Abstract
Background/Objectives:
Breakfast skipping increases during adolescence and is associated with lower levels of physical activity and weight gain. Theory-based interventions promoting breakfast consumption in adolescents report mixed findings, potentially because of limited research identifying which determinants to target. This study aimed to: (i) utilise the Theory of Planned Behaviour (TPB) to identify the relative contribution of attitudes (affective, cognitive and behavioural) to predict intention to eat breakfast and breakfast consumption in adolescents and (ii) determine whether demographic factors moderate the relationship between TPB variables, intention and behaviour.
Subjects/Methods:
Questionnaires were completed by 434 students (mean 14±0.9 years) measuring breakfast consumption (0–2, 3–6 or 7 days), physical activity levels and TPB measures. Data were analysed by breakfast frequency and demographics using hierarchical and multinomial regression analyses.
Results:
Breakfast was consumed everyday by 57% of students, with boys more likely to eat a regular breakfast, report higher activity levels and report more positive attitudes towards breakfast than girls (P<0.001). The TPB predicted 58% of the variation in intentions. Overall, the model was predictive of breakfast behaviours (P<0.001), but the relative contribution of TPB constructs varied depending on breakfast frequency. Interactions between gender and intentions were significant when comparing 0–2- and 3–6-day breakfast eaters only highlighting a stronger intention–behaviour relationship for girls.
Conclusions:
Findings confirm that the TPB is a successful model for predicting breakfast intentions and behaviours in adolescents. The potential for a direct effect of attitudes on behaviours should be considered in the implementation and design of breakfast interventions.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Get just this article for as long as you need it
$39.95
Prices may be subject to local taxes which are calculated during checkout
References
PHE. How healthy behaviour supports children’s wellbeing. Public Health England; 2013 [updated August 2013; cited 21 August 21] Available at www.gov.uk/government/uploads/system/uploads/attachment_data/file/232978/Smart_Restart_280813_web.pdf.
Siega-Riz AM, Popkin BM, Carson T . Trends in breakfast consumption for children in the United States from 1965-1991. Am J Clin Nutr 1998; 67: 748s–756s.
Hallstrom L, Vereecken CA, Labayen I, Ruiz JR, Le Donne C, Garcia MC et al. Breakfast habits among European adolescents and their association with sociodemographic factors: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Public Health Nutr 2012; 15: 1879–1889.
Mullan BA, Singh M . A systematic review of the quality, content, and context of breakfast consumption. Nutr Food Sci 2010; 40: 81–114.
Timlin MT, Pereira MA, Story M, Neumark-Sztainer D . Breakfast eating and weight change in a 5-year prospective analysis of adolescents: Project EAT (Eating Among Teens). Pediatrics 2008; 121: e638–e645.
Conner M, Hugh-Jones S, Berg C . Using the two-factor Theory of Planned Behaviour to predict adolescent breakfast choices. Educ Child Psychol 2011; 28: 37–50.
Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD . Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc 2005; 105: 743–760.
Berkey CS, Rockett HR, Gillman MW, Field AE, Colditz GA . Longitudinal study of skipping breakfast and weight change in adolescents. Int J Obes Relat Metab Disord 2003; 27: 1258–1266.
Odegaard AO, Jacobs DR, Steffen LM, Van Horn L, Ludwig DS, Pereira MA . Breakfast frequency and development of metabolic risk. Diabetes Care 2013; 36: 3100–3106.
Michie S, Abraham C, Whittington C, McAteer J, Gupta S . Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol 2009; 28: 690–701.
Ajzen I . The Theory of Planned Behavior. In Paul AM, Van Lange AWK, Higgins E Tory eds Handbook of Theories of Social Psychology: Volume One.. SAGE: London, UK, 2012.
Armitage CJ, Conner M . Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol 2001; 40: 471–499.
McEachan RRC, Conner M, Taylor NJ, Lawton RJ . Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. Health Psychol Rev 2011; 5: 97–144.
Chan K, Tsang L . Promote healthy eating among adolescents: a Hong Kong study. J Consum Mark 2011; 28: 354–362.
