Curbing a Global Childhood Overweight Epidemic: Understanding Children's Milk/Soda Intake Behaviors

Thursday, 16 July 2009: 10:50 AM

Arax A. Balian-Krikorian, RN, MPH, PhD
School of Nursing, Case Western Reserve University, Cleveland, OH

Learning Objective 1: List the factors influencing school-age children's milk and soft drink intake behaviors

Learning Objective 2: State the constructs of the Theory of Planned Behavior in its application to school-age children

The epidemic of childhood overweight has become a global public health concern. Prevalence of childhood overweight has tripled since 1976 leading to serious health conditions. Milk intake among 6-to11-year-olds has steadily declined and concomitantly, consumption of calorie and carbohydrate-rich soft drinks doubled, raising concerns related to overweight. A cross-sectional descriptive correlational study was undertaken using the Theory of Planned Behavior.

Purpose: (1) to determine influences on school-age children’s milk and soft drink intake and (2) to determine the effect of gender, ethnicity, and body mass index (BMI) on behavioral, normative and control beliefs, attitude, subjective norm, perceived behavioral control (PBC), intention, and milk/soft drink intake.

Methods: Using the roster of Kaiser Permanente Ohio, a random sample of ninety seven 10 to 11-year-olds completed a 24-hour dietary recall and Milk/Soda Pop Intake Questionnaires.   
Results: The majority of children had ≥ 1 glass of milk on a school day and two-thirds consumed soda. Intention predicted milk and soda intake; attitude had the strongest contribution, followed by PBC, in predicting soda intention. Within the beliefs, taste and being healthy predicted attitudes, friends predicted subjective norms, and availability of milk at home predicted PBC to drink milk. No gender and BMI differences were found in the milk/soda TPB variables and both behaviors. Compared to the minority group, white participants had stronger intention to drink milk, stronger perception that: drinking milk makes them healthy,  someone in their family thinks they should drink milk daily, and having milk at home makes its consumption easier. Compared to white participants, the minority group had stronger perception that someone in their family and friends think they should drink soda daily and they consumed it significantly more.

Conclusion: Understanding factors shaping children’s behavior to milk/soft drink intake will help nurses devise educational interventions and policies aiming at addressing the overweight epidemic.