence scores of 14.42 out of 24 and 14.22 out of 24, respectively. The present study identified a significant relationship between subjective norms and the intention to consume fast food. In this study, majority of the students consumed fast food with their family members. The finding is consistent to the previous study (Jayawickrama et al.,2020; Mirkarimi et al.,2016; Askari et al.,2016; Shori et al., 2017). Possible explanation may be that, the rise of fast-food restaurants, especially in urban areas, has negatively impacted the lifestyles of many families, leading to a decreased likelihood of having meals together. As a result, families often choose fast food over home-cooked meals as a more convenient option (Ejike & Obeagu, 2018; Banik et al., 2020). The study also showed that students believed their friends would likely consume fast food regularly, consistent with findings from previous studies (Mirkarimi et al., 2016; Askari et al., 2016; Didarloo et al., 2022). This perception may be influenced by the widespread availability and popularity of fast food among adolescents, contributing to the normalization of fast-food consumption within peer groups.

Perceived Behavioral Control and Intention to Fast Food Consumption

The study showed a total mean score of perceived behavioral control at 44.14 out of 70, suggesting that students had a lower perceived behavioral control to consume fast food. In contrast, the findings of Seo et al. (2011) and Mirkarimi et al. (2016) reported perceived behavioral control scores for fast-food consumption at 27.5 out of 52 and 27.05 out of 52, respectively. The present study found a significant result indicating that a higher score of perceived behavioral control was associated with a higher intention to consume fast food. This finding aligns with previous studies (Seo et al., 2011; Mirkarimi et al., 2016) but contradicts the results of Didarloo et al. (2022). The findings related to perceived behavioral control about dieting, exposure to fewer advertisements, limited sale promotions, nutrition education using multimedia, and simple meal preparation are nearly consistent with the results of Mirkarimi et al. (2016). One plausible explanation for this consistency could be that students who scored higher on perceived behavioral control regarding fast food consumption also indicated a higher intention to consume fast food, as observed in the study by Sharifirad et al. (2013).

Study Limitations

Firstly, the descriptive study used a correlational design, limiting its ability to identify influencing factors that affect the intention to consume fast food. Secondly, the study utilized a convenience sampling technique for data collection, potentially introducing selection bias into the sample. Thirdly, the results of this study may not be generalizable to students residing in rural areas. Finally, the study was conducted at two selected schools, and as such, the findings may not accurately represent the diversity of school students across Bangladesh.

Conclusion: The study's results indicate that the majority of students with higher scores in attitude, subjective norm, and perceived behavioral control exhibited a higher intention to consume fast food. Furthermore, the findings demonstrate a negative association between students' age and the intention to consume fast food, suggesting that age may influence the intention to consume fast food as the tendency for unhealthy eating increases with adolescents' age.

Recommendations

Despite the study's limitations, several recommendations emerge to guide future research: Firstly, given the descriptive and correlational nature of this study, future research should explore interventional approaches in diverse settings. Secondly, government and private authorities should consider implementing midday meal programs for high school students. This initiative aims to address health consequences and mitigate barriers related to caste and class among children. Thirdly, Policymakers are encouraged to take proactive measures to formulate strategies aimed at reducing the morbidity associated with obesity and overweight. Lastly, the government and private authorities should consider hiring child health nurses to work in schools or colleges. These professionals can play a crucial role in influencing healthier lifestyle choices. Finally, Educational institutions should collaborate on media awareness campaigns focusing on nutrition and educational programs. These campaigns should target families and friends to enhance understanding of the harmful effects of excessive fast-food consumption on health and overall well-being.

Acknowledgements

We are grateful to the research assistants who assisted with data collection as well as the study participants who provided the data. We also thank the members of the school administration committee for their consent to data collecting.

Authors contributions

All authors contributed to the study conception and design. The individual contribution of the authors is given herewith: Md. Ariful Islam involved in conceptualization, methodology, data cleaning & screening, data analysis, writing-original draft, writing review & editing; Dr. Shanzida Khatun involved in Investigation, Resources, Supervision, writing review & editing; Dr. Taslima Begum involved in Resources, Supervision, writing review & editing; Dr. Fahima Khatun contributed to Writing review & editing. All authors have read and agreed to the published of the manuscript.

Funding

The authors received no financial support for the research, and publication of this article.

Availability of data and materials

The original dataset analyzed in this study are not publicly available in accordance with participants privacy. The dataset of the current study is available from the corresponding author on reasonable request.

Ethics approval and consent to participate

Study approval was taken from Institutional Review Board (IRB No. Exp.NIA-S-226) of NIANER, Mugda, Dhaka. All participants provided either written or oral informed consent. Privacy and confidentiality of the participants were maintained.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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No competing interests reported.

Fast-Food Consumption Intention among High School Students in Bangladesh

Status:

Version 1

Abstract

I. INTRODUCTION

II. METHODS

III. RESULTS

IV. DISCUSSION

V. CONCLUSION AND RECOMMENDATIONS

Declarations

References

Additional Declarations

Status:

Version 1