The Effect of Social Marketing Model on Promoting Nutrition Literacy and Healthy Dietary Behaviors of Women in Sanandaj City: A Mixed-Methods Approach

Abstract

Background: Nutrition literacy can be defined as the degree to which people have the capacity to obtain, process and understand basic nutrition information. Objectives: The aim of this study was to apply a social marketing model in order to improve nutrition literacy and healthy eating habits in women. Methods: This was a mixed method sequential exploratory study. The first phase of the study was the qualitative study conducted based on content analysis within the framework of the social marketing model. Based on the extracted concepts from qualitative studies, two questionnaires were obtained. The nutrition literacy questionnaire and eating behavior questionnaire were implemented by applying public health approach and the structures of social marketing model, respectively. Validity of the nutrition literacy questionnaire was 0.7 and the results of R-test were P = 0.012, r = 0.75. Validity of the eating behavior questionnaire was 0.8 and 0.78 for Cronbach's Alpha. The second phase of the study was an experimental trial with a control group. The study population included 752 married women. The interventions for nutrition literacy improvement were administered based on the Harvard Dietary Pyramid and social marketing model. Data analysis was performed using SPSS and by the application of chi-square, paired t-test, t-test, and Pearson's correlation coefficient. Results: In the qualitative phase of the total interviews and discussion groups, 350 initial codes were obtained and based on the structures of social marketing model, they were grouped into two categories. during the analysis process four main themes and eight sub-themes including product (product/behavior, product/demand, product/benefit), price (individual barriers and social barriers), place and promotion (overcoming individual barriers, overcoming social barriers, the best way to send a message) were extracted. The results indicated a significant difference between the two groups in nutrition literacy score (P< 0.05) and nutritional behavior (P < 0.01) after the intervention. Conclusions: The concept of exchange in healthy diet social marketing was helpful in reducing the barriers to healthy diet and boosting the advantages of healthy eating from the customers' viewpoint. Finally, the studied women were empowered through gaining healthy diet skills which led to healthy eating habits.