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Both behavioral capacity and self-efcacy are linked to nutrition-related behavior change in children, contrary to
research that posited self-efcacy was more inuential than knowledge (Hall et al., 2015).
Environmental communication strategies, including messaging in social and physical environments, can serve to
increase the effectiveness of classroom nutrition interventions, consistent with the conclusions drawn by previous
researchers, e.g.: Bauer, Yang, and Austin (2004); Kubik, Lytle, Hannan, Perry, and Story (2003); and Neumark-
Sztainer et al. (2003). Lack of consistency, such as the presence of vending machines with nonnutritious content,
can undermine health promotion efforts.
The delivery of media literacy skills is consistent with the healthful intentions of nutrition education interventions, and
it is not inconsistent to teach these skills in the context of nutrition behaviors. The data in my study supported
research that claimed increased media literacy may improve eating habits (Godbold Kean et al., 2012).
The classroom provides opportunities for teachers to undermine communication inequalities (Viswanath, 2016) that
exist between school districts and Big Food; and for teachers to serve as inuential sources of nutrition education,
contrary to research that concluded teachers were not perceived by students as being a helpful source of nutrition
information that leads to nutrition-related behavior changes (Shepherd et al., 2006).
BACKGROUND AND STATEMENT OF THE PROBLEM
Obesity in America has been on the rise for 20 years. Today, more than one-third of adults in this country and
nearly one-fth of children and youth are obese (CDC, 2012). Obesity is a signicant issue in our society,
costing an estimated $147 billion in 2008 (Finkelstein, Trogdon, Cohen, & Dietz, 2009) – more than the cost
of smoking at $133 billion (American Cancer Society, 2015; Finkelstein, Brown, Wrage, Allaire, & Hoerger,
2010; Moriarty et al., 2012). In response to the growing issue of childhood obesity, public health ofcials and
government agencies have called upon schools to support the health and wellness of our nation’s children.
U.S. children ages six to 17 spend nearly 33 hours each week in school (Swanbrow, 2004), making these
prime spaces for addressing health promotion and disease prevention. Yet, most schools fail to meet the
recommended hours for changing nutrition-related behaviors: 40-50 hours are suggested (Connell, Turner, &
Mason, 1985), while most middle schools offer an average of 5 hours per year. Schools are also spaces
where children are exposed to food marketing efforts, including those for competitive foods and promotions
for Big Food. This study helps to provide an understanding of the complex intersection between food
marketing and nutrition education in schools, the role of communication in this context, and the inuence on
seventh and eighth graders’ nutrition-related attitudes and behaviors.
LIMITATIONS AND FUTURE RESEARCH
• Findings of this case study are not generalizable to other middle schools.
• A purely qualitative approach to the topic limited the opportunities for discovering causality; lack of a control
group did not allow temporal and other biases to be accounted for.
• Focus groups with children can be particularly inuenced by social desirability and social approval biases.
Despite the limitations of this study, the research contributes to understanding the ecological
inuences on children’s nutrition-related attitudes and behaviors from a communication-centered
perspective, and the ndings offer directions for future research in the eld.
• Distinguishing the differences between social cognitive theory’s self-efcacy and behavioral capability
constructs can help shape the delivery of nutrition education in schools, offering an understanding of the
relationship between the two concepts. This research found that behavioral capability may be a prerequisite
to self-efcacy, while other researchers have found self-efcacy is more of a relevant inuence, despite
behavioral capability.
• Mixed methods designs that incorporate participant observation as a qualitative methodology can help
determine whether or not nutrition-related beliefs, attitudes, and behaviors are changed as a result of
participation in a nutrition education class and to what degrees, as well as how those changes are prompted.
• Furthering the investigation of how students’ nutrition behaviors are inuenced by food marketing after
participation in nutrition education can promote an increased understanding of the intersections of nutrition
education, food marketing, and children’s nutrition behaviors to help inform policies related to both food
marketing and school-based nutrition intervention designs.
