Nutrition Promotion for Children in Schools: A Content Analysis of Nutrition Marketing in Arizona School Cafeterias.

Background: Children consistently fall short of the recommended intake of fruits and vegetables while consuming excess nutrient-poor foods, which is associated with adverse health outcomes and academic performance. Food and beverage companies widely promote nutrient-poor foods to children. Schools reach tens of millions of students daily, providing an opportunity to market healthful choices, yet few studies have examined effective healthful nutrition marketing in schools. This study examined the content of nutrition marketing materials within elementary, middle, and high school cafeterias in Arizona to understand the current strategies being used to promote nutrition to students. Methods: Photographs of existing nutrition marketing within 37 school cafeterias in Arizona, including elementary (n = 13), middle (n = 12), and high schools (n = 12) between 2017-2020, were taken, and an analysis was conducted to code for content, purpose, prevalence, visual messaging, and literary messaging used to influence eating behaviors. Results: The most common marketing material was posters, the most common behavior target was selecting a fruit or vegetable, the most common content was social media or website links followed by the use of cartoon characters, the most common messaging strategy was gain-frame (framing a message by highlighting the benefits of engaging in a behavior), the most common outcome was short-term messages, and the reading level was not appropriate for most elementary and middle schools. Conclusions: Some, but not all, nutrition marketing in the sampled schools mirrors current effective food marketing. This research can serve as a baseline of current nutrition marketing strategies to improve nutrition marketing for students.