Effectiveness of structured teaching programme on knowledge regarding effect of junk food

“EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON
KNOWLEDGE REGARDING EFFECT OF JUNK FOOD ON MUCOSAL LAYER

OF GI TRACT AMONG NURSING STUDENTS IN SELECTED NURSING
COLLEGES AT BENGALURU”
BY
MR. SAIF ULLAH SHEIKH
D ISSERTATION S UBMITTED TO THE
R AJIV G ANDHI U NIVERSITY OF H EALTH S CIENCES , B ENGALURU
In partial fulfillment
of requirement for the degree of
MASTER OF SCIENCE IN NURSING
In
Medical Surgical Nursing
Under the guidance of
Prof. Thresa A
PROFESSOR, HOD
DEPARTMENT OF MEDICAL SURGICAL NURSING,
VARALAKSHMI COLLEGE OF NURSING
T. DASARAHALLI, BENGALURU-560 057
2019
I
II
III
IV
V
ACKNOWLEDGMENT
In the name of Allah, the Most Gracious and the Most Merciful
Alhamdulillah, First and foremost, I am thankful to Allah Subhanahu wa-ta’ala that by His grace and
bounty I am able to write my thesis. I ask sincerity in all my actions from Allah Subhanahu wa-ta’ala and I
quote the verse from the Holy Quran “Say, My prayer, my offering, my life and my death are for Allah, the
Lord of all the world” (Surat Al-’An ‘am, verse 162).
I as a researcher convey my sincere indebtedness to Varalakshmi College of Nursing, T.

Dasarahalli, Bengaluru-57 for giving an opportunity to pursue my studies in this esteemed institution and to
conduct this study.
It gives me immense pleasure to thank with gratitude and respect to
Professor Walter Jaisingh P, Principal, Varalakshmi College of Nursing, T.Dasarahalli, Bengaluru -57
for being the source of inspiration and constant support.
I express my sincere gratitude to resourceful and respectful Professor Sasikala Jaisingh, Vice-
Principal, Varalakshmi College of Nursing, for her guidance, suggestions and blessings that enable me to
complete this study.
It is my great honor and privilege for taking up and working on this project under the guidance of
Professor Thresa A, HOD Medical Surgical Nursing, Varalakshmi College of Nursing, I am thankful for
her expert guidance, untiring soulful encouragement and immense interest and support during the course of
study which brought life to the study.
I am indebted to Mrs. Jasmine James Assistant Professor, Department of Medical Surgical
Nursing, Varalakshmi College of Nursing, for her encouragement, guidance and suggestions.
I extend my sincere thanks to Mrs. Sheena Kuriakose, Lecturer, Department of Medical Surgical
Nursing, Varalakshmi College of Nursing, for all the guidance and co-operation received.
I am extremely grateful to Mr. Surendra, Associate Professor, Department of Statistics, Applied

mathematics and computer sciences, University of GKVK, Bengaluru for his expert guidance in analysis
and interpretation of data.
It is my pride and pleasure to express my gratitude to all Experts who validated the tool, who
contributed in the form of constructive criticism and suggestions to formulate the tool.
Grateful acknowledgement is extended to Mr. Gh.Ahmad Mir, Lecturer in English, for editing my
thesis.
I extend my sincere thanks to Principal, Varalakshmi College of Nursing for granting me

permission to conduct Pilot study and the Students of Varalakshmi College of nursing for participating in
the Pilot study.
I owe my gratitude to the Principal, RR College of Nursing Bengaluru for granting permission to
conduct the study.
VI
VII
LIST OF ABBREVIATIONS USED
1. χ2 Chi square
2. df Degree of freedom
3. GI Gastro Intestinal
4. > Greater than
5. H1 Research Hypothesis one
6. H2 Research Hypothesis two
7. < Less than
8. NS Non Significant
9. % Percentage
10. * Significance
11. SD Standard deviation
12. STP Structured Teaching Programme
13. WHO World Health Organization
VIII
LIST OF TABLES
SI.NO NAME OF THE TABLE PAGE

NUMBERS
1. Research Design 21
2. Classification of knowledge scores 26
3. Classification of Respondents by Age 34
4. Classification of Respondents by Gender 35
5. Classification of Respondents by Religion 36
6. Classification of Respondents by Permanent residence 37
7. Classification of Respondents Presently residing at 38
8. Classification of Respondents Monthly family income 39
9. Classification of Respondents by Previous exposure to information 40
10. Classification of Respondents by Source of information 41
11. Classification of Respondents by Do you consume junk food 42
12. Overall aspect wise Pre-test Knowledge scores of Respondents on level on 44

effect of junk food on mucosal layer of GI Tract
13. Aspect wise Pre-test Mean Knowledge scores of Respondents on effect of junk 45
food on mucosal layer of GI Tract
14. Overall aspect wise Post-test Mean Knowledge scores of Respondents on effect 46
of junk food on mucosal layer of GI Tract
15. Aspect wise Post-test Mean Knowledge scores of Respondents on effect of 47

junk food on mucosal layer of GI Tract
16. Over all Pre-test and Post-test Mean Knowledge scores 48
IX
SI.NO NAME OF THE TABLE PAGE
NUMBERS
17. Classification of Respondents on Pre-test and Post-test Knowledge level on
effect of junk food on mucosal layer of GI Tract 49
18. Aspect wise Mean Pre-test and Post-test Knowledge scores on effect of junk 50
19. Association between Demographic variables and Pre test Knowledge level on 53
20. Association between Age and Pre-test Knowledge level on effect of junk food 54
on mucosal layer of GI Tract
21. Association between Gender and Pre-test Knowledge level on effect of junk 56
22. Association between Religion and Pre-test Knowledge level on effect of junk 58
23. Association between Permanent residence and Pre-test Knowledge level on 59

24. Association between Presently residing at and Pre-test Knowledge level on 61

25. Association between Monthly family income and Pre-test Knowledge level on 63
26. Association between Previous exposure to information on effect of junk food on 64

mucosal layer of GI Tract and Pre-test Knowledge level on effect of junk food
27. Association between Source of information and Pre-test Knowledge level on 66

28. Association between Do you consume junk food and Pre-test Knowledge level 67
on effect of junk food on mucosal layer of GI Tract
X
LIST OF FIGURES
PAGE
SI.NO NAME OF THE FIGURE
NUMBERS
Conceptual framework based on General System Theory by

1. 9
Von Bertalanffy with Nursing Process
2. Schematic representation of the study design 22
3. Classification of Respondents by Age 34
4. Classification of Respondents by Gender 35
5. Classification of Respondents by Religion 36
6. Classification of Respondents by Permanent residence 37
7. Classification of Respondents by Presently residing at 38
8. Classification of Respondents by Monthly family income 39
Classification of Respondents by Previous exposure to

9. 40
information
10. Classification of Respondents by Source of information 41
11. Classification of Respondents by Do you consume junk food 42
Overall aspect wise Pre-test Knowledge scores of
12. Respondents on effect of junk food on mucosal layer of GI 44
Tract
XI
PAGE
SI.NO NAME OF THE FIGURE
NUMBERS
Overall aspect wise Post-test Mean Knowledge scores of

13. Respondents on effect of junk food on mucosal layer of GI 46
Tract
Over all Pre-test and Post-test Mean Knowledge scores on

14. 48
Classification of Respondents on Pre-test and Post-test

15. Knowledge level on effect of junk food on mucosal layer of 48
GI Tract
Aspect wise Mean Pre-test and Post-test Knowledge scores
16. 51
Association between Age and Pre-test Knowledge level on

17. 55
Association between Gender and Pre-test Knowledge level

18. 57
Association between Permanent residence and Pre-test

GI Tract
Association between Presently residing at and Pre-test

GI Tract
Association between Previous exposure to information on

effect of junk food on mucosal layer of GI Tract and Pre-test
21. 65
Knowledge level on effect of junk food on mucosal layer of
GI Tract
XII
STRUCTURED ABSTRACT
“Effectiveness of structured teaching programme on knowledge regarding effect of junk food on

mucosal layer of GI Tract among nursing students in selected nursing colleges at Bengaluru”
Background
Junk foods are rich in calories, salt and fats. Excess consumption of junk foods leads rise to wide
variety of health disorders. Consuming junk foods might stop the adolescents from taking healthy meals
either at college or at home. The practice of high consumption of junk foods like maggi noodles, burgers,
pao-bhaji, sandwiches, hot dogs, patties, pastries, pop-corn, potato chips, carbonated drinks, biscuits,
muffins, toast, kulcha-channa, samosa, chocolates etc have become common feature of adolescent’s diet
throughout the world. Besides many health problems junk food affects digestive system, mostly mucosal
layer of GI Tract which is the first part to come in contact after consumption. Knowledge is one of the most
effective tools of changing the food habits without affecting their sentiments. Knowledge regarding the
importance of balanced diet, harmful effects of junk foods on health and mucosal layer of GI Tract will help
to curb the junk food addiction and improving their nutritional status. It should be suggested that there is a
need to focus on knowledge which will facilitate the intake of healthy junk foods like fermented foods,
wheat noodles by adding lots of vegetables, sprouted pulses, sprouted tikki, vegetable samosa & cutlets,
wheat and multigrain bread. Hence, the researcher intended to assess the effectiveness of structured teaching
programme on knowledge regarding effect of junk food on mucosal layer of GI Tract among nursing
students in selected Nursing colleges at Bengaluru.
Objectives
1. To assess the existing knowledge of nursing students regarding the effect of junk food on mucosal layer of
GI Tract in selected nursing colleges at Bengaluru.
2. To determine the effectiveness of structured teaching programme regarding the effect of junk food on
mucosal layer of GI Tract among nursing students in selected nursing colleges at Bengaluru.
3. To find the association between pre-test knowledge score regarding the effect of junk food on mucosal
layer of GI Tract and selected demographic variables among nursing students in selected nursing colleges at
Bengaluru.
Methods:
Quasi-experimental design, with non probability purposive sampling method was used. The sample
consisted of 60 nursing students and information was collected regarding effect of junk food on mucosal
layer of GI Tract using the structured knowledge questionnaire. Structured teaching programme was
implemented and post-test was conducted after 7 days to find the effectiveness.
XIV
Results:
The data was analyzed by descriptive and inferential statistics. Regarding effectiveness of STP, the
overall mean knowledge score in the pre-test was 44.8% and post test score was 78.0% with 33.2% mean
percentage knowledge enhancement and it was significant at 5% level. Analysis of socio-demographic
variables showed significant association between age in years, gender, permanent residence, presently residing,
exposure to information, with knowledge score at 5% level (P>0.05).
Interpretation and conclusion:
The overall experience of conducting this study was satisfying and enriching. The study findings
suggested that structured teaching programme is an effective instructional method in improving the
knowledge of nursing students regarding effect of Junk food on mucosal layer of GI Tract.
Keywords:
Effectiveness; Structured Teaching Programme; Knowledge; Effect of Junk Food on Mucosal Layer
of GI Tract; Nursing Students.
XV
1. INTRODUCTION
Eat of the good things which we have provided for you.
Quran 2:172
Healthy nutritious foods have been replaced by the new food mantra - JUNK FOOD! Junk foods
have empty calories. An empty calorie food is a high calorie or calorie rich food which lacks in nutrients
such as vitamins, minerals, or amino acids, and fiber but has high energy calories. Junk food is an informal
term applied to some foods which are perceived to have little or no nutritional value, but which also have
ingredients considered unhealthy when eaten regularly, or to those considered unhealthy to consume at all.
The term “Junk food” was coined as a slang in the public interest in 1972 by Michael Jacobson, Director of
the Center for Science, Washington D.C. 1
India’s Junk food industry is growing by 40 percent a year. Statistics place India in 10th place in
fast food per capita spending figures with 2.1% of expenditure of annual total spending. Junk food seems to
have engulfed every age; every race and the newest entrants are children. Adolescents and children suddenly
seem to have stepped into a world of fast foods and vending machines, totally unaware of the havoc they are
creating for themselves. For children who have less vision of the heart disease, cancer, high blood pressure
or diabetes that might befall them decades later, the tentacles of a junk food environment are virtually
inescapable.2
Adolescence is the only time following infancy when the rate of physical growth actually
increases. First, there is a greater demand for calories and nutrients due to the dramatic increase in physical
growth and development over a relatively short period of time. Second, adolescence is a time of changing
lifestyles and food habit--changes that affect both nutrient needs and intake. Third, adolescent drive for
individuation means more opportunity to assert food choices and expand or narrow healthy options.3
Adolescence is a transitional period between childhood and adulthood, which begins from the
earliest signs of secondary sexual characteristics development and ends when a person has achieved adult
status (WHO, 1995).Hence, dramatic changes and development of the physical, emotional and cognitive
functions occur during adolescence. In order to achieve optimal growth and development during
adolescence, the nutritional requirements are the highest across the life span.4
Many people try to avoid or limit Junk food in their diets, out of concerns that such food is not
healthy despite the fact numerous food manufacturer produce a range of products which could be considered
junk food. Nutritionist, doctors, and other health advocates often work to educate people about junk food,
encouraging them to eat well balanced diets which contain a high proportion healthy food.5
1
Eating junk food has become a trend. The adolescents hate homemade healthy food. Junk food is
injurious to health. Good nutritious diet or balanced diet is basic need of every individual for their growth
and development. Because of delicious taste of junk food most of the adolescents during their meal time eat
junk food and get addicted to the taste of the junk food.6
Junk foods are not healthy and have various ill-effects. Junk foods are also laced with colours
which are often in edible, carcinogenic and harmful to the body. Their effects can emerge after many years.
Junk foods are often eaten instead of regular food which is not good for health. Junk food is a classic
example of unbalanced diet and besides obesity can raise other health concerns like indigestion, cardiac
disease, diabetes, high cholesterol, high blood pressure etc.7
Good digestion is very crucial for maintaining healthy immune function. A healthy digestive
system depends on a healthy diet. The gastrointestinal tract has a large surface exposed to the intestinal
content and is as such a major entry point for pathogens. Junk food slow down the digestion process making
the stomach bloated. In order to digest food, stomach needs enzymes and fast food does not have them.
When food is absorbed by the intestine it requires fiber and water to excrete but they don’t have such
nutrients which lead to poor digestion and irritable bowels. Junk foods make gut microbes to switch upon
mucosal layer as junk food lack the fiber which is food for these microbes. Junk food aggravates gastro
esophageal diseases, gastritis, esophagitis, irritable bowel disease and irritable bowel syndrome. Junk food
damage the mucosal layer of GI Tract and cause infection and inflammation of intestines. 8
2
Need for the Study
“Those who think they have no time for healthy eating will sooner or later have to find time for illness”.
– Edward Stanley
Junk food has empty calories and is unhealthy. Junk food advertising and the lure of convenience in
addition to taste drag people to junk food addiction. Excess fats and oils along with spices added in these
foods act as an irritant to gastric mucosa leading to excess secretion of hydrochloric acid, landing in gastritis
and other gastrointestinal problems.9
Patients who consume more cholesterol, saturated fatty acids and had more percentage calories from
fat were significantly more likely to experience a perceived reflux event. Against the background that what
one eats affects the gastrointestinal tract (G.I T), the role of diet and dietary habits including fibers, food
additives and preservatives on the etiology of gastric cancers, colorectal cancers and other G.I disorders in
the tropics are being reviewed. Carcinomas of the gut believed to be on the decline in the developed
10
countries have plateaued and increasing cases are being reported in the tropics.
A study conducted on one hundred and twenty-six Korean patients with weekly typical GERD
symptoms revealed that in 19 (37.3%) of 51 GERD cases and in 17 (22.7%) of 75 possible GERD cases,
foods inducing typical GERD symptoms were identified. In the GERD group (n = 19), frequent symptom-
inducers were hot spicy stews, rice cakes, ramen noodles, fried foods, and topokki. In the possible GERD
group (n = 17), frequent symptom-inducers were hot spicy stews, fried foods, doughnuts, breads, ramen
noodles, coffee, pizza, topokki, rice cakes, champon noodles, and hotdogs. 11
Junk food contain chemical carcinogens, irritants as additives or preservatives, high cholesterol,
highly spiced foods, alcohol, nicotine, xanthenes, caffeine, most of which provoke gastric acid secretions
dyspepsia and heartburn, and they lack vegetables and dietary fibers known to protect the G.I tract against
various diseases. It presupposes that well articulated diet must be encouraged to ensure proper and healthy
gastrointestinal tract 12
Relation between the gut microbiota and human health is being increasingly recognized. It is now well
established that a healthy gut flora is largely responsible for overall health of the host. Several factors play a
role in shaping the normal gut microbiota.13
Diet has the ability to quickly shift the type of bacteria in your gut. A good old-fashioned good-quality
diet, rather than short stints of ‘dieting’, is best for improving and maintaining a healthy gut.14
Average, young adults who watched more than five hours a day of television had a 10 per cent higher
calorie intake than those who had spent less than two hours a day in front of the box. Their average fast food
3
intake is 15 per cent higher and their consumption of sugary drinks is 17 per cent higher than those who
watched least television as teenagers.15
Discussion with experts and review of literature helped the researcher to realize that providing an
effective education on the knowledge regarding effect of junk food on mucosal layer of GI Tract is essential
to enhance the healthy eating patterns of adolescent nursing students.
During the review of literature, the researcher found that studies related to effect of junk food on
mucosal layer of GI Tract among nursing students in Karnataka is less, which has shown the increasing need
of the study.
As a researcher, at the time of my B.Sc. Nursing student period, I found fellow students very often
using the term junk food but very few actually knew what it means and hardly anyone knows what are their
effects on mucosal layer of GI Tract, which is the first line of contact with food when we consume it.
Nursing students are being considered role models in terms of health and are very frequently asked for health
related issues by their family, relatives and friends, so they must practice healthy eating habits. The
unhealthy eating patterns of nursing students not only affect their health but also have impact on the people
they interact with.
Considering all the factors mentioned above, I as a researcher felt the importance of teaching to
nursing students on knowledge regarding effect of junk food on mucosal layer of GI Tract and selected the
structured teaching programme as the medium of teaching. Structured teaching programme when used with
effective AV Aids create a lasting effect, so, they will be more aware of the effect of junk food.
4
2. OBJECTIVES
Statement of the problem
“Effectiveness of Structured teaching programme on knowledge regarding effect of Junk food on mucosal
layer of GI Tract among nursing students in selected Nursing colleges at Bengaluru”
Objectives of the study:-
1. To assess the existing knowledge of nursing students regarding the effect of junk food on mucosal layer of
GI Tract in selected nursing colleges at Bengaluru.
3. To find the association between pre-test knowledge score regarding the effect of junk food on mucosal
Bengaluru.
Operational definitions: -
1. Effectiveness: - In this study it refers to significant gain in knowledge scores of nursing students
regarding effect of junk food on mucosal layer of GI Tract as determined by the significant
difference in pre-test and post- test scores as assessed by structured knowledge questionnaire.
2. Structured teaching programme: - In this study it refers to systematically organized, planned

