Objective: To conduct a content analysis of nutrition marketing in school cafeterias in Arizona to understand how nutrition concepts are currently marketed to students. This is the first study to investigate the content of nutrition marketing in school cafeterias, and also the first to compare content across elementary, middle, and high schools. Methods: Photographs of marketing materials on display in school cafeterias were obtained from a convenient sample of 13 elementary schools, 12 middle schools, and 12 high schools. In total, n=284 examples of nutrition marketing were collected. The photographs were sorted by grade level and then coded quantitatively and qualitatively based on their purpose, visual aspects, marketing strategies used, and language and literacy aspects. Given the multiple comparisons, statistical significance was assessed with a Bonferroni adjustment of p<0.0006. Results: The average number of nutrition marketing materials within the school cafeterias was 7.7 ± 7.2. The purpose of the marketing materials ranged from promoting selection and consumption of fruits and vegetables, promoting nutrition and physical activity together, food safety, and educating about healthy eating. The sample of nutrition marketing materials emphasized selecting F/Vs over consumption of F/Vs. However, the opposite was found in marketing that exclusively promoted fruits and vegetables. The most common type of marketing in school cafeterias were flyers and most of the materials were small in size. The sample demonstrated a lack of implementation of marketing appeals in half of the sample, but the half that did utilized techniques that are known to be appealing to child and adolescent demographics, such as use of cartoons, humor, and social media/websites. 98.9% of the nutrition marketing with text were written in English and only 1.1% of the materials (n=3) were written in Spanish. Conclusion: The nutrition marketing sample demonstrated some use of social marketing principles but does not compete with the scale and scope of the child-directed food and beverage marketing that students encounter in their environment. More research is needed to better understand how to best target nutrition marketing to child and adolescent student populations.

The objective of this study was to evaluate and compare the content of nutrition marketing materials within the cafeterias of schools in Central Arizona. By collecting photographs of marketing material from three elementary schools, one K-8 school, three middle schools and three high schools, 59 pieces of nutrition marketing were gathered. The schools chosen were a convenience sample and selected from schools that were already participating in ASU' s School Lunch Study. The photographs were sorted by grade level and then coded quantitatively and qualitatively for their purpose, visual components, strategies used and relevance. Results from this novel study provided insight into prevalence, size, textual content, educational content, strategies for fruit and vegetable marketing, messaging and overall design of existing nutrition marketing within the sample schools. This study found that the prevalence of nutrition marketing within all school cafeterias appeared to be low, particularly within elementary and middle schools. Diverse types of messaging were present among elementary, middle and high schools and a variety of appeals were utilized with little consistency. Many of the strategies used in the nutrition marketing appeared disconnected from the population it was intended to appeal to. Educational components were notably lacking within middle school cafeterias but were often effectively integrated into high school nutrition marketing. The results are unique to this population, and further research is required to evaluate the content of existing nutrition material on a larger scale, so efforts can be made to improve the persuasiveness of nutrition marketing in promoting fruit and vegetable consumption.