Grønhøj A, Bech-Larsen T, Chan K, Tsang L . Using theory of planned behavior to predict healthy eating among Danish adolescents. Health Educ 2013; 113: 4–17.
Duncan MJ, Rivis A, Jordan C . Brief report: Understanding intention to be physically active and physical activity behaviour in adolescents from a low socio-economic status background: an application of the Theory of Planned Behaviour. J Adolesc 2012; 35: 761–764.
Rivis A, Sheeran P, Armitage CJ . Augmenting the theory of planned behaviour with the prototype/willingness model: predictive validity of actor versus abstainer prototypes for adolescents' health-protective and health-risk intentions. Br J Health Psychol 2006; 11: 483–500.
DeJong CS, van Lenthe FJ, van der Horst K, Oenema A . Environmental and cognitive correlates of adolescent breakfast consumption. Prev Med 2009; 48: 372–377.
Kothe EJ, Mullan BA, Amaratunga R . Randomised controlled trial of a brief theory-based intervention promoting breakfast consumption. Appetite 2011; 56: 148–155.
Wong CL, Mullan BA . Predicting breakfast consumption: an application of the theory of planned behaviour and the investigation of past behaviour and executive function. Br J Health Psychol 2009; 14 (Pt 3), 489–504.
Mullan B, Wong C, Kothe E . Predicting adolescent breakfast consumption in the UK and Australia using an extended theory of planned behaviour. Appetite 2013; 62: 127–132.
Mullan BA, Wong CL, Kothe EJ, MacCann C . Predicting breakfast consumption: a comparison of the theory of planned behaviour and health action process approach. Br Food J 2013; 115: 1638–1657.
Ajzen I . Constructing a theory of planned behavior questionnaire. 2006. Available at http://people.umass.edu/aizen/pdf/tpb.measurement.pdf (accessed 20 May 2014)..
Riebl SK, Estabrooks PA, Dunsmore JC, Savla J, Frisard MI, Dietrich AM et al. A systematic literature review and meta-analysis: The Theory of Planned Behavior's application to understand and predict nutrition-related behaviors in youth. Eat Behav 2015; 18: 160–178.
Berg C, Jonsson I, Conner M . Understanding choice of milk and bread for breakfast among Swedish children aged 11–15 years: an application of the Theory of Planned Behaviour. Appetite 2000; 34: 5–19.
Hewitt AM, Stephens C . Healthy eating among 10-13-year-old New Zealand children: understanding choice using the Theory of Planned Behaviour and the role of parental influence. Psychol Health Med 2007; 12: 526–535.
Gummeson L, Jonsson l, Conner M . Predicting intentions and behaviour of Swedish 10 to 16 year olds at breakfast. Food Qual Prefer 1997; 8: 297–306.
Moore GF, Moore L, Murphy S . Normative and cognitive correlates of breakfast skipping in 9–11-year-old schoolchildren in Wales. Appetite 2009; 53: 332–337.
Martens MK, van Assema P, Brug J . Why do adolescents eat what they eat? Personal and social environmental predictors of fruit, snack and breakfast consumption among 12-14-year-old Dutch students. Public Health Nutr 2005; 8: 1258–1265.
Ajzen I . Attitudes, Personality and Behaviour. 2nd edn, Open University Press: Maidenhead, UK, 2005.
Tapper K, Murphy S, Lynch R, Clark R, Moore GF, Moore L . Development of a scale to measure 9-11-year-olds' attitudes towards breakfast. Eur J Clin Nutr 2008; 62: 511–518.
Gharlipour Z, Ghaffari M, Hoseini Z, Heidarabadi AB, Tavassoli E, Hozuri M et al. Investigation of educational intervention based on Theory of Planned Behavior on breakfast consumption among middle school students of Qom City in 2012. J Educ Health Promot 2015; 4: 39.
Hosseini Z, Aghamolaei T, Gharlipour Gharghani Z, Ghanbarnejad A . Effect of educational interventions based on theory of planned behavior to promote breakfast consumption behavior in students. Hormozgan Med J 2015; 19: 35–43.
