ArticleJournal of health, population, and nutrition2026
Predicting fast food avoidance behavior among male adolescents: a structural equation modeling approach to the theory of planned behavior.
Article in Journal of health, population, and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFast food consumption is a growing public health concern, particularly among adolescents, due to its association with obesity and chronic diseases. Understanding the behavioral determinants of fast-food avoidance can inform the design of effective interventions targeting male adolescents.
objectiveThis study aimed to investigate the determinants of fast-food avoidance behaviors among male high school students in Shiraz, Iran, using the Theory of Planned Behavior (TPB) and Structural Equation Modeling (SEM).
methodsA cross-sectional study was conducted among 862 male students in grades 1 and 2 of high school in Shiraz in 2025. A multi-stage sampling strategy was applied, whereby 16 high schools were randomly selected from four educational districts. Within selected schools, classes and students were recruited using a convenience-based approach, and all eligible students present in the selected classes were invited to participate. Data were collected using a demographic questionnaire and a validated TPB-based instrument assessing knowledge, attitude, subjective norms, perceived behavioral control (PBC), behavioral intention, and fast-food avoidance behavior. Data analysis was performed using JAMOVI (v2.5.6), and SEM was employed to test the hypothesized TPB model.
resultsThe final TPB model demonstrated excellent fit indices (χ²/df = 2.04, CFI = 0.94, RMSEA = 0.05). Attitude (β = 0.58), subjective norms (β = 0.34), and PBC (β = 0.26) significantly predicted behavioral intention (p < .001), which in turn strongly predicted fast-food avoidance behavior (β = 0.49, p < .001). PBC also had a direct effect on behavior (β = 0.31). Knowledge exerted an indirect effect on behavior through attitude and intention. Demographic variables, including parental education, household income, and maternal employment, were associated with TPB constructs.
conclusionFast-food avoidance behaviors among male adolescents are primarily influenced by motivational and control beliefs. From a practical and policy perspective, school-based nutrition education programs and adolescent health policies should prioritize strengthening positive attitudes, enhancing perceived behavioral control, and reinforcing supportive social norms to promote healthier dietary behaviors and reduce fast-food consumption among adolescents.
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