teaching strategy designed for nursing students prepared by researcher regarding effect of junk food
on mucosal layer of GI Tract.
3. Knowledge: - In this study it refers to the correct response from the participants regarding effect of
junk food on mucosal layer of GI Tract through structured knowledge questionnaire.
4. Junk food: - In this study it refers to those commercial products, including candy, bakery products,
ice cream, salty snacks, and soft drinks, which have little or no nutritional value but do have plenty of
calories, salt, and fats.
5. Mucosal layer of GI Tract: - In this study it refers to the innermost layer in the mucosa, underneath
which is submucosa, followed by the muscularis propria and finally, the outermost layer –the
adventitia.
5
6. Nursing students: - In this study, it refers to adolescent nursing students who are studying in
selected nursing colleges at Bengaluru.
Variables:-
1. Independent variables: Structured teaching programme which includes effect of junk food on mucosal
layer of GI Tract.
2. Dependent variables: Level of knowledge on effect of junk food on mucosal layer of GI Tract.
3. Demographic variables: : Age, gender, religion, permanent residence, presently residing at, family
income, previous exposure to the information, source of information and do you consume junk food.
Hypotheses:-
To achieve the stated objectives, the following hypotheses were formulated.
H1:There will be statistically significant difference between pre-test and post-test knowledge scores on
effect of junk food on mucosal layer of GI Tract among nursing students in selected nursing colleges at
Bengaluru as measured by structured knowledge questionnaire at P<0.05 level.
H2: There will be statistically significant association between pre-test knowledge scores and their selected
socio demographic variables among nursing students in selected Nursing Colleges at Bengaluru.
Assumptions:-
1. Nursing students may not have adequate knowledge regarding effect of junk food on mucosal layer
of GI Tract.
2. Nursing students will have more interest to know regarding effect of junk food on mucosal layer of
GI Tract.
Delimitations:-
1. The Study is limited to nursing students studying in RR College of Nursing Bengaluru.

2. The study is conducted in the duration of 4 weeks.
6
Conceptual frame work
Good research generally integrates research findings into an orderly, coherent system. Such
integration typically involves linking new research and existing knowledge by performing a thorough review
of the prior research on a topic and by identifying an appropriate conceptual framework.
When conducting research, a theoretical framework serve as a guide (or) map to systematically
identify a logical, precisely defined relationship between variables. (17)
The conceptual framework selected for this study is based on General System’s Theory of Von
Bertalanffy (1968)16. He defines system as a complex interaction which means that system consists of two or
more converted elements which form an organized whole and which interact with each other.
System
System refers to a whole human being who contains articulated sets of many subcomponents and this whole
system operates or functions within the boundaries of self, family and community and also constantly
exchanges information, energy and matter.
Types of Systems:
Open and Closed Systems
Karl Ludwig Bertalanffy describes two types of systems: open systems and closed systems.
Open Systems:
The open systems are systems that allow interactions between its internal elements and the environment. An
open system is defined as a “system in exchange of matter with its environment, presenting import and
export, building-up and breaking-down of its material components.” Here, this study is based on open
system.
Closed Systems:
Closed systems, on the other hand, are considered to be isolated from their environment.
INPUT
According to this theory, “input” refers to energy, matter and information from the environment. All
system must receive varying type and amount of information from the environment. The system uses the
input to maintain its homeostasis. In the present study, input includes:
 Demographic variables: Age, gender, religion, permanent residence, presently residing at, monthly
family income, previous exposure to information, source of information and do you consume junk foods.
This will be included in the assessment stage of nursing process.
7
 The knowledge level of nursing students is assessed through pre-test by using structured knowledge
questionnaire regarding effect of junk food on mucosal layer of GI Tract.
THROUGHPUT
According to this theory, “throughput” refers to process by which the system process input and
releases an output. In the present study, the throughput considering for processing the input are:
 Formulating nursing diagnosis, expected outcome and plan of care among nursing students before
and after administration of structure teaching programme.
 Conducting Structured Teaching Programme on effect of junk food on mucosal layer of GI Tract.
 Post test by using same structured knowledge questionnaire.
OUTPUT
It is the energy, material or information that is transferred to the environment. In this, it refers to the
information received in terms of gain in knowledge obtained through the processing of post test knowledge
scores as evaluation.
FEEDBACK
According to system theory, “Feedback” refers to output that is returned to the system that allow it to
monitor itself overtime in an attempt to move closer to a steady state known as equilibrium or homeostasis.
Feedback may be positive, negative or neutral.
For the present study, the feedback is related to the effectiveness of structured teaching programme and that
will be obtained by post-test.
In this study the post test knowledge score was significantly higher than pre-test at 0.05 level by
paired‘t’ test. This shows a positive feedback to the system, hence expected outcome of the study was
achieved.
8
Fig 1: Conceptual framework based on General System Theory by Von Bertalanffy with Nursing Process
9
10
3. REVIEW OF LITERATURE
“Literature is the art of writing something that will be read twice who teach the people who don’t read the
books.”
Literature reviews can serve a number of important functions in research process. A literature review helps
to lay the foundation for a study also inspire new research ideas.
- (Polit, D.F, Hunger B.D 2005)17.
IN THIS STUDY, REVIEW OF LITERATURE WERE CLASSIFIED