Kowalski K, Crocker P, Kowalski N . Convergent validity of the Physical Activity Questionnaire for adolescents. Pediatr Exerc Sci 1997; 9: 342–352.
Pan H, Cole TJ . LMSgrowth, a Microsoft Excel add-in to access growth references based on the LMS method. Version 2.77. Available at: http://www.healthforallchildren.co.uk/ 2.77 ed2012.
Cole TJ, Freeman JV, Preece MA . Body mass index reference curves for the UK, 1990. Arch Dis Child 1995; 73: 25–29.
Vereecken C, Dupuy M, Rasmussen M, Kelly C, Nansel TR, Al Sabbah H et al. Breakfast consumption and its socio-demographic and lifestyle correlates in schoolchildren in 41 countries participating in the HBSC study. Int J Public Health 2009; 54 (Suppl 2), 180–190.
Sandercock GR, Voss C, Dye L . Associations between habitual school-day breakfast consumption, body mass index, physical activity and cardiorespiratory fitness in English schoolchildren. Eur J Clin Nutr 2010; 64: 1086–1092.
Hoyland A, McWilliams KA, Duff RJ, Walton JL . Breakfast consumption in UK schoolchildren and provision of school breakfast clubs. Nutr Bull 2012; 37: 232–240.
Utter J, Scragg R, Mhurchu CN, Schaaf D . At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors. J Am Diet Assoc 2007; 107: 570–576.
Unusan N, Sanlier N, Danisik H . Comparison of attitudes towards breakfast by Turkish fourth graders living in Turkey and Germany. Appetite 2006; 46: 248–253.
Moore GF, Tapper K, Murphy S, Lynch R, Raisanen L, Pimm C et al. Associations between deprivation, attitudes towards eating breakfast and breakfast eating behaviours in 9–11-year-olds. Public Health Nutr 2007; 10: 582–589.
Murphy S, Moore GF, Tapper K, Lynch R, Clarke R, Raisanen L et al. Free healthy breakfasts in primary schools: a cluster randomised controlled trial of a policy intervention in Wales, UK. Public Health Nutr 2011; 14: 219–226.
Kennedy C, Hajek A, Morris D, Linnell S, Gines J . Strategies to increase breakfast consumption in a residential university population: an environmental intervention. Am J Health Promot 2005; 19: 457–458.
Haddock G, Maio GR . Contemporary perspectives on the psychology of attitudes In: EAoES . (ed.). Psychology. Psychology Press: East Sussex, NY, 2004.
Van der Horst K, Oenema A, Ferreira I, Wendel-Vos W, Giskes K, van Lenthe F et al. A systematic review of environmental correlates of obesity-related dietary behaviors in youth. Health Educ Res 2007; 22: 203–226.
Pearson N, Biddle SJH, Gorely T . Family correlates of breakfast consumption among children and adolescents. A systematic review. Appetite 2009; 52: 1–7.
Neumark-Sztainer D, Story M, Hannan PJ, Perry CL, Irving LM . Weight-related concerns and behaviors among overweight and nonoverweight adolescents: implications for preventing weight-related disorders. Arch Pediatr Adolesc Med 2002; 156: 171–178.
Sniehotta FF, Presseau J, Araújo-Soares V . Time to retire the theory of planned behaviour. Health Psychol Rev 2013; 8: 1–7.
Ogden J (ed). Essential Readings in Health Psychology. Open University Press: Maidenhead, England, 2008.
Acknowledgements
We thank all the schools who supported the study and the students for taking part in the study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
SK was funded by a Nigel Groome PhD research studentship from Oxford Brookes University. The remaining authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Kennedy, S., Davies, E., Ryan, L. et al. Applying an extended theory of planned behaviour to predict breakfast consumption in adolescents. Eur J Clin Nutr 71, 607–613 (2017). https://doi.org/10.1038/ejcn.2016.192
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ejcn.2016.192