THEORETICAL FRAMEWORK
This study infused the social cognitive theory model
with an ecological approach, allowing for the
development of a conceptual framework that ensured
social cognitive theory constructs like facilitators and
impediments were considered from an ecological,
rather than interpersonal, perspective. Communication
theory and constructs were incorporated in this
perspective, presenting the eld with a broad approach
to communication. Communication was considered to
be structural, environmental, verbal, and nonverbal. In
this sense, even food is a system of communication
(Barthes, 2008).
Social cognitive theory is the most widely used
theoretical framework for nutrition education design
and evaluation (Hoelscher et al., 2002; Neumark-
Sztainer et al., 2003; Sharma, 2011). This work
supported the value of a comprehensive approach to
social cognitive theory that includes evaluation of the
interactions across environmental inuences,
investigating not only children’s behavior, but the
myriad of meditating factors that facilitate or impede
that behavior on an environmental level. It also
highlighted the value of extrapolating behavioral
capability, also known as behavioral capacity, as a
unique and specic construct that contributes to
behavior change.
METHODOLOGY AND RESEARCH SITE
Research was conducted at a middle school in upstate
New York. The study entailed a multi-method
qualitative data collection approach:
• Focus groups with middle school students (n=28)
• Interviews with key informants: the Family and
Consumer Sciences teacher and the school district
superintendent (n=2)
• Participant observation of nutrition-related lessons
in a Family and Consumer Sciences class
Qualitative data analysis was guided by practical
grounded theory; coding completed with NVivo.
From MyPlate to McTeacher’s Night: Communication about Nutrition in a Middle School
A Communication-Centered and Ecological Investigation
Crystal L. Brandow, PhD
Macro-Level Environment
Social Environment
Personal Factors
Physical Environment
LEVELS OF NUTRITION INFLUENCE AMONG CHILDREN
State School Nutrition
Guidelines
Federal School
Nutrition Guidelines
Food and
Beverage Industry
School Funding and
Budgeting
Signage
Vending Machine
Content
School
Lunch
Food Availability/
Accessibility
Teachers
Parents
Peers
Food Marketing
Cognitions
Tastes/Preferences
Knowledge/Skills
(Behavioral Capability)
Self-Efcacy
Behavior
Food
Marketing
FINDINGS
The school physical environment was largely an impediment to the
development of healthful nutrition attitudes and behaviors.
The school social environment largely helped to facilitate healthful
nutrition behaviors.
Nutrition education did indeed inuence children’s self-reported
nutrition-related attitudes and behaviors, largely through
improvements in behavioral capability and self-efcacy that were
generated through communication.
There was evidence that students who participated in nutrition
education applied concepts from the class in their interpretation of
food marketing messages.
CONCLUSIONS
DATA SOURCES
STUDENT PARTICIPANTS (N=28)
7th and 8th Grade
Middle School
Population
Study Sample
Sex
Male 44% 32%
Female 46% 68%
Race
Nonwhite 27% 29%
White 73% 71%
KEY INFORMANTS (N=2)
FIELD NOTES (33 OBSERVATION DAYS)
“The school doesn’t really care.”
“I mean, ice cream vending
machines?”
“The teacher told us that
McDonald’s food is the worst.”
“Now, whenever I eat
something, I look on the
back to see what the main
ingredient is, if it’s good or
not.”
90%
of teachers develop their own
materials for teaching nutrition,
yet most studies investigate the
effectiveness of codied nutrition
interventions.1
50 hours of school-based nutrition education are
recommended for changing behaviors.2
The average number of hours spent on
nutrition education in middle schools:35
$149 million
was spent on youth-directed food marketing in
schools in 2009.4
62%
of middle schools have at least one
vending machine to purchase
snacks or beverages; most school
vending machines sell foods that are
high in salt, fat, and sugar.5$19,000
The direct cost of childhood obesity, per child,
is estimated to be:61 Westat, Inc. (1996)
2 Connell, Turner, and Mason (1985)
3 Story, Nanney, and Schwartz (2009)
4 Federal Trade Commission (2012)
5 Wechsler, Brener, Keuster, and Miller (2001)
6 Finkelstein, Graham, and Malhotra (2014)