UNDER THE FOLLOWING HEADINGS
􀂙 Studies related to health hazards and factors promoting of junk food consumption
􀂙 Studies related to effects of junk food on mucosal layer of GI tract
􀂙 Studies related to the effectiveness of structured teaching programme on effect of junk food on mucosal
layer of GI Tract.
􀂙 Studies related to health hazards of junk food consumption
A comparative study was conducted on effects of junk food and beverages on adolescent’s health in
Tamil Nadu. About one fourth of the adolescents skipped breakfast on at least one day during the school
week. A greater proportion of adolescents studying in the private schools skipped breakfast than those
studying in government schools. The percentage of adolescents who skipped breakfast (23.3%) in this study
is in concordance to the studies done in the United States (Story et al 2002). Only 27.1 per cent of the
adolescents always brought lunch to school. In fact none of the participants from the government schools
ever brought lunch to school. As a result 84.5 per cent of the adolescents from government schools consume
junk food which could be cheap and easily available near the school premises. The study findings show that
41.4 per cent of the adolescents do not have dinner with parents and 21.2 per cent adolescents have dinner
while watching television. Mass media had been found to be an influential factor affecting the food choices
of children (Story et al 2002). The study found that 45.7 per cent of the adolescents go out for dinner at least
once a week. In fact eating out is strongly associated with junk food consumption (p = 0.001). Adolescents
who go out for dinner have a two times higher chance of consuming junk food as compared to those who
never dined out. Also adolescents who consume moderate amounts of vegetables and fruits daily were less
likely to eat junk food compared to those who took low amounts of vegetables and fruits.(18)
A descriptive study was conducted in Lucknow District to know about the effect of fast food
consumption on the health of school going children (9-13year). Total of 100 school going student were
selected from five different schools of Lucknow District. The study was carried out by using the following
tools to analyze the effect of fast food consumption health of respondents. Self designed& pre tested
questionnaire was used in the study. SPSS version 20 was used to draw meaningful inferences from the
collected raw data. The result found that among 9 year 100% respondents were found obese level 1. Among
10 year 42.8% of respondents were found obese level 3. Among 11 year 8.6% of respondents were found
obese level 3. Among 12 year 36.3% respondents were found obese level 2. Among 13 year 8.3%
respondents were found obese level 3. (19)
11
A comparative Survey Research study was conducted ‘to compare the knowledge on effects of junk
food Consumption between urban and rural school children at, Tirupathi, India to assess the knowledge on
practices regarding effect of junk food consumption, and to find the association of knowledge and practice
with demographic variables between urban and rural area among school children and self-instructional
module on effects of junk food consumption. Fifty school children of from urban areas and fifty school
children from rural area were selected by using simple random sampling technique. The results of the study
show type of family was found to be significant in urban school children, and education of the father was
found to be significant in rural school children. There was a significant difference between urban and rural
school children knowledge and knowledge on health practice related to effects of junk food consumption at
p<0.01 level. (20)
A comparative study was done to evaluate the association between fast food consumption and
incidence of metabolic syndrome (MetS) and its components among children and adolescents over a 3.6 year
follow-up. Dietary data of 424 healthy subjects, aged 6-18 years, was collected using a valid and reliable
food frequency questionnaire. Consumption of fast foods including hamburgers, sausages, bologna (beef),
and fried potatoes was calculated and further categorized to quartiles. Multiple logistic regression models
were used to estimate the incidence of MetS and its components in each quartile of fast food intake. The
incidence of MetS was 11.3% after a 3.6 year follow up. In the fully adjusted model, compared to the lowest
quartile of fast food intake, individuals in the highest had odds ratios of 2.96 (95% CI: 1.02-8.63; P for
trend<0.001), 2.82 (95% CI: 1.01-7.87; P for trend = 0.037), and 2.58 (95% CI: 1.01-6.61; P for trend =
0.009) for incidence of MetS, hypertriglyceridemia, and abdominal obesity, respectively. Fast food
consumption is associated with the incidence of MetS, abdominal obesity, and hypertriglyceridemia in
Tehranian children and adolescents.(21)
An experimental study was done to explore how people respond to images of junk versus healthy food
as a function of their eating habits and food knowledge. The experiment reported here proposed and tested
the idea that those with unhealthy eating habits but highly knowledgeable about healthy eating would feel
more positive and also more negative toward junk food images compared to images of healthy food because
they may perceive them as risky—desirable but potentially harmful. The findings are critical from a health
communication perspective. Because unhealthy eaters produce stronger emotional responses to images of
junk food, they are more likely to process information associated with junk food with more cognitive effort
and scrutiny. Thus, when targeting this group and using images of junk food, it is important to combine these
images with strong message claims and relevant arguments; otherwise, if the arguments are perceived as
irrelevant or weak, the motivational activation associated with junk food itself may transfer into an increased
desire to consume the unhealthy product. (22)
A pre-experimental study was conducted to assess the consumption of Junk food on School aged
children in rural, Himachal Pradesh. There has been an increase in the consumption of junk food (JF) among
school-aged children (SAC) possibly leading to obesity and diet-related diseases among them. We do not
have evidence on consumption of JF in rural areas; hence. A total of 425 children in the age group of 12–18
years studying in 30 government schools (clusters) were included. The clusters were selected using
population proportionate to size sampling methodology. It was found that high prevalence (36%) of
consumption of JF among SAC during the last 24 h. Efforts should be taken to reduce the consumption of JF
by promotion of healthy dietary habits and educating children about the ill effects of JF. (23)
A cross-sectional survey examining associations between children's regular TV viewing habits and their
food-related attitudes and behavior; and an experiment assessing the impact of varying combinations of TV
12
advertisements (ads) for unhealthy and healthy foods on children's dietary knowledge, attitudes and
intentions. Participants were 919 grade five and six students from schools in Melbourne, Australia. The
survey showed that heavier TV use and more frequent commercial TV viewing were independently
associated with more positive attitudes toward junk food; heavier TV use was also independently associated
with higher reported junk food consumption. The experiment found that ads for nutritious foods promote
selected positive attitudes and beliefs concerning these foods. It is concluded that changing the food
advertising environment on children's TV to one where nutritious foods are promoted and junk foods are
relatively unrepresented would help to normalize and reinforce healthy eating. (24)
A descriptive, cross-sectional study was undertaken to determine fast food consumption patterns,
socio-economic characteristics and other factors that influence the fast food intake of young adults from
different socio-economic areas in Johannesburg, South Africa. Using an interviewer-administered, validated
questionnaire to elicit the characteristics of the study population (adults aged from 19 to 30 years), their
reasons for and frequency of fast food consumption, their specific fast food choices, and their attitudes
towards health. The study population (n=341) consisted primarily of young working adults (n=242) with at
least a secondary education. Almost half (42%, n=102) of the employed participants earned less than R5 000
per month, but spent more than R200 on fast food per month. Twenty-one per cent of all participants had fast
food at least once a week, while 27.6% had it two to three times a week. Socio-economic group (SEG) and
gender were significantly related to fast food intake (p < 0.01), with a larger proportion of participants (65%,
n=76) in the lower socio-economic group (LSEG) showing more frequent use. Males consumed fast food
more frequently than females. The most popular fast foods consumed were burgers (69.5%), pizza (56.6%)
and fried chicken (38.4%). Soft drinks were the most popular beverage consumed (56%). The main reasons
for choosing fast food were time limitations (58.9%), convenience (58.2%) and taste (52.5%). (25)
A pre-experimental study was conducted on factors influencing the food choices of Irish children and
adolescents. Focus group discussions were conducted with 29 young people from three age groups (9-10, 13-
14 and 16-18 years). An inductive thematic analysis identified three key factors as influencing food choices.
These factors included intra-individual factors: the link between food preferences and awareness of healthy
eating; intra-familial factors: the role of the home food environment; and extra-familial factors: eating away
from the home. Findings indicate that there were developmental differences between children's and
adolescents' perceptions of factors influencing food choice. Among adolescents, parental control began to
diminish and adolescents exercised increased autonomy over their food choices compared with children. (26)
An exploratory study was conducted on current fast food consumption status among middle school
students and explored factors influencing fast food consumption by applying Theory of Planned Behavior. A
total of 354 (52.5% boys) students were recruited from a middle school. The subjects completed a pre-tested
questionnaire. The average monthly frequency of fast food consumption was 4.05 (4.25 for boys, 3.83 for
girls). As expected, fast food consumption was considered to be a special event rather than part of an
everyday diet, closely associated with meeting friends or celebrating, most likely with friends, special days.
The Theory of Planned Behavior effectively explained fast food consumption behaviors with relatively high
R2 around 0.6. Multiple regression analyses showed that fast food consumption behavior was significantly
related to behavioral intention (b = 0.61, P < 0.001) and perceived behavioral control (b = 0.19, P < 0.001).
Further analysis showed that behavioral intention was significantly related to subjective norm (b = 0.15, P <
0.01) and perceived behavioral control (b = 0.56, P < 0.001). (27)
A cross-sectional survey was conducted, the objective of which was to determine the use of street
foods and fast foods purchased by South Africans living in different provinces and geographic areas.
13
Structured interview-administered questionnaires in 11 official languages were conducted at the participants'
homes. A nationally representative sample (n = 3287) was drawn from all ethnic groups, and provinces
including participants 16 years and older. Logistic regression was done to evaluate factors impacting on fast
food consumption. Frequent (2 ≥ times/week) street food consumption ranged from 1.8% in Northern Cape
to 20.6% in Limpopo; frequent (2 ≥ times/week) fast food consumption ranged between 1.5% in North West
Province to 14.7% in Gauteng. The highest intake of street food was in the medium socio-economic category
(14.7%) while the highest intake of fast foods was in the high socio-economic category (13.2%). Overall,
fruit was the most commonly purchased street food by all ethnic groups over the previous week although this
practice was highest in black participants (35.8%). Purchases of soft drinks ranged from 4.8% in whites to
16.4% in blacks and savory snacks from 2.3% to 14.5% in whites and blacks, respectively. (28)
A descriptive study was conducted to identify psychosocial factors that influence fast-food
consumption in urban and rural Costa Rican adolescents. A self-administered questionnaire designed for the
study asked about sociodemographic information, frequency of fast-food consumption, meaning of "fast
food," location of purchase, and psychosocial correlates. Five psychosocial factors were extracted by using
principal components analysis with Varian rotation method and eigenvalues. Descriptive statistics and a
hierarchical linear regression model were used to predict the frequency of fast-food consumption. Responses
from 400 adolescents (ages 12-17 y) reveal that daily consumption of fast food was 1.8 times more
frequently mentioned by rural adolescents compared with urban youth. Urban and rural differences were
found in the way adolescents classified fast foods (rural adolescents included more traditional foods like
chips, sandwiches, and Casado-a dish consisting of rice, black beans, plantains, salad, and a meat), and in
purchasing locations (rural adolescents identified neighborhood convenience stores as fast-food restaurants).
Living in rural areas, convenience and availability of foods, and the presence of external loci of control were
predictors of a higher frequency of fast-food consumption, whereas health awareness predicted a lower
frequency. (29)
A descriptive study was conducted on Growing menace of fast food consumption in India. High
consumption of fast food has been reported in school going children and this is quite substantial in college
and university students - in spite of the fact that a significant proportion of population are aware about
adverse consequences of fast food consumption. Children of pregnant and lactating women eating fast foods
are more prone to obesity. High fat and high sugar diet leads to change in fetal brain reward pathway altering
food preferences. Fast food consumption is rising in India across all income categories and this is
contributing significantly to rising trend of non-communicable diseases (NCDs) in this country. Regulation
of marketing and nutritional labeling is not up to mark in India. (30)
A survey was conducted on fast food Consumption in children. Sponsorship of sports or cultural
competitions with attractive gifts is the main way of promotion of first food sale. Nuclear families, working
mother, socioeconomic status, and close proximity of fast food shop, food test and quick service in the shop
are important contributing factors of fast food consumption. This kind of food is responsible for obesity,
hypertension, dyslipidemia, heart disease and diabetes. Easy availability of healthy food with reasonable
prices along with its campaign, school midday-food programme and health education can improve dietary
habits of children. Implementation of laws for regulation of marketing and selling of fast food may be
another step in controlling consumption of such food by our children.(31)
A qualitative study was conducted in 2012 - 2013 in Tehran, the capital of Iran. To achieve the
objective of this study was to investigate the factors influencing fast-food consumption among adolescents in
Tehran, Iran, 42 adolescents were enrolled in this study through a purposive sampling method, and the
14
required data was collected via individual semi-structured in-depth interviews. Data collection and analysis
were carried out simultaneously, and the collected data was analyzed via a thematic content analysis. In this
study after coding the transcribed interviews, the findings were categorized into three main themes as
follows: personal views, social factors, and family factors. Each theme included several categories and
subcategories, and the coded sentences and phrases were placed under each category and subcategory. The
results of this study showed that the number of factors promoting fast-food consumption appeared to be
more than the inhibiting factors and that the diverse factors at the individual and social level influenced fast-
food consumption among adolescents. (32)
A study was conducted to determine factors affecting the frequency of fast food consumption.
Progress in science, technology, and industry has changed human lifestyle and especially food consumption
habits. For many families, especially in large urban centers, fast food consumption has become routine. This
study surveyed 396 families using Poisson and negative binomial regression models. The main reasons that
households consume fast food are a shortage of time and for entertainment. Policy makers could use social
marketing tools to control the growing trend of fast food consumption. (33)
A qualitative study was conducted on factors influencing eating behavior and dietary intake among
resident students in a public university in Bangladesh. Adopting a qualitative approach, 25 in-depth
interviews and 13 focus group discussions with students of various disciplines and semesters. Thematic
analysis was used to analyze the textual data, and methodological triangulation to validate the information
provided. Student eating behavior and dietary intake are influenced by a variety of factors. Individual factors
(cooking skills, food taste, food taboos, and knowledge and perceptions), societal factors (influence of peers
and social norms), factors related to university (campus culture and frequency of examination), and
environmental factors (availability of cooking resources and facilities and food prices) emerged as the key
aspects that determine students’ eating behavior and dietary intake. This is the first study that explored
factors influencing nutritional behavior and dietary intake among resident graduates in a Bangladeshi
university. The results suggest that resident students have a poor dietary intake that might have a harmful
impact on their health, well-being, and academic performance. Therefore, multilevel nutritional interventions
may be beneficial to promote healthy eating behavior and dietary intake among university students. (34)
􀂙 Studies related to and effects of junk food on mucosal layer of GI tract
A descriptive study was conducted on specific dietary components have been associated with
gastroesophageal reflux disease (GERD) in Europe and the United States. A total of 268 patients who were
newly diagnosed as reflux esophagitis (RE) in Outpatient Endoscopy Center of Tongji Hospital were
recruited. In addition, 269 sex- and age-matched subjects were also recruited as controls. The body
measurements were determined, and the dietary intake during the previous year was evaluated using food
frequency questionnaire (FFQ). Stepwise multiple logistic regression analysis was performed to examine the
association between nutrients and RE. After adjustment for WC, WHR, total energy intake, and
demographics, there were a positive dose-response relationship between RE and calcium, meat, oils, and salt
and a negative dose-response relationship between RE and protein, carbohydrate, calories from protein (%),
vitamin C, grains and potatoes, fruits, and eggs. High intake of meat, oils, salt, and calcium is associated
with an increased risk for RE while high intake of protein, carbohydrate, calories from protein (%), vitamin
C, grains and potatoes, fruits, and eggs correlates with a reduced risk for RE. (35)
15
A descriptive study was conducted on the effect of high- fat diet –induced pathophysiological changes
in the gut on obesity. Although gut is protected by immune system and contains high level of antioxidants,
obesity developed presumably when this protective mechanism is compromised by the presence of excessive
fat. Several therapeutic approaches targeting different pathways have been proposed. There may be no one
single most effective treatment, but all aimed to prevent obesity. This review will elaborate on the
physiological and molecular changes in the gut that lead to obesity, and will provide a summary of potential
treatments to manage these pathophysiological changes(36)
A descriptive study was conducted on the impacts of the western diet on immunity. The manuscript
reviews the impacts and mechanisms of harm for our over-indulgence in sugar, salt, and fat, as well as the
data outlining the impacts of artificial sweeteners, gluten, and genetically modified foods; attention is given
to revealing where the literature on the immune impacts of macronutrients is limited to either animal or in
vitro models versus where human trials exist. Detailed attention is given to the dietary impact on the gut
microbiome and the mechanisms by which our poor dietary choices are encoded into our gut, our genes, and
are passed to our offspring. While today's modern diet may provide beneficial protection from micro- and
macronutrient deficiencies, our over abundance of calories and the macronutrients that compose our diet
may all lead to increased inflammation, reduced control of infection, increased rates of cancer, and increased
risk for allergic and auto-inflammatory disease.(37)
A descriptive study was done on the impact of diet and lifestyle on gut microbiota and human health.
The impacts of dietary fats and protein on the gut microbiota are less well defined. Both short- and long-term
dietary change can influence the microbial profiles, and infant nutrition may have life-long consequences
through microbial modulation of the immune system. The impact of environmental factors, including aspects
of lifestyle, on the microbiota is particularly poorly understood but some of these factors are described. They
also discussed the use and potential benefits of prebiotics and probiotics to modify microbial populations. A
description of some areas that should be addressed in future research is also presented. (38)
A study was conducted on modern diet and its impact on human health. Diet conscious like the
mainstream populace, are now getting the message that wise dietary fat choices offer essential fatty acids,
blood lipid management, maintained endocrine and immune function, inflammation control, metabolic
effects and even potential body composition and performance benefits. Toward this end, many companies
now sell specialty dietary fat supplements and recognized health authorities have begun recommending them
to certain population. Increasingly, the average consumer has come to regard the supermarket as obstacle of
conflicting and potentially dangerous dietary decisions: low fat, high fat, no fat; no meat, less fatty meat; no
eggs, one egg a week, unlimited eggs; less carbohydrate, more whole grains, no cereal products; more fruit,
less sugar; and so on. The present review of studies aims to strengthen our knowledge regarding the dietary
requirements, food sources, and potential benefits, Modern food and its impact on human health. Practical
suggestions for incorporating healthy fats will be made. Both food-source and supplemental intakes will be
addressed with interrelationships to health throughout. (39)
A study was conducted on role of the intestinal mucosa in acute gastrointestinal graft-versus-host
disease (GVHD) remains a significant obstacle to the success of allogeneic hematopoietic cell
transplantation. Recent advances have significantly improved our understanding of the interactions between
the intestinal mucosa and the enteric microbiota. Changes in host mucosal tissue and commences post
transplant have been actively investigated, and provocative insights into mucosal immunity and the enteric
microbiota are now being translated into clinical trials of novel approaches for preventing and treating acute
16
GVHD. In this review, we summarize recent findings related to aspects of the intestinal mucosa during acute
GVHD.(40)
A study was conducted on role of diet in inflammatory bowel disease. Gut microbiota of twenty two
patients suffering from IBD (acute stage) was compared with gut microbiota of the follow-up samples from
same patient (remission stage). Biopsy samples were collected via colonoscopy, and tissue samples were
processed immediately upon collection for isolation of DNA. Mucosal micro biota was analyzed by means
of 16S rRNA gene-based short gun clone library sequencing. Clostridium difficile co-infection during IBD
was analyzed using qPCR method. Results: Analysis of 6437 good quality sequences demonstrated a
significant reduction of bacterial diversity consistently from phylum to species level (p-value < 0.05) of
individuals in the acute phase of IBD, Significant increase in abundance of unusual aerobes and facultative
anaerobes, including members from the phylum Proteobacteria (p-value=0.031) was also observed.
Infectious bacterial communities belonging to genus Stenotrophomonas, Parabacteroides, Elizabethkingia,
Pseudomonas, Micrococcus, Ochrobactrum and Achromobacter were found to be dominant the intestine
during the acute phase of IBD as compared to IBD patients in remission phase. (41)
A study was conducted on diet and nutritional factors in inflammatory bowel diseases. A diet with a
modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides,
disaccharides, monosaccharide’s and polyols are under investigation. Due to chronic inflammation as well as
side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor
deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It
should also be remembered that there is no single common diet suitable for all IBD patients; each of them is
unique and dietary recommendations must be individually developed for each patient, depending on the
course of the disease, past surgical procedures and type of pharmacotherapy. (42)
A study was conducted on the behavior of dietary fiber in the gastrointestinal tract determines its
physiological effect. The behavior of DF in the human digestive tract is discussed and linked to its
physiological effect with special attention to four aspects of such behavior: (i) the modulation of
bioavailability by the plant cell walls, (ii) the effect of DF on the rheological and colloidal state of digesta,
(iii) the binding of DF with phenolic compounds, bile salts, mineral ions, and digestive enzymes, and (iv) DF
fermentation in the large intestine and the corresponding effect on microbiota composition. It is stressed that
the detailed chemical characterization of DF is crucial to explain its effect on health and that DF behavior in
the digestive tract can be modulated by interactions with other food and meal components so that
information of the bare content in DF of food is not sufficient to predict its physiological effect. (43)
A comparative study was conducted on foods inducing typical gastroesophageal reflux disease
symptoms in Korea. Non communicable diseases (NCDs)—mainly cancers, cardiovascular diseases,
diabetes, and chronic respiratory diseases—are responsible for about two-thirds of deaths worldwide, mostly
in low-and middle-income countries. Effective approaches for large-scale NCD prevention include
comprehensive tobacco and alcohol control through taxes and regulation of sales and advertising; reducing
dietary salt, unhealthy fats, and sugars through regulation and well-designed public education; increasing the
consumption of fresh fruits and vegetables, healthy fats, and whole grains by lowering prices and improving
availability; and implementing a universal, effective, and equitable primary-care system that reduces NCD
risk factors. Comparison of disease rates across populations or over time, especially when done in relation to
risk-factor levels in the population, indicates by how much disease may be prevented and what the most
important risk factors are at the population level. (44)
17
A study was conducted on examination of diet for the maintenance of remission in inflammatory
bowel disease For the Diet has been speculated to be a factor in the pathogenesis of inflammatory bowel
disease and may be an important factor in managing disease symptoms. Patients manipulate their diet in
attempt to control symptoms, often leading to the adoption of inappropriately restrictive diets, which places
them at risk for nutritional complications. Health professionals struggle to provide evidence-based nutrition
guidance to patients due to an overall lack of uniformity or clarity amongst research studies.(45)
A study was conducted on the gastric mucosal-associated microbiome in patients with gastric
polyposis. The characteristics of the gastric microbiota in patients with gastric polyposis (GP) remain
unclear. Given this we collected gastric antrum and gastric body biopsies from healthy controls (HC.A
and HC.B group) and gastric antrum, gastric body and polyp biopsies from patients with multiple gastric
polyps (GP.A, GP.B and GP.P group) for 16S rDNA sequencing. The results showed that the diversity of
the gastric flora in the GP group was significantly lower than that of the HC group. The gastric flora
composition of the GP group was significantly different from the HC group. However, flora diversity and
compositions in different parts of the stomach (gastric antrum, gastric body or polyp tissue) were not
significantly different. H. pylori abundance could influence the composition of gastric microbiota.
Meanwhile, patients with fundic gland polyps (FGPs) and those with hyperplastic polyps (HPs) had
considerably similar gastric bacterial compositions. (46)
􀂙 Studies related to the effectiveness of teaching programme on effects of junk food.
A pre- experimental study was done, the purpose of which was to assess the effectiveness of
structured teaching program on knowledge regarding harmful effects of junk food among adolescents at
Jalandhar, Punjab. Total of 60 adolescents were selected by non-probability convenience sampling
technique. The pre-test was taken by using self structured questionnaire followed by structured teaching
programme .After 7 days post –test was taken. The mean percentage of the knowledge score of post test
(22.88) was higher than pre test (12.96). The ‘t’ value for total pre test and post test was 16.76. The
difference between pre- test knowledge score and post test knowledge score was 9.92. It means that the
knowledge score was increased after structured teaching programme. The finding of the study revealed that
the education had a vital role in improving the knowledge of adolescents regarding effects of junk food . (47)
A pre--experimental study on adolescents of 11 to 18 years of age in Delhi to determine the

