Document Type : Original Article


1 Department of Public Health, School of Health, Shahid Beheshti University of Medical Sciences,

2 Department of Public Health, School of Health, Tehran University of Medical Sciences, Tehran,

3 Department of Public Health, School of Health, Shahid Beheshti University of Medical Sciences, Department of Public Health, School of Health, Shahrekord University of Medical Sciences, Shahrekord

4 Department of Public Health, School of Health, Bushehr University of Medical Sciences, Bushehr, Iran

5 Department of Public Health, Research Deputy, Qom University of Medical Sciences, Qom


Background: Eating breakfast is crucial for adolescents to be healthy. It also improves
students’ capacity of learning and doing school homework. Although healthy habits such as
eating breakfast, weight control, and regular sleep increase the lifespan in adults, the effects of
healthy habits on school‑age children have not been studied much. The present study aimed at
investigating the impact of an educational program based on Theory of Planned Behavior (TPB)
on eating breakfast among middle school students. Materials and Methods: This interventional
study was conducted on sixth‑grade students in Qom City during the academic year 2012–2013.
First, 97 students were randomly assigned to the experimental group and 97 other students
were assigned to the control group. Then, a questionnaire was developed on eating breakfast
by the researchers according to the TPB. A pilot study was conducted to assess the reliability
of the questionnaire. To assess the validity of the questionnaire, advice by a panel of experts
was sought. To carry out a pre‑test, both groups answered the questions. After analyzing the
pre‑test results, the required content was developed for the experimental group. Educational
methods included delivering speech, discussion groups, pamphlets, and posters. The required
educational content was provided for students during five sessions and for parents in one session.
To determine the effect of educational intervention, a post‑test study was carried out 2 months
after the intervention. Collected data were analyzed using independent t‑test, χ,
[2] and repeated
measures. Results: In the experimental group, 36.7% of students were eating breakfast at least in
a day of a week, before educational intervention. After implementation of the educational program,
only 32.7% of them were continuing their past habit. There was a significant difference between the
mean scores of attitudes, perceived behavioral control, intention, and practice of eating breakfast in
the experimental and control groups (P < 0.05), while there was no significant difference between
the mean scores of subjective norms after
implementing the educational program in both
groups (P < 0.26). Conclusion: Using the TPB
improved students’ intentions and behavior
of eating breakfast. Thus, it seems necessary
to consider all effective environmental factors
on the subjective norms in the education
of healthy eating behaviors or improving
breakfast‑eating practice among students.


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