Direct observations of in-school food and beverage promotion : advances in measures and prevalence differences at the school-level



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Previous research shows that food/beverage promotions are prevalent in traditional channels, such as television, and that children's exposure to these promotions may be associated with dietary- and weight-related outcomes. However, little research has been conducted on in-school food/beverage promotions, despite evidence that promotions are present in schools and that similar associations between students' exposure to promotions and weight-related outcomes may exist. In an attempt to better understand in-school food/beverage promotions, the current study was undertaken. Specifically, the reliability of a new electronic tool to document direct observations of in-school food/beverage promotions was examined. Direct observation data, using the new tool, were collected in 30 middle schools in central Texas, and a new coding system was developed to categorize and quantify these data. Analyses were run to examine percent agreement between records for intra- and inter-rater reliability. Analyses were also run to assess percent agreement between coded records in order to examine inter-rater reliability for the new coding system. Descriptive analyses on direct observation data were conducted in order to further examine the types and prevalence of food/beverage promotions. T-tests were run to examine variations in food/beverage promotions by school-level differences including economic disadvantage and percent minority. Overall, sufficient intra- and inter-rater reliability was established for the new electronic data collection tool. Sufficient inter-rater reliability was found for the new coding system. Direct observation data showed that food and beverage promotions are prevalent in central Texas middle schools, particularly those displaying nutrition education messages, commercial products, brand logos, and unhealthier food/beverage items. Additionally, a higher prevalence of food and beverage promotions, especially for less healthy products, and those displaying commercial brands and visible logos, were found to vary by school-level differences. Specifically, lower economically disadvantaged and lower percent minority schools had significantly higher levels of these types of promotions, as compared to higher economically disadvantaged and higher percent minority schools. Future studies should further examine prevalence of and school-level differences regarding in-school food/beverage promotions, and if these promotions are associated with dietary- and weight-related outcomes. Results may inform stricter policies regarding in-school food/beverage advertising aimed at youth.