effectiveness of planned teaching programme on knowledge regarding health hazards of junk foods. They
study comprised of 100 adolescents selected through purposive sample method. The data collection was
done with self-administered questionnaire. Inferential statistics and descriptive statistics were used to
analyze the data. The results showed that the mean pretest score was 9.95 and mean post test score was
18.50 the mean difference between the pretest knowledge score and post test knowledge score was 8.55.The
study concluded that planned teaching programme was effective in order to increase the knowledge of the
adolescents. (48)
A pre experimental study was conducted on knowledge regarding harmful effects of junk food among
adolescents. This study was carried out to assess effectiveness of planned teaching program through a
structured knowledge questionnaire. A quantitative research approach and pre experimental one group pre
test post test research design was adopted to conduct study. Structured knowledge questionnaire was used to
assess the knowledge of adolescents regarding harmful effects of junk food. Pre test was taken on first day
followed by planned teaching programme to group and then post test was taken after seven days. In pre test
majority adolescents (65%) had average level of knowledge but in post test majority adolescents (55%) had
18
good level of knowledge. There was significant difference between the mean pre test and post test
knowledge score (t = 9.590, p = 0.0001). (49)
A study was conducted to identify the effectiveness of teaching program on knowledge and
practice on consuming junk food among adolescents. A Quantitative Research approach of pre experimental
research design with one group pretest posttest was chosen for the study. The study was conducted in a
Private high school, Puducherry. The samples were the adolescents between 13-15years. A total of 100
samples were recruited for the study using non- probability convenient sampling technique. Descriptive and
inferential statistics were used for the analysis. The paired t test revealed that there was a statistical
significant difference between pre test and post test knowledge and practice of consuming junk food after the
video assisted teaching programme at p<0.001 level. As the junk food industry targets children, it is
important to ban junk food from schools and places where children have easy access to these foods. Health
professionals should play an active role in imparting health education regarding the ill effects of consuming
junk food.(50)
A non-experimental descriptive survey study was conducted to assess the knowledge regarding the
effects of fast food on health among adolescents in selected Pre University College at Mangaluru. To assess
the knowledge regarding the effects of fast food on health among adolescents in selected Pre University
College and the association between knowledge of adolescents regarding the effect of fast food on health
and the selected demographic variables. A structured knowledge questionnaire regarding effects of fast food
consumption was prepared in order to assess the knowledge of adolescents. A sample of 100 adolescents was
selected by using non probability purposive Sampling technique. The result revealed that 13% of
adolescents had inadequate knowledge, 69% has moderate knowledge and 18% has adequate knowledge
regarding effects of fast food on health. It was also found that there is a significant association between the
knowledge score with selected demographic variables. The study results show that only 18% of adolescents
were having adequate knowledge regarding effects of fast food on health. Hence it is necessary to improve
the adolescent’s knowledge on health hazards of fast food in order to save them from the ill effects of fast
food. (51)
19
4, METHODOLOGY
Research methodology is a way of systemically solving the research problems. It explains the steps
that are generally adopted by a researcher in studying the research problem along with the logic behind
them. (17)
Research methodology involves the systematic procedure by the researcher, which starts from initial
identification of the problem to its final conclusion. This chapter deals with the type of research approach
used, research design, setting of the study, population, sample and sampling techniques, criteria for selection
of samples, development and description of tools, pilot study, data collection and plan for data analysis.
Research Approach
The selection of research approach is the basic procedure for the research of enquiry. The research
approach helps the researcher to determine how to collect the data and analyze the data. It also suggests
possible conclusions to be drawn from the data. In view of the nature of the problem selected for the present
study and the objectives to be accomplished, an evaluative approach was considered the best to determine the
effectiveness of structured teaching programme.
An evaluative research is generally applied where the primary objective is to determine the extent to
which a given procedure meets the desired result.
Research Design
A researcher’s overall plan for obtaining answers to the research questions or for testing hypothesis is
referred to as the research design.
In the present study, Quasi-experimental pre-test post-test design was selected. The primary objective
of the study was to find the effectiveness of structured teaching programme.
20
The design chosen for the study is presented in the table as follows.
Group Pre-test Intervention Post-test
Nursing students Day 1 Day 1 After 7 days of structured teaching

programme knowledge of students
Assessment of Structured
is assessed using same structured
knowledge using teaching
knowledge questionnaire.
structured programme
knowledge regarding effect of
questionnaire junk food on
regarding effect of mucosal layer of
junk food on GI Tract.
mucosal layer of GI
Tract.
S O1 X O2
TABLE - 1 shows research design
The symbols used are

S = Single group
O1 = Assessment of knowledge by pre test
X = Structured teaching programme on effect of junk food on mucosal layer of GI Tract
O2 = Assessment of knowledge by post test.
21
Fig: 2 Schematic represemtation of the study design
22
Research setting
The setting is the physical location and conditions in which data collection takes place in a study.
The study was conducted in RR College of Nursing Bengaluru. The college was selected for the study on the
basis of:
 Geographical proximity
 Availability of the sample
 Familiarity with the setting
 Economic feasibility for conducting the study.
Variables under study
Variable is an attribute of a person or object that varies when taken on different values. The variables
in this study are
1. Independent variables: Structured teaching programme which includes effect of junk food on mucosal
layer of GI Tract.
2. Dependent variables: Level of knowledge on effect of junk food on mucosal layer of GI Tract.
3. Demographic variables: Age, gender, religion, permanent residence, presently residing at, family income,
previous exposure to the information, source of information and do you consume junk food.
Population
Population is a group whose member possesses specific attributes that a researcher is interested to study. The
population in the present study comprises of nursing students studying in Bengaluru.
Sample and sampling technique
Sample refers to a sub set of population, selected to participate in the research study. Sampling refers to the
process of selecting a portion of population to represent the entire population. The sample of this study
comprised of 60 1st year BSc Nursing students studying in RR College Chikkabanavara at Bengaluru. Non
probability purposive sampling method was used to draw the sample.
Criteria for Selection of Sample
A) Inclusion criteria:
1. 1st year nursing students of selected nursing colleges.
2. Adolescent nursing students between the age group of 16-19 years.
23
3. Adolescent nursing students who were willing to participate in the study
B) Exclusion criteria:
1. Nursing students who are not available at the time of data collection.
2. Nursing students who are exposed to similar teaching previously.
Data collection tool
Selection and development of the tool
A Structured knowledge questionnaire was selected for the study to assess the knowledge of
nursing students regarding effect of junk food on mucosal layer of GI Tract as it was considered to be most
appropriate tool to elicit there response from the students. To meet the objectives of the study the tool was
developed by the researcher. The tool used for the study comprised of a structured knowledge questionnaire
and was prepared on following steps;
 Review of literature to provide adequate content area and information.

 Consultation and discussion with experts from Medical surgical Nursing and doctor.
 Reviewing of textbooks.
 Discussion and consultation with the statistician.
 The final tool was prepared with guidance and suggestion of the guide.
Preparation of Blue Print
The blue print of the structured knowledge questionnaire was prepared according to the demographic
characteristics and knowledge of nursing students regarding effect of junk food on mucosal layer of GI
Tract. The blue print consisted of 30 questions and depicted the distribution of items according to the content
areas based on three domains namely knowledge, comprehension, and problem solving. The prepared items
were subjected to content validation, pre-testing and estimation of reliability.
Development of criteria rating scale

Criteria rating scale for validation of tool was development
Part-I - Comprised of socio-demographic data
Part-II- Comprised of structured knowledge questionnaire on effect of junk food on mucosal layer of GI
Tract which had Relevant, Need modification, Not relevant, and Remarks of experts.
Description of the tool
The structured knowledge questionnaire consisted of two sections

24
Part-I:
Consisted of 9 items related to socio-demographic variables as age in years, gender, religion,

permanent residence, presently residing at, monthly family income, previous exposure to information, source
of information on effect of junk food on mucosal layer of GI Tract and do you consume junk food.
Part - II –Structured knowledge questionnaire consisted of 30 multiple choice questions on knowledge

regarding effect of junk food on mucosal layer of GI Tract under 4 headings
Section - A
Questions on anatomy and physiology of mucosal layer of GI Tract
Section- B
Questions on factors promoting junk food consumption
Section-C
Questions on health hazards of junk food
Section-D
Questions on effects of junk food on mucosal layer of GI Tract
Each item of the schedule has one correct answer and three wrong answers, every correct answer
would fetch one mark and wrong answer fetch zero mark and the total score of the knowledge questionnaire
is 30.
Scoring of items
There were 30 items. Each of which has four options with one accurate answer. The score for correct
response to each item was ‘one’ and incorrect response was ‘zero’. Thus for 30 items maximum
obtainable score was 30 and minimum was zero.
Percentage = obtained score ×100

Total score
To find out the association with the selected demographic variables and knowledge scores, respondents
are categorized into three groups.
25
Knowledge scores were classified as:
<50% Inadequate
51% to 75% Moderate
76% and above Adequate
Table 2: Classification of knowledge scores
Testing of the tool
Content Validity of the tool
The prepared blue print of the tool along with objectives of the study was submitted to 14 experts
who included 12 Medical Surgical Nursing experts, 1 Doctor and 1 Statistician.
The suggestions given by them were incorporated and the tool was modified. The final tool got its
shape after modification based on the opinions of the guide. It consisted of 9 socio-demographic data items
and knowledge questionnaires 30 items.
Reliability of the tool
The tool after validation was subjected to test for its reliability by administering structured
knowledge questionnaire to 10 samples. The reliability of the tool is computed using Split Half Karl
Pearson’s correlation formula (Raw Score Method) and Internal Consistency Reliability.
Spearman Brown’s Prophecy formula was used to find out the reliability of the full test.
R= 2r
1+ r
R - Reliability co-efficient of correlation of whole test
R - Reliability co-efficient of correlation of half test
The reliability co-efficient worked to be 0.97 for structured knowledge questionnaire, revealing
that the tool is feasible for administration for the main study. Since the knowledge reliability co-
efficient for the scale r >0.70, the tool was found to be reliable and feasible.
Development of the structured teaching programme (STP):
Structured Teaching Programme on knowledge regarding effect of junk food on mucosal layer of GI
Tract was developed based on review of literature and consulting with experts.
26
The steps adopted in the development of Structured Teaching Programme were:
 Preparation of first draft of Structured Teaching Programme

 Development of criteria checklist to evaluate the Structured Teaching Programme
 Content validity of Structured Teaching Programme
 Editing of Structured Teaching Programme
 Preparation of final draft of Structured Teaching Programme
Preparation of First Draft
Structured Teaching Programme was prepared on the basis of review of literature, which was
pertaining to the development of STP on effect of junk food on mucosal layer of GI Tract.
Development of Criteria Checklist to evaluate the Structured Teaching Programme
 Identification and stating of objectives in behavioral terms
The teaching objectives were identified and written in behavioral terms depending on the needs of
the learner i.e., effect of junk food on mucosal layer of GI Tract.
 Selection of the content
The content of effect of junk food on mucosal layer of GI Tract was selected through literature search and
in consultation with the subject experts and their suggestions and opinions. Then content was analyzed into
sub topics and sub topics were broken down into elements.
 Organization of the content
The content selected was organized under following main headings.
 Introduction
 Anatomy and physiology of mucosal layer of GI Tract
 Definition of junk food
 Types of junk food
 Category of people consuming junk food
 Contributing factors
 Factors promoting junk food consumption
 Health hazards of junk food
 Effect of junk food on mucosal layer of GI Tract
27
 Factors contributing to healthy digestion
 Conclusion & Summary.
Content Validity of the STP:
The initial draft of Structured Teaching Programme was given to 14 experts in the field along with
the tool. To assess the content validity of Structured Teaching Programme a criteria checklist was used,
which consisted of criteria for four areas. Against each criterion four responses were given and a column
was provided for their remarks. The suggestions were incorporated in the Structured Teaching Programme.
Planning to Implement the STP:
The time and date was decided to implement the Structured Teaching Programme.
Preparation of Final Draft of STP:
The draft of Structured Teaching Programme consisted of introduction, content and summary. The
illustration was presented in Structured Teaching Programme along with the AV Aids on effect of junk food
Pilot study
Pilot study is a small scale version or a trail run done in preparation for a major study. The function of
the pilot study is to obtain information for improving the project or assessing its feasibility.
A pilot study was conducted from 08-10-2018 to 15-10-2018 at Varalakshmi College of Nursing
Bengaluru. Approval was obtained from the Principal to conduct the pilot study. The purposes of the pilot
study were to:
 Evaluate the effectiveness of Structured Teaching Programme on effect of junk food on mucosal
layer of GI Tract
 Find out the feasibility of conducting the final study and
 Determine the method of statistical analysis
28
10 1st year nursing students of Varalakshmi College of Nursing were selected. On day 1, pre-test was
conducted by using structured knowledge questionnaire, on the same day Structured Teaching Programme
was conducted for 45 minutes. On 7thday, the post-test was conducted by using same structured knowledge
questionnaire to evaluate the effectiveness of Structured Teaching Programme on knowledge regarding
effect of junk food on mucosal layer of GI Tract among nursing students.
The overall mean percentage knowledge score of post-test (81.7%) was higher than the mean
percentage knowledge score of pre-test (47.7%), with the enhancement mean percentage knowledge scores
(34.0%) were found to be significant at 5% (P<0.05) level. The findings of the Pilot Study revealed that the
Study is feasible.
Procedure for data collection
(a) Permission from the concerned authority
The researcher took into consideration the ethical issues. Formal prior permission was obtained
from the Principal RR College of Nursing Bengaluru to conduct the study through the Principal,
Varalakshmi college of Nursing, Bengaluru-57 and conducted as per schedule. Oral and written
consent was obtained from the study samples and explanation was given regarding purpose of the
study.
(b) Period of data collection
The main study was conducted between 01-11-2018 to 30-11-2018 for period of 4 weeks at RR
College of Nursing Bengaluru.
(c) Pre-test (O1)
Data collection is the gathering of information from the sampling units. The researcher
collected data from 60 1st year nursing students in RR College of Nursing Bengaluru.
The need of the study and confidentiality was assured. 60 1st year nursing students were
administered with tool. Structured knowledge questionnaire was used to collect the data from nursing
students studying in RR College of Nursing Bengaluru, after obtaining permission from the authority
and consent from the subjects. The researcher collected data from 60 students in one day and it took
approximately 45 minutes for subjects to complete structured knowledge questionnaire.
29
(d) Implementation of structured teaching programme (X)
Followed by pre-test on same day structured teaching programme was conducted by the researcher
in English language.
(e) Post-test (O2)
The same structured knowledge questionnaire was used to collect the post-test data. Post-test
data was collected on 8th day after structured teaching programme.
Plan of data analysis
The data obtained was analyzed in terms of achieving the objectives of the study using descriptive
and inferential statistics.
Statistical Analysis of Data
A. Descriptive Statistics
1. Frequency and percentage will be used to analyze personal data of nursing students studying in RR
College of Nursing Bengaluru.
2. Percentage distribution, mean, mean percentage and standard deviation will be used to assess the
level of knowledge of nursing students studying in RR College of Nursing Bengaluru.
B. Inferential Statistics.
1. Paired‘t’ test will be used to compare the pre-test and post- test knowledge scores.
2. Chi-square will be used to determine the association between level of knowledge and selected socio
demographic variables.
30
SAMPLE SIZE ESTIMATION
The sample size was calculated based on comparison of mean with standard deviation (5.1) of pilot
study.
The sample size was estimated using the formula
n = z2σ2
d2
Where,
n = required sample size
z= standard table value for 95% confidence interval (1.96)
σ = standard deviation (5.1)
d = precision (1.28)
n = (1.96)2 x (5.1)2
(1.28)2
n =61.2
Through this, recommended sample size was 61.2, the study was conducted among an arbitrary 60 samples
after discussion with the experts.
31
5. RESULTS
This chapter deals with the analysis and interpretation of the data collected in order to determine the
effectiveness of structured teaching programme on knowledge regarding effect of junk food on mucosal
layer of GI Tract, among 60 nursing students in selected Nursing colleges at Bengaluru who completed the
three major phases of the study.
Analysis of data is a process by which quantitative information is reduced, summarized, organized,

evaluated, interpreted and communicated in a meaningful way.
The analysis and interpretation of data of this study are based on data collected through a structured
questionnaire among students. The results were computed using descriptive and inferential statistics based
on the objectives of the study.
 Pre-test phase
 Learning phase
 Post-test phase
The data gathered itself do not provide us with answers to our research questions. Ordinarily, the
amount of data collected in study is rather extensive and therefore needs to be processed and analyzed in an
orderly coherent fashion so that patterns of relationship can be discerned the central focus of the task of
analysis is the testing of research hypothesis.
Objectives of the study:
The data of this study was analyzed on the basis of the following objectives.
1. To assess the existing knowledge of nursing students regarding the effect of junk food on mucosal layer
of GI Tract in selected nursing colleges at Bengaluru.
3. To find out the association between pre-test knowledge score regarding the effect of junk food on mucosal
Bengaluru.
32
Research hypotheses:
socio demographic variables among nursing students in selected Nursing Colleges at Bengaluru
Organization and presentation of data:

In order to find out the gain in knowledge and also to find out the relationship between the variables
the data gathered was tabulated, analyzed and interpreted using both descriptive and inferential statistics.
Based on the objectives and hypothesis the data are presented under the following headings:-
Section I: Socio-demographic characteristics of respondents.
Section II: Overall and aspect wise knowledge scores of respondents in pre test, post test and effectiveness
in terms of enhancement of knowledge.
Section III: Analysis of association between Pre-test knowledge scores and selected socio- demographic
variables.
The findings are presented in tables 3 to 28 and figures 3 to 21
33
SECTION-I
Socio-demographic characteristics of respondents
TABLE – 3
Classification of Respondents by Age
N=60
Characteristics Category Respondents
Number Percent
Age group (years) 16-17 26 43.3
18-19 34 56.7
Total 60 100.0
The above table reveals that majority 34(56.7%) respondents belongs to the age group of 18-19 years, rest
26(43.3%) respondents belongs to the age group of 16-17 years.
56.7
60.0
Respondents (%)
43.3
50.0
40.0
30.0
20.0
10.0
-
16-17 18-19
Age group (years)
Figure 3: Classification of respondents by age
34
TABLE -4
Classification of respondents by Gender
N=60
Number Percent
Gender Males 23 38.3
Females 37 61.7
Total 60 100.0
The above table depicts that majority 37(61.7%) respondents were Females, rest 23(38.3%) were Males.
70.0
60.0
Respondents (%)
50.0
40.0
61.7
30.0
20.0 38.3
10.0
-
Male Female
Gender
Figure 4: Classification of respondents by gender
35
TABLE – 5
Classification of Respondents by Religion

N=60
Number Percent
Religion Hindu 45 75.0
Muslim 7 11.7
Christian 5 8.3
Others 3 5.0
Total 60 100.0
The above table depicts that majority 45(75.0%) respondents were Hindus, 7(11.7%) respondents were
Muslims, 5(8.3%) respondents were Christians and remaining 3(5.0% were of other religions.
Religion
80
70
60
50
Respondents (%)
40
75
30
20
10
11.7 8.3 5
0
Hindus Muslims Christains Others
Figure 5: Classification of respondents by religion
36
TABLE- 6
Classification of Respondents by Permanent residence

N=60
Number Percent
Permanent residence Urban 25 41.7
Rural 35 58.3
Total 60 100.0
The above table shows that 35(58.3%) respondents were from rural areas, 25(141.7%) respondents were
from urban areas.
58.3
60.0
50.0 41.7
Respondents (%)
40.0
30.0
20.0
10.0
-
Urban Rural
Permanent Residence
Figure 6: Classification of respondents by Permanent residence
37
TABLE – 7
Classification of respondents by presently residing at
N=60
Number Percent
Presently residing at Home 7 11.7
Hostel 45 75.0
Relative’s house 8 13.3
Total 60 100.0
The above table shows that majority of students 45(75%) respondents presently reside at hostel, 8(13.3)
reside at relative’s house, and rest 7(11.7%) reside at home
75.0
80.0
Respondents (%)
60.0
40.0
11.7 13.3
20.0
0.0
Home Hostel Relatives
Present Residence
Figure 7: Classification of respondents by Presently residing at
38
TABLE – 8
Classification of Respondents by Family income

N=60
Number Percent
Family income/month Rs.5,000-10,000 11 18.3
Rs.10,001-15,000 22 36.7
Rs.15,001-20,000 27 45.0
Total 60 100.0
The above table depicts that majority of respondents 27(45%) had family monthly income between 15,001-
20,000, 22(36.7%) respondents had monthly family income between 10,001-15,000 11(18.3%) had family
income between 5,000-10,000
60.0
45.0
50.0
Respondents (%)
36.7
40.0
30.0
18.3
20.0
10.0
-
Family income/month
Figure 8: Classification of respondents by monthly income in rupees
39
TABLE – 9
Classification of Respondents by Previous exposure to information
N=60
Number Percent
Previous exposure to Yes 11 18.3
information of effect of junk
No 49 81.7
foods on mucosal layer of GI
Tract
Total 60 100.0
The above table depicts that majority 49(81.7%) had information and 11(18.3%) had no information.
81.7%
18.3%
Yes No
Figure 9: Classification of Respondents by Previous exposure to information
40
TABLE – 10
Classification of Respondents by Source of information
N=11
Number Percent
Source of Print media 2 18.2
information Visual media 3 27.3
Health professionals and 4 36.4
friends
Internet 2 18.2
Total 11 100.0
The above table depicts that 2(18.2) respondents had source of information from print media, 3(27.3%)
respondents had source of information from visual media, 4(36.4%) respondents had source of information
from health professionals and friends, rest 2(18.2%) had source of information from internet.
40
36.4
35
% of POST PTCA patients
30 27.3
25
20 18.2 18.2
15
10
0
Print media Visual media Health personnels Internet
& friends
If yes, source of information
Figure 10: Classification of Respondents by Source of information
41
TABLE – 11
Classification of Respondents by Do you consume junk food
N=60
Number Percent
Do you consume junk food Yes 43 71.7
No 17 28.3
Total 60 100.0
The above table depicts that majority 43(71.7%) consume junk food and 17(28.3%) do not consume junk
foods.
28.3
Yes
71.7 No
Figure 11: Classification of Respondents by Do you consume junk food
42
SECTION – II
Overall and aspect wise knowledge scores of respondents in pre test, post test and effectiveness of STP
in terms of enhancement of knowledge
This section deals with the findings related to knowledge scores of participants in terms of
 Findings related to pre-test knowledge scores of students
 Findings related to post-test knowledge scores of students
 Findings related to enhancement of knowledge scores of students
Objectives
 To assess the existing knowledge of nursing students regarding the effect of junk food on mucosal
layer of GI Tract in selected nursing colleges at Bengaluru.
 To determine the effectiveness of structured teaching programme regarding the effect of junk food on
mucosal layer of GI Tract among nursing students in selected nursing colleges at Bengaluru
43
TABLE – 12
Overall aspect wise Pre-test Knowledge scores of Respondents on effect of junk food on mucosal layer
of GI Tract
N = 60
Knowledge Category Respondents
Level
Number Percent
Inadequate ≤ 50 % Score 37 61.7
Moderate 51-75 % Score 23 38.3
Adequate > 75 % Score 0 0.0
Total 60 100.0
The above table shows that 61.7% of the respondents in pre-test had inadequate knowledge (≤ 50%) and
38.3 %( 51-75%) of respondents had moderate knowledge and 0 %(> 75%) had adequate knowledge on
effect of junk food on mucosal layer of GI Tract.
70.0 61.7
Respondents (%)
60.0
50.0 38.3
40.0
30.0
20.0
10.0 0.0
0.0
Inadequate Moderate Adequate
Knowledge level
Figure 12: Overall aspect wise Pre-test Knowledge scores of respondents on effect of junk food on
mucosal layer of GI Tract
44
TABLE -13
Aspect wise Pre test Mean Knowledge scores of Respondents on effect on Junk food on mucosal layer
of GI tract
N=60
No. Knowledge Aspects Statem Max. Knowledge Scores
ents Score Mean SD Mean(%) SD(%)
I Anatomy and Physiology of 5 5 2.17 0.7 43.3 14.7

Mucosal laver of GI tract
II Factors promoting junk 4 4 1.95 0.9 48.8 22.6
food consumption
III Health hazards of junk food 4 4 1.82 1.1 45.4 26.4
IV Effects of junk food on 17 17 7.52 2.3 44.2 13.7
mucosal laver of GI tract
Combined 30 30 13.45 3.8 44.8 12.6
The above table reveals that the aspects wise pre-test mean knowledge of respondents regarding effect of
junk food on mucosal layer of GI Tract. The highest mean pre-test knowledge percentage seen in aspects of
factors promoting junk food consumption was 48.8% with a SD 22.6% followed by health hazards of junk
food was 45.4% with a SD 26.4%, then anatomy and physiology of mucosal layer of GI Tract as 43.3% and
lowest pre-test mean knowledge percentage seen in effects of junk food on mucosal layer of GI Tract was
44.2% with a SD 13.7%.
45
TABLE -14
Overall and Aspect wise Post-test Knowledge Scores of Respondents on effect of junk food on mucosal
layer of GI Tract
N = 60
Knowledge Category Respondents

Level
Number Percent
Inadequate ≤ 50 % Score 0 0.0
Moderate 51-75 % Score 33 55.0
Adequate > 75 % Score 27 45.0
Total 60 100.0
The above table shows that majority of the respondents in post-test had adequate knowledge 33(55.0%),
27(45.0%) had moderate knowledge and 0(0.0%) had inadequate knowledge regarding effect of junk food
55.0
60.0
45.0
50.0
Respondents (%)
40.0
30.0
20.0
10.0 0.0
-
Knowledge level
Figure 13: Classification of Respondents of Post-test Knowledge level on effect of junk food on
mucosal layer of GI Tract.
46
TABLE -15
Aspect wise Post-test Mean Knowledge scores of Respondents on effect of junk food on mucosal layer
of GI Tract
N=60
No. Knowledge Aspects Statem Max. Knowledge Scores
ents Score Mean SD Mean SD (%)
(%)
I Anatomy and Physiology of 5 5 3.08 1.1 61.7 22.6
Mucosal laver of GI tract
II Factors promoting junk 4 4 3.33 0.7 83.3 17.5
food consumption
III Health hazards of junk food 4 4 3.45 0.6 86.3 15.4
IV Effects of junk food on 17 17 13.53 1.7 79.6 9.8
Combined 30 30 23.40 3.1 78.0 10.4
The above table reveals that the aspects wise post-test mean knowledge of respondents regarding effect of
junk food on mucosal layer of GI Tract. The highest mean post-test knowledge percentage was seen in
aspects of health hazards of junk food as 86.3% with a SD 15.4%, followed by factors promoting junk food
consumption was 83.3% with a SD 17.5%, then effects of junk food on mucosal layer of GI Tract was 79.6%
with a SD 9.8% and anatomy and physiology of mucosal layer of GI Tract as 61.7% with a SD 22.6%.
47
TABLE – 16
Over all Pre-test and Post-test Mean Knowledge scores on effect of junk food on mucosal layer of GI
Tract
N=60
Aspects Max. Knowledge Scores Paired
Score Mean SD Mean (%) SD (%) ‘t’
Test
Pre test 30 13.45 3.8 44.8 12.6
29.90*
Post test 30 23.40 3.1 78.0 10.4
Enhancement 30 9.95 2.6 33.2 8.6
* Significant at 5% level, t (0.05, 59df) = 1.96
The above table depicts that Pre-test mean knowledge percentage was 44.8% and post –test mean
knowledge percentage was 78.0% with enhancement of 33.2%, with paired‘t’ test value of 29.90 which is
significant at 0.05 level as calculated value is greater than table value.
78.0
60.0
44.8
50.0
Mean scores (%)
40.0 33.2
30.0
20.0
10.0
-
Pre test Post test Enhancement
Knowledge
Figure 14: Over all Pre-test and Post-test Mean Knowledge scores on effect of junk food on mucosal
layer of GI Tract
48
TABLE – 17
Classification of Respondents on Pre-test and Post-test Knowledge level on effect of junk food on
N=60
Knowledge Category Classification of Respondents χ2

Level Pre test Post test Value
N % N %
Inadequate ≤ 50 % Score 37 61.7 0 0.0
65.79*
Moderate 51-75 % Score 23 38.3 33 55.0
Adequate > 75 % Score 0 0.0 27 45.0
Total 60 100.0 60 100.0

* Significant at 5% level, χ2 (0.05,2df ) = 5.991
The above table depicts that in pre-test 37 (61.7%) had inadequate knowledge and in Post-test none of them
had inadequate knowledge, 23(38.3%) respondents had moderate knowledge in Pre-test and 33(55.0%) in
Post-test, no respondents had adequate knowledge in Pre-test and 27 (45.0%) respondents had adequate
knowledge in Post-test.
Pre test Post test
61.7
Respondents (%)
55.0
45.0
38.3
0.0 0.0
Inadequate Moderate Adequate
knowledge level
Figure 15: Classification of Respondents on Pre-test and Post-test Knowledge level on effect of junk
49
TABLE – 18
Aspect wise Mean Pre-test and Post-test Knowledge scores on effect of junk food on mucosal layer of
GI Tract
N=60
No. Knowledge Aspects Respondents Knowledge (%) Paired
Pre test Post test Enhancement ‘t’
Mean SD Mean SD Mean SD Test
I Anatomy and Physiology 43.3 14.7 61.7 22.6 18.3 24.3 5.83*
of Mucosal laver of GI
tract
II Factors promoting junk 48.8 22.6 83.3 17.5 34.6 21.0 12.76*
food consumption
III Health hazards of junk 45.4 26.4 86.3 15.4 40.8 26.2 12.06*
food
IV Effect of junk food on 44.2 13.7 79.6 9.8 35.4 9.5 28.86*
Combined 44.8 12.6 78.0 10.4 33.2 8.6 29.90*
* Significant at 5% level, t (0.05,59df ) = 1.96
The above table reveals that the aspect wise mean pre-test and post-test and knowledge enhancement
scores on effect of junk food on mucosal layer of GI Tract. The mean pre-test knowledge percentage
regarding anatomy and physiology of mucosal layer of GI Tract was 43.3%, SD 14.7% and the post-test
mean percentage 61.7%, SD 22.6%, with enhancement of the mean knowledge 18.3% and SD 24.3% was
found. Knowledge regarding factors promoting junk food consumption the pre-test mean 48.8%, SD 22.6%
and post-test mean 83.3%, SD 17.5% with the enhancement of mean knowledge 34.6% and SD 21.0% was
found. Knowledge regarding health hazards of junk food the pre-test mean 45.4%, SD 26.4% and post-test
mean 86.3%, SD 15.4%, with the enhancement of mean knowledge 40.8% and SD 26.2% was found.
Knowledge regarding effect of junk food on mucosal layer of GI Tract the pre-test mean 44.2%, SD 13.7%
and post-test mean 78.0%, SD 10.4, with the enhancement of mean knowledge 33.2% and SD 8.6% was
found.
The overall mean score in the pre-test was 44.8%, SD 12.6% and post-test mean 78.0%, SD 10.4 with an
enhancement of mean 33.2% and SD 8.6%. The statistical paired‘t’ test indicates the enhancement in the
mean knowledge scores is found to be significant at 0.05 level for all the aspect under the study.
50
Pre test Post test
100.0
86.3
83.3
Mean scores(%)
79.6
80.0
61.7
60.0
48.8
43.3 45.4 44.2
40.0
20.0
0.0
I II III IV
Knowledge Aspects
Figure 16: Aspect wise Mean Pre-test and Post-test Knowledge scores on effect of junk food on
51
SECTION – III
Analysis of association between Pre-test knowledge scores and selected socio- demographic variables
This section deals with analysis and interpretation of the data collected to find out the association
between demographic variables and knowledge scores of participants. A non parametric chi-square (X2) test
was used to describe the association between knowledge scores and selected demographic variables.
Objective
 To find out the association between pre-test knowledge score regarding the effect of junk food on
mucosal layer of GI Tract and selected demographic variables among nursing students in selected
nursing colleges at Bengaluru.
52
TABLE – 19
Association between Demographic variables and Pre test Knowledge level on Effects on Junk food on
mucosal layer of GI tract
N=60
Demographic Category Sa Knowledge Level χ2 P
Variables mpl Inadequate Moderate Value Value
e N % N %
Age group (years) 16-17 26 20 76.9 6 23.1 4.47* P<0.05
18-19 34 17 50.0 17 50.0 (3.841)
Gender Male 23 18 78.3 5 21.7 4.45* P<0.05
Female 37 19 51.4 18 48.6 (3.841)
Religion Hindu 45 28 62.2 17 37.8 0.1033 P>0.05
Muslim 7 4 57.1 3 42.9 NS (7.815)
Christian 5 3 60.0 2 40.0
Others 3 2 66.7 1 33.3
Permanent residence Urban 25 11 44.0 14 56.0 5.68* P<0.05
Rural 35 26 74.3 9 25.7 (3.841)
Presently residing at Home 7 6 85.7 1 14.3 6.396* P<0.05
Hostel 45 29 64.4 16 35.6 (5.991)
Relatives house 8 2 25.0 6 75.0
Family income/month Rs.5000-10000 11 6 54.6 5 45.4 0.90 P>0.05
Rs.10001-15000 22 15 68.2 7 31.8 NS (5.991)
Rs.15001-20000 27 16 59.3 11 40.7
Exposure to Yes 11 3 27.2 8 72.8 6.01* P<0.05
information
No 49 33 67.3 16 32.7 (3.841)
If Yes n= 11
Source of information Print media 2 1 50.0 1 50.0 5.107 P>0.05

Visual media 3 2 66.7 1 33.3
Health 4 0 0.0 4 100.0 NS (7.815)
professionals
and friends
Internet 2 0 0.0 2 100.0
Consume Junk food Yes 43 26 60.4 17 39.6 0.014 P>0.05
NS (3.841)
No 17 10 58.9 7 41.1
* Significant at 5% Level, NS: Non-significant
Note: Figures in the parenthesis indicate Table value
53
TABLE – 20
Association between Age group and Pre-test Knowledge level on effect of junk foods on mucosal layer
of junk food
N=60
Variable Category Sample Knowledge Level χ2 P
Inadequate Moderate Value Value
N % N %
Age group 16-17 26 20 76.9 6 23.1 4.47* P<0.05
(years) (3.841)
18-19 34 17 50.0 17 50.0
Combined 60 37 61.7 23 38.3
The above table describes the association between age group and Pre-test knowledge level on effect
of junk food on mucosal layer of GI Tract. In the present study, 76.9% of the respondents belonging to age
group 16-17years have inadequate knowledge on effect of junk food on mucosal layer of GI Tract, 23.1% of
the respondents of the age group 16-17years have moderate knowledge.50.0% of the respondents belonging
to age group 18-19years have inadequate knowledge and 50.0% have moderate knowledge on effect of junk
food on mucosal layer of GI Tract.
The obtained chi-square value was found to be 4.47*, P <0.05(3.841). Hence, there is a significant
association between age group and knowledge level of respondents so research hypothesis is accepted.
54
Inadequate Moderate
76.9
80.0
70.0
60.0 50.0 50.0
Respondnets (%)
50.0
40.0
30.0 23.1
20.0
10.0
0.0
16-17 18-19
Age group (years)
Figure 17: Association between Age group and Pre-test Knowledge level on effect of junk food on
55
TABLE – 21
Association between Gender and Pre-test Knowledge level on effect of junk food on mucosal layer of
GI Tract
N= 60
N % N %
Gender Male 23 18 78.3 5 21.7 4.45* P<0.05
(3.841)
Female 37 19 51.4 18 48.6
Combined 60 37 61.7 23 38.3
The above table indicates association between gender and knowledge scores on effect of junk food on
mucosal layer of GI Tract. Among male respondents 78.3% had inadequate knowledge and 21.7% had
moderate knowledge. Among female respondents 51.4% had inadequate knowledge and 48.6% had
moderate knowledge regarding effect of junk food on mucosal layer of GI Tract.
The obtained chi-square value was found to be 4.45, P >0.05(3.841). Hence, there significant association
between gender and knowledge level of respondents so research hypothesis is accepted.
56
Inadequate Moderate
78.3
80.0
70.0
Respondents (%)
60.0 51.4
48.6
50.0
40.0
30.0 21.7
20.0
10.0
0.0
Male Female
Gender
Figure 18: Association between Gender and Pre-test Knowledge level on effect of junk food on mucosal
layer of GI Tract
57
TABLE – 22
Association between Religion and Pre-test Knowledge level on effect of junk food on mucosal layer of
GI Tract
N=60
N % N %
Religion Hindu 45 28 62.2 17 37.8 0.1033 P>0.05
Muslim 7 4 57.1 3 42.9 NS (7.815)
Christian 5 3 60.0 2 40.0
Others 3 2 66.7 1 33.3
Combined 60 37 61.7 23 38.3
The above table indicates association between religion and knowledge scores on effect of junk food
on mucosal layer of GI Tract. Among Hindu respondents 62.2% had inadequate knowledge and 37.8% had
moderate knowledge level. Among Muslim respondents 57.1% had inadequate knowledge and 42.9% had
moderate knowledge. Among Christian respondents 60.0% had inadequate knowledge and 40.0% had
moderate knowledge regarding effect of junk food on mucosal layer of GI Tract.
The obtained chi-square value was found to be 0.1033, P >0.05(7.815). Hence, there is no significant
association between religion and knowledge level of respondents so research hypothesis is rejected.
58
TABLE – 23
Association between Permanent residence and Pre-test Knowledge level on effect of junk food on
N=60
Inadequat Moderate Valu Value
e e
N % N %
Permanent Urban 25 11 44.0 14 56.0 5.68 P<0.05
residence (3.841)
Rural 35 26 74.3 9 25.7
Combined 60 37 61.7 23 38.3
* Significant at 5% level, NS: Non-significant
The above table indicates association between permanent residence and knowledge scores on effect
of junk food on mucosal layer of GI Tract. Among respondents with permanent residence in urban areas
44.0% had inadequate knowledge and 56.0% had moderate knowledge level. Among respondents with
permanent residence in rural areas 74.3% had inadequate knowledge and 25.7% had moderate knowledge
regarding effect of junk food on mucosal layer of GI Tract.
The obtained chi-square value was found to be 5.68, P <0.05(3.841). Hence, there is significant
association between permanent residence and knowledge level of respondents so research hypothesis is
accepted.
59
Inadequate Moderate
74.3
80.0
Respondnets (%)
56.0
60.0
44.0
40.0 25.7
20.0
0.0
Urban Rural
Permanent residence
Figure 19: Association between Permanent residence and Pre-test Knowledge level on effect of
Junk food on mucosal layer of GI Tract
60
TABLE – 24
Association between Presently residing at and Pre-test Knowledge level on effect of junk food on
N=60
N % N %
Presently Home 7 6 85.7 1 14.3 6.396* P>0.05
residing at Hostel 45 29 64.4 16 35.6 (5.991)
Relative’s 8 2 25.0 6 75.0
house
Combined 60 37 61.7 23 38.3
The above table indicates association between presently residing at and knowledge scores on effect
of junk food on mucosal layer of GI Tract. Among respondents presently residing at home 85.7% have
inadequate knowledge and 14.3% have moderate knowledge level. Among respondents presently residing at
hostel 64.4% have inadequate knowledge and 35.6% had moderate knowledge. Among respondents
presently residing at relative’s house 25.0% have inadequate knowledge and 75.0% had moderate regarding
The obtained chi-square value was found to be 6.396, P >0.05(5.991). Hence, there is significant
association between occupation and knowledge level of respondents so research hypothesis is accepted.
61
Inadequate Moderate
85.7
90.0
75.0
Respondnets (%)
80.0
64.4
70.0
60.0
50.0
35.6
40.0
25.0
30.0
14.3
20.0
10.0
0.0
Home Hostel Relatives
Present residence
Figure 20: Association between Permanent residence and Pre-test Knowledge level on effect of
junk food on mucosal layer of GI Tract
62
TABLE – 25
Association between Monthly family income and Pre-test Knowledge level on effect of junk food on
N=60
N % N %
Family Rs.5,000-10,000 11 6 54.6 5 45.4 0.094 P>0.05
income/m Rs.10,001- 22 15 68.2 7 31.8 NS (5.991)
onth 15,000
Rs.15,001- 27 16 59.3 11 40.7
20,000
Combined 60 37 61.7 23 38.3
The above table indicates association between Family income and knowledge scores on effect of
junk food on mucosal layer of GI Tract. The respondents who have monthly income between Rs. 5,000-
10,000, 54.6% had inadequate knowledge and 45.4% have moderate knowledge level. The respondents who
have monthly income between Rs. 10,001 - 15,000, 68.2% had inadequate knowledge and 31.8% had
moderate knowledge. The respondents who had monthly income between Rs. 15,001-20,000, 59.3% had
inadequate knowledge and 40.7% had moderate knowledge regarding effect of junk food on mucosal layer
of GI Tract.
The obtained chi-square value was found to be 0.094, P <0.05(5.991). Hence, there is a no significant
association between family income and knowledge level of respondents so research hypothesis is rejected.
63
TABLE – 26
Association between Previous exposure to information on effect of junk food on mucosal layer of GI
Tract and Pre-test Knowledge level on effect of junk food on mucosal layer of GI Tract
N=60
N % N %
Previous Yes 11 3 27.2 8 72.8 6.01* P<0.05
exposure to No 49 33 67.3 16 32.7 (3.841)
information
Combined 60 36 60.0 24 40.0
The above table indicates association between previous exposure to information and knowledge
scores on effect of junk food on mucosal layer of GI Tract. The respondents who replied with Yes, 27.2%
had inadequate knowledge and 72.8% have moderate knowledge level. The respondents who replied with
No, 67.3% had inadequate knowledge and 32.7% had moderate knowledge regarding effect of junk food on
The obtained chi-square value was found to be 6.01, P <0.05(3.841). Hence, there is a significant
association between previous information and knowledge level of respondents so research hypothesis is
accepted.
64
80 72.8
67.3
70
60
Respondents(%)
50
32.7 Inadequate
40
Moderate
27.2
30
20
10
0
Yes No
Previous information
Figure 21: Association between Previous exposure information and Pre-test Knowledge level on effect
of junk food on mucosal layer of GI Tract
65
TABLE – 27
Association between source of information and Pre-test Knowledge level on effect of junk food on
N=11
N % N %
Source of Print media 2 1 50.0 1 50.0 5.107 P>0.05
information Visual media 3 2 66.7 1 33.3 NS (7.815)
Health professionals 4 0 0.0 4 100.0
and friends
Internet 2 0 0.0 2 100.0
Combined 11 3 27.2 8 72.8
The above table indicates association between source of information and knowledge scores on effect
of junk food on mucosal layer of GI Tract. The respondents who had print media as source of information,
50.0% have inadequate knowledge and 50.0% have moderate knowledge level. The respondents who had
visual media as source of information, 66.7% have inadequate knowledge and 33.3% have moderate
knowledge. The respondents who had health professionals and friends as source of information, 0.0% has
inadequate knowledge and 100.0% have moderate knowledge. The respondents who had internet as source
of information, 0.0% has inadequate knowledge and 100.0% have moderate knowledge regarding effect of
junk food on mucosal layer of GI Tract.
The obtained chi-square value was found to be 5.107, P <0.05(7.815). Hence, there is no significant
association between source of information and knowledge level of respondents so research hypothesis is
rejected.
66
TABLE – 28
Association between Do you consume junk food and Pre-test Knowledge level on effect on junk foods
N=60
Variable Categor Sample Knowledge Level χ2 P
y Value Value
Inadequate Moderate
N % N %
Do you Yes 43 26 60.4 17 39.6 0.014 P>0.05
consume NS (3.841)
No 17 10 58.9 7 41.1
junk foods
Combined 60 36 60.0 24 40.0
The above table indicates association between Do you consume junk foods and knowledge scores on
effect of junk food on mucosal layer of GI Tract. Among respondents who have replied yes, 60.4% had
inadequate knowledge and 39.6% had moderate knowledge level. Among respondents who have replied No,
58.9% have inadequate knowledge and 41.1% had moderate knowledge regarding effect of junk food on
The obtained chi-square value was found to be 0.014, P >0.05(3.841). Hence, there is no significant
association between consumption of junk foods and knowledge level of respondents so research hypothesis
is rejected.
67
7. CONCLUSION
This chapter presents the conclusions drawn, implications and recommendations. The main aim of
the study was to assess the existing knowledge of nursing students on effect of junk food on mucosal layer
of GI Tract, to conduct structured teaching programme regarding effect of junk food on mucosal layer of
GI Tract and to evaluate the effectiveness of structured teaching programme among nursing students. The
research approach adopted in the present study is a Quasi-experimental approach and 60 nursing students
were selected using non-probability purposive sampling technique. A structured knowledge questionnaire
was used to assess the knowledge of nursing students. The data was interpreted by suitable appropriate
statistical methods which help the nursing students to enhance their knowledge regarding effect of junk
The following conclusions were drawn on the basis of the findings of the study:
1) The pre-test knowledge score among majority of nursing students was found to be inadequate and
post-test knowledge score is enhanced.
2) There was significant enhancement in knowledge of nursing students after conducting structured
teaching programme on effect of junk food on mucosal layer of GI Tract.
3) There was significant association between pre-test knowledge scores and selected socio-demographic
variables such as age in years, gender, permanent residence, presently residing, and exposure to
information at 0.05 levels.
4) The findings of the study revealed that there was no significant association between pre-test
knowledge score and few selected socio-demographic variables such as religion, monthly income of
family, source of information, and do you consume junk food at 0.05 levels.
Nursing Implications:
The main aim of the present study is to educate the nursing students regarding effect of junk food on
mucosal layer of GI Tract. The study revealed that there are gaps in knowledge of nursing students. It is
indicated that concentrated efforts should be taken by teachers in educating the nursing students regarding
effect of junk food on mucosal layer of GI Tract to impart knowledge.
The findings of this study have implications in the field of Nursing education, Nursing practice,
Nursing administration and Nursing research. The dissemination of the knowledge takes place when the
research findings are made use in the following fields.
73
Nursing Practice: -
A nurse plays a vital role at the fore front of health care battles. The contributions made by nurses
have always made significant difference for improving health care quality. Nurse’s role has always been
extended and expanded with the changing trends. Innovations in health care, expanding health care systems
and practice settings & the increasing needs of patients have been as stimulus for new nursing roles
One of the major roles that nurse play is educating the client and community regarding various health
related facts. Updating the knowledge of staff nurses is a very important task which helps the staff nurses to
prepare the clients and attendants regarding effect of junk food on mucosal layer of GI Tract.
The content of the structured teaching programme module will help the Nursing personnel in all
areas like hospital as well as community area and clinics for teaching the people to avoid consumption of
junk food and switch on to traditional home made foods.
Nursing Education:
The nurse educator can use the structured teaching programme module to teach the students as well
as health workers to improve their knowledge regarding effect of junk food on mucosal layer of GI Tract and
motivate the people for adopting healthy eating practices. The institutes of nursing education should play an
active role in conducting education programmes, workshop and continuing education programmes to educate
nursing personnel of the hospital regarding effect of junk food on mucosal layer of GI Tract. The nurse
educators can target the nurses and multipurpose health workers in the community areas. Continuing
Nursing Education programs along with training of trainers programs can be organized to help them in
imparting education on effect of junk food on mucosal layer of GI Tract.
 As a nurse educator, there are abundant opportunities for nursing professionals to educate the student
nurses who are in the clinical posting, and visitors regarding effect of junk food on mucosal layer of
GI Tract.
 It can be used as a training module for educating the health workers.
 Nurse educators can use the findings of this study to upgrade her knowledge and find the other
different strategies which are simple so that it will be easy to educate the nursing students.
Nursing Administration:
Nursing Administration should take active part in policy making, developing, validating, approving
protocols, procedures and standing orders concerning structured teaching for students.
 They should concentrate on proper selection, placement and effective utilization of the nurses in all
areas, giving room for creativity, interest and ability in providing structured teaching programme for
74
the needed areas must provide opportunity for innovations, trial of emerging trends in the video
teaching in fostering care.
 An ongoing education programme on educative role of the nurses along with good supervision of
nursing care service would motivate nurses to carry out the role in day to day nursing care.
 Publishing paper related to the use of structured teaching programme and trial of structured teaching
programme would help sharing of knowledge and strengthening the practice in various settings.
 Efficient administrators can help in dissemination of research based knowledge
through organization of in-service education program regarding effect of junk
 Nursing administration should promote necessary facilities and opportunities for nursing staff to
equip themselves with the knowledge to deal with various types of visitors, willing to take health
education on knowledge regarding effect of junk food on mucosal layer of GI Tract.
 Nursing administration should encourage and conduct various types of health educational and family
planning camps in the community as well as in the hospital, which will encourage people to
acceptance of healthy eating patterns.
Nursing research:
 Based on the present study further research can be conducted related to practice of consumption of
junk food and the factors influencing the use of junk food.
 Exclusively illiterate people can be taught to improve their knowledge on effect of junk food on
mucosal layer or GI Tract, to develop positive attitude towards the healthy eating practices.
 Nursing research will help to know the nurse’s role in developing knowledge of the people and
developing the attitude related to hazards of consumption of junk food.
Limitations of the study:

The limitations recognized in the study were
1. It is difficult task to collect information from students because of the time table and back to back
classes they have. Researcher tried his best to collect factual data at the highest possible level.
2. Sample selected for the study was limited to nursing students only.
3. The tool used for data collection was not a standardized tool, so the researcher made the tool and it
was a structured tool with close ended question, leads to restricted free response of the nursing
students.
4. The data collected was based only on written responses of the students.
5. Study is limited to specific geographic area which may limit the generalization.
6. Long-term follow-up could not be carried out due to limited time
75
7. Only a single domain that is knowledge is considered in the present study.
8. The sample for the study was limited to 60 nursing students studying in selected nursing colleges at
Bengaluru.
Recommendations:
Suggestions and Recommendations for further study based on the findings of the study the following
recommendations could be made
 The similar study can be undertaken on large scale
 An Experimental study can be carried out with control group for effective comparison of results.
 Comparative study can be conducted in urban and rural areas.
 A follow up study need to be conducted to find the effectiveness in terms and retention of
knowledge.
 Study can be conducted at community settings among the people.
 Study can be conducted among adolescent students doing courses other than nursing.
 Study can be conducted among school going children.
 Study can be conducted at hospital settings among the visitors.
 A self-instructional module can be prepared related to effect of junk food on mucosal layer of GI
Tract and find out its effectiveness.
 A study can be conducted to know the existing role of the nursing personnel regarding health
education on effect of junk food on mucosal layer of GI Tract.
Summary
This chapter has brought out various implications of the present study and also provided suggestions for
future studies. Such a type of study will add to the body of knowledge of the nursing profession.
This chapter has also dealt with the conclusion of the findings of the study. It was found that structured
teaching programme regarding effect of junk food on mucosal layer of GI Tract has been able to effectively
improve the knowledge of nursing students.
“Preparation through education is less costly than learning through the tragedy”
76
7. CONCLUSION
This chapter presents the conclusions drawn, implications and recommendations. The main aim of
the study was to assess the existing knowledge of nursing students on effect of junk food on mucosal layer
of GI Tract, to conduct structured teaching programme regarding effect of junk food on mucosal layer of
GI Tract and to evaluate the effectiveness of structured teaching programme among nursing students. The
research approach adopted in the present study is a Quasi-experimental approach and 60 nursing students
were selected using non-probability purposive sampling technique. A structured knowledge questionnaire
was used to assess the knowledge of nursing students. The data was interpreted by suitable appropriate
statistical methods which help the nursing students to enhance their knowledge regarding effect of junk
The following conclusions were drawn on the basis of the findings of the study:
1) The pre-test knowledge score among majority of nursing students was found to be inadequate and
post-test knowledge score is enhanced.
2) There was significant enhancement in knowledge of nursing students after conducting structured
teaching programme on effect of junk food on mucosal layer of GI Tract.
3) There was significant association between pre-test knowledge scores and selected socio-demographic
variables such as age in years, gender, permanent residence, presently residing, and exposure to
information at 0.05 levels.
4) The findings of the study revealed that there was no significant association between pre-test
knowledge score and few selected socio-demographic variables such as religion, monthly income of
family, source of information, and do you consume junk food at 0.05 levels.
Nursing Implications:
The main aim of the present study is to educate the nursing students regarding effect of junk food on
mucosal layer of GI Tract. The study revealed that there are gaps in knowledge of nursing students. It is
indicated that concentrated efforts should be taken by teachers in educating the nursing students regarding
effect of junk food on mucosal layer of GI Tract to impart knowledge.
The findings of this study have implications in the field of Nursing education, Nursing practice,
Nursing administration and Nursing research. The dissemination of the knowledge takes place when the
research findings are made use in the following fields.
73
Nursing Practice: -
A nurse plays a vital role at the fore front of health care battles. The contributions made by nurses
have always made significant difference for improving health care quality. Nurse’s role has always been
extended and expanded with the changing trends. Innovations in health care, expanding health care systems
and practice settings & the increasing needs of patients have been as stimulus for new nursing roles
One of the major roles that nurse play is educating the client and community regarding various health
related facts. Updating the knowledge of staff nurses is a very important task which helps the staff nurses to
prepare the clients and attendants regarding effect of junk food on mucosal layer of GI Tract.
The content of the structured teaching programme module will help the Nursing personnel in all
areas like hospital as well as community area and clinics for teaching the people to avoid consumption of
junk food and switch on to traditional home made foods.
Nursing Education:
The nurse educator can use the structured teaching programme module to teach the students as well
as health workers to improve their knowledge regarding effect of junk food on mucosal layer of GI Tract and
motivate the people for adopting healthy eating practices. The institutes of nursing education should play an
active role in conducting education programmes, workshop and continuing education programmes to educate
nursing personnel of the hospital regarding effect of junk food on mucosal layer of GI Tract. The nurse
educators can target the nurses and multipurpose health workers in the community areas. Continuing
Nursing Education programs along with training of trainers programs can be organized to help them in
imparting education on effect of junk food on mucosal layer of GI Tract.
 As a nurse educator, there are abundant opportunities for nursing professionals to educate the student
nurses who are in the clinical posting, and visitors regarding effect of junk food on mucosal layer of
GI Tract.
 It can be used as a training module for educating the health workers.
 Nurse educators can use the findings of this study to upgrade her knowledge and find the other
different strategies which are simple so that it will be easy to educate the nursing students.
Nursing Administration:
Nursing Administration should take active part in policy making, developing, validating, approving
protocols, procedures and standing orders concerning structured teaching for students.
 They should concentrate on proper selection, placement and effective utilization of the nurses in all
areas, giving room for creativity, interest and ability in providing structured teaching programme for
74
the needed areas must provide opportunity for innovations, trial of emerging trends in the video
teaching in fostering care.
 An ongoing education programme on educative role of the nurses along with good supervision of
nursing care service would motivate nurses to carry out the role in day to day nursing care.
 Publishing paper related to the use of structured teaching programme and trial of structured teaching
programme would help sharing of knowledge and strengthening the practice in various settings.
 Efficient administrators can help in dissemination of research based knowledge
through organization of in-service education program regarding effect of junk
 Nursing administration should promote necessary facilities and opportunities for nursing staff to
equip themselves with the knowledge to deal with various types of visitors, willing to take health
education on knowledge regarding effect of junk food on mucosal layer of GI Tract.
 Nursing administration should encourage and conduct various types of health educational and family
planning camps in the community as well as in the hospital, which will encourage people to
acceptance of healthy eating patterns.
Nursing research:
 Based on the present study further research can be conducted related to practice of consumption of
junk food and the factors influencing the use of junk food.
 Exclusively illiterate people can be taught to improve their knowledge on effect of junk food on
mucosal layer or GI Tract, to develop positive attitude towards the healthy eating practices.
 Nursing research will help to know the nurse’s role in developing knowledge of the people and
developing the attitude related to hazards of consumption of junk food.
Limitations of the study:

The limitations recognized in the study were
1. It is difficult task to collect information from students because of the time table and back to back
classes they have. Researcher tried his best to collect factual data at the highest possible level.
2. Sample selected for the study was limited to nursing students only.
3. The tool used for data collection was not a standardized tool, so the researcher made the tool and it
was a structured tool with close ended question, leads to restricted free response of the nursing
students.
4. The data collected was based only on written responses of the students.
5. Study is limited to specific geographic area which may limit the generalization.
6. Long-term follow-up could not be carried out due to limited time
75
7. Only a single domain that is knowledge is considered in the present study.
8. The sample for the study was limited to 60 nursing students studying in selected nursing colleges at
Bengaluru.
Recommendations:
Suggestions and Recommendations for further study based on the findings of the study the following
recommendations could be made
 The similar study can be undertaken on large scale
 An Experimental study can be carried out with control group for effective comparison of results.
 Comparative study can be conducted in urban and rural areas.
 A follow up study need to be conducted to find the effectiveness in terms and retention of
knowledge.
 Study can be conducted at community settings among the people.
 Study can be conducted among adolescent students doing courses other than nursing.
 Study can be conducted among school going children.
 Study can be conducted at hospital settings among the visitors.
 A self-instructional module can be prepared related to effect of junk food on mucosal layer of GI
Tract and find out its effectiveness.
 A study can be conducted to know the existing role of the nursing personnel regarding health
education on effect of junk food on mucosal layer of GI Tract.
Summary
This chapter has brought out various implications of the present study and also provided suggestions for
future studies. Such a type of study will add to the body of knowledge of the nursing profession.
This chapter has also dealt with the conclusion of the findings of the study. It was found that structured
teaching programme regarding effect of junk food on mucosal layer of GI Tract has been able to effectively
improve the knowledge of nursing students.
“Preparation through education is less costly than learning through the tragedy”
76
8. SUMMARY
“We will never meet human needs on this infinite planet unless we stabilize human numbers”
This chapter deals with the summary of the study and its major findings along with implications. The
study was conducted to evaluate the “Effectiveness of Structured Teaching Programme on knowledge
regarding effect of junk food on mucosal layer of GI Tract, among nursing students studying in selected
nursing colleges at Bengaluru”.
Objectives of the study:
1. To assess the existing knowledge of nursing students regarding the effect of junk food on
mucosal layer of GI Tract in selected nursing colleges at Bengaluru.
2. To determine the effectiveness of structured teaching programme regarding the effect of junk
food on mucosal layer of GI Tract among nursing students in selected nursing colleges at
Bengaluru.
3. To find the association between pre-test knowledge score regarding the effect of junk food on
mucosal layer of GI Tract and selected demographic variables among nursing students in selected
nursing colleges at Bengaluru.
Hypotheses:
socio demographic variables among nursing students in selected Nursing Colleges at Bengaluru.
In the present study, related literatures were reviewed and grouped under suitable headings. The
conceptual framework for the present study is based on the General System Theory of Bertalanffy (1968). He
defines system as a complex interaction which means that system consists of two or more converted
elements which forms an organized whole and which interact with each other. In this theory, main focus was
on the discrete parts of their interrelationship, which make up and describes the whole. The present study
aimed at helping the nursing students by improving the level of knowledge regarding effect of junk food on
The research design selected for the study was Quasi-experimental, non-randomized control group.
The independent variable was structured teaching programme on effect of junk food on mucosal layer of GI
77
Tract and the dependent variable was knowledge scores of nursing students regarding effect of junk food on
The sample of this study comprised of 60 nursing students studying in RR College of Nursing
Bengaluru. Non probability purposive sampling technique was used to draw the samples of the study. The
tool developed and used for the data collection was structured knowledge questionnaire. 14 experts validated
the content validity of the tool and the tool was found to be reliable and feasible. The structured teaching
programme consisted of various aspects on effect of junk food on mucosal layer of GI Tract. The structured
teaching programme was developed with a view to enhance the knowledge of students regarding effect of
junk food on mucosal layer of GI Tract.
Pilot study was conducted 08-10-2018 to 15-10-2018 at Varalakshmi College of Nursing Bengaluru.
As a part of the major study, tool proved to be comprehensible, feasible and acceptable. Data collection
procedure for main study began from 01.11.2018 to 30.11.2018, after obtaining permission from the
concerned authorities of RR College of Nursing Bengaluru. The researcher personally explained the need to
the respondents and assured them of confidentiality of their responses.
The pre-test was administered followed by a structured teaching programme; post-test was
administered 7 days after teaching by using the same questionnaire used in the pre-test.
The data gathered were analysed and interpreted according to objectives. Descriptive statistics mean
and standard deviation were used. And inferential statistics paired‘t’ test and chi-square were included to test
the hypotheses at different levels of significance and the data obtained are presented in the graphical form.
Major findings of the study:
A. Findings related to demographic characteristics of the subjects:

 The majority 56.7% respondents fall between the age group of 18-19 years and 43.3% respondents
fall between the age group of 16-17 years.
 The majority 61.7% respondents were females and 38.3% respondents were males.
 The majority 75%respondents were Hindu, 11.7% respondents were Muslim, 8.3% were Christian
and remaining 5.0% respondents were of other religions.
 The majority 58.3% respondents had permanent residence in rural areas while as 41.7% had
permanent residence in urban areas.
 The majority 75.0% respondents were residing at hostel, 13.3.0% were residing at relative’s house
and 11.7% reside at their homes.
 The majority 45.0% respondents had family monthly income between 15,001-20,000, 36.7%
respondents had monthly family income between 10,001-15,000, and 18.3% had family income
between 5,000-10,000.
78
 The majority 81.7% respondents replied with yes and 18.3% replied with no option regarding previous
exposure to information.
 The majority 36.4% had source of information health professionals and friends, 27.3 % had visual
media, 18.2% had prints media and rest 18.2% have internet as source of information.
 The majority 71.7% replied with yes and 28.3% replied with no for if they do you consume junk food
or not.
B. Findings related to knowledge on effect of junk food on mucosal layer of GI Tract among nursing
students:
 The highest mean pre-test knowledge percentage seen in aspects of factors promoting junk food
consumption was 48.8% followed by health hazards of junk food was 45.4%, then anatomy and
physiology of mucosal layer of GI Tract as 43.3% and lowest pre-test mean knowledge percentage
seen in effects of junk food on mucosal layer of GI Tract was 44.2%.
 The highest mean post-test knowledge percentage was seen in aspects of health hazards of junk food
as 86.3%, followed by factors promoting junk food consumption was 83.3% , then effects of junk
food on mucosal layer of GI Tract was 79.6% and then anatomy and physiology of mucosal layer of
GI Tract as 61.7%.
 The overall pre-test mean knowledge percentage was found to be 44.8% and post-test mean
knowledge percentage was 78.0% with enhancement of 33.2%. Paired t-test shows statistical
significance at 5% level (p<0.05) establishing the impact of structured teaching programme on
knowledge regarding effect of junk food on mucosal layer of GI Tract, among nursing students
studying in selected nursing colleges at Bengaluru.
C. Findings related to association between Socio-demographic variables and Post-test knowledge

scores:
 The association between pre-test knowledge score and socio-demographic variables computed by
using chi-square test.
 There was significant association between age in years, gender, permanent residence, presently
residing at, and previous exposure to the knowledge with pre test knowledge scores at 5% level.
 However, there was no significant association between socio-demographic variables such as religion,
family monthly income, source of information, and do you consume junk food with the pre-test
knowledge scores.
79
9. LIST OF REFERENCES
1. Geeta Arya SM. Effects of junk food & beverages on adolescent’s health – a Review Article. IOSR J
Nurs Heal Sci [Internet]. 2013;1(6):26–32
2. Kim YS, HO SB. Intestinal Goblet Cells and Mucins in Health and Disease: Recent Insights
and Progress. Curr.Gastroenterol.Rep. 2010; 12:319–330.
3. Lang T, Hansson GC, Samuelsson T. Gel-forming mucins appeared early in metazoan evolution.
Proc.Natl.Acad.Sci.USA. 2007; 104:16209–16214. [PubMed] Describes the evolution of mucins
andespecially that the typical domain arrangement in the gel forming mucins is found already among
metazoans.
4. Syed ZA, Hard T, Uv A, van Dijk-Hard IF. A Potential Role for Drosophila Mucins in Development
and Physiology. PLoS ONE. 2008; 3:e3041.
5. Atuma C, Strugula V, Allen A, Holm L. The adherent gastrointestinal mucus gel layer: thickness and
physical state in vivo. Am.J.Physiol. 2001; 280:G922–G929. [PubMed] The mucus thickness
throughout the gastrointestinal tract was measured on live, anaestesized rats.
6. Godl K, Johansson MEV, Karlsson H, Morgelin M, Lidell ME, Olson FJ, Gum JR, Kim YS,
Hansson GC. The N-termini of the MUC2 mucin form trimers that are held together within a
trypsinresistant core fragment. J.Biol.Chem. 2002; 277:47248–47256. [PubMed].
7. Monika Singh and SunitaMishra ,“Effect of fast food on the health of school going children (9-13
years) in Lukhnow district” Indian Streams Research Journal | Volume 4 | Issue 6 | July 2014 | Online
& Print. Available at http://www.iosrjournals.org/iosr-jnhs/papers/vol1-
issue6/F0162632.pdf?id=4043.
8. https://m.indiatimes.com/health/healthyliving/how-junk-food-affects-our-digestion-238614.html
9. Bayol SA, Macharia R, Farrington SJ, Simbi BH, Stickland NC. Evidence that a maternal junk food
diet during pregnancy and lactation can reduce muscle force in offspring. Eur J Nutr2009; 48: 62-5
10. Shapiro M1, Green C, Bautista JM, Dekel R, Risner-Adler S, Whitacre R, Graver E, Fass R.
Assessment of dietary nutrients that influence perception of intra-esophageal acid reflux events in
80
patients with gastro-esophageal reflux disease.2007Jan1;25(1):93-101.
https://www.ncbi.nlm.nih.gov/pubmed/17229224.
11. Jung Wan Choe, Moon Kyung Joo, Hyo Jung Kim, Beom Jae Lee, Ji Hoon Kim, Jong Eun Yeon,
Jong-Jae Park, Jae Seon Kim, Kwan Soo Byun, and Young-Tae Bak*Foods Inducing Typical
Gastroesophageal Reflux Disease Symptoms in Korea. J Neurogastroenterol Motil. 2017 Jul; 23(3):
363–369.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503285.
12. Nneli RO1, Nwafia WC, Orji JO. Diets/dietary habits and certain gastrointestinal disorders in the
tropics: a review. Niger J Physiol Sci. 2007 Jun-Dec;22(1-2):1-
13.https://www.ncbi.nlm.nih.gov/pubmed/18379611.
13. Sai Manasa Jandhyala, Rupjyoti Talukdar, Chivkula Subramanyam, Harish Vuyyuru, Mitnala
Sasikala, and D Nageshwar Reddy. Role of the normal gut microbiota. World J Gastroenterol. 2015
Aug 7; 21(29): 8787–8803.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528021.
14. Food and Mood Centre. Diet and The Gut Microbiota. https://foodandmoodcentre.com.au/diet-and-
the-gut-microbiota.
15. Bandini LG, Vu D, Must A, Cyr H,Goldberg A, Dietz WH. Comparison of high-calorie, low-
nutrient-dense food consumption among obese and no obese adolescents. Obese Res 1999; 7:438- 43.
16. Conceptual Framework: General System Theory. Bertalanffy LV. General System Theory:
Foundations, Development, Applications. 2ndedition, Nov 1960. Library of Congress. P. 30-153
17. Polit, D.F, Hunger B.P, “Nursing Research Principles and Methods”, J.B Lippencott.co,
Philadelphia;( 2012) Pg-87, 117, 743.
18. Geeta Arya SM. Effects of junk food & beverages on adolescent’s health – a Review Article. IOSR J
Nurs Heal Sci [Internet]. 2013;1(6):26–32. Available from:http://www.iosrjournals.org/iosr-
jnhs/papers/vol1-issue6/F0162632.pdf?id=4043.
19. Monika Singh and SunitaMishra ,“effect of fast food consumption on the health of school going
children (9-13years)in Lukhnow district” Indian Streams Research Journal | Volume 4 | Issue 6 | July
81
2014 | Online & Print.
20. Chittaluri V. Biohouse Journal of Advanced Medical Research. 2015;1(4):9–13.
21. Asghari G, Yuzbashian E, Mirmiran P, Mahmoodi B, Azizi F. Fast food intake increases the
incidence of metabolic syndrome in children and adolescents: Tehran lipid and glucose study. PLoS
One. 2015;
22. Narine S. Yegiyan& Rachel L. Bailey (2016) Food as Risk: How Eating Habits and Food Knowledge
Affect Reactivity to Pictures of Junk and Healthy
Foods, HealthCommunication, 31:5, 635642, DOI: 10.1080/10410236.2014.987098.
23. Gupta A, Kapil U, Singh G. Consumption of junk foods by school-aged children in rural Himachal
Pradesh, India. Indian J Public Health 2018;62:65-7
24. Dixon HG, Scully ML, Wakefield MA, White VM, Crawford DA. The effects of television
advertisements for junk food versus nutritious food on children’s food attitudes and preferences. Soc
Sci Med. 2007;
25. Van Zyl MK, Steyn NP, Marais ML. Characteristics and factors infuencing fast food intake of young
adult consumers in Johannesburg, South Africa. South African J Clin Nutr. 2010;
26. Fitzgerald A, Heary C, Nixon E, Kelly C. Factors influencing the food choices of Irish children and
adolescents: A qualitative investigation. Health Promot Int. 2010;
27. Seo HS, Lee SK, Nam S. Factors influencing fast food consumption behaviors of middle-school
students in Seoul: an application of theory of planned behaviors. Nutr Res Pract. 2011;5(2):169-78.
28. Steyn NP, Labadarios D, Nel JH. Factors which influence the consumption of street foods and fast
foods in South Africa--a national survey. Nutr J. 2011;10:104. Published 2011 Oct 4.
doi:10.1186/1475-2891-10-104.
82
29. Monge-Rojas R, Smith-Castro V, Colón-Ramos U, Aragón MC, Herrera-Raven F. Psychosocial
factors influencing the frequency of fast-food consumption among urban and rural Costa Rican
adolescents. Nutrition. 2013;29(7–8):1007–12.
30. Keshari P, Mishra CP. Growing menace of fast food consumption in India : time to act. Int J
Community Med public Heal. 2016;
31. Das JC. Fast Food Consumption in Children: A Review. Med Clin Rev. 2016
32. AskariMajabadi H, Solhi M, Montazeri A, et al. Factors Influencing Fast-Food Consumption Among
Adolescents in Tehran: A Qualitative Study. Iran Red Crescent Med J. 2016;18(3):e23890. Published
2016 Mar 6. doi:10.5812/ircmj.23890
33. https://www.fdrsinc.org/wpcontent/uploads/2018/03/JFDR_49.1_5_Saghaian.pdf
34. Kabir A, Miah S, Islam A. Factors influencing eating behavior and dietary intake among resident
students in a public university in Bangladesh: A qualitative study. PLoS One. 2018
35. Wu P, Zhao XH, Ai ZS, Sun HH, Chen Y, Jiang YX, et al. Dietary intake and risk for reflux
esophagitis: A case-control study. Gastroenterol Res Pract. 2013;
36. Lee CY. The effect of high-fat diet-induced pathophysiological changes in the gut on obesity: What
should be the ideal treatment. Clin Transl Gastroenterol. 2013;
37. Myles IA. Fast food fever: Reviewing the impacts of the Western diet on immunity. Nutrition
Journal. 2014.
38. Conlon MA, Bird AR. The impact of diet and lifestyle on gut microbiota and human health.
Nutrients. 2015.
39. G S, N R, H M, P S. Modern Diet and its Impact on Human Health. J Nutr Food Sci. 2015;
83
40. Peled JU, Hanash AM, Jenq RR. Role of the intestinal mucosa in acute gastrointestinal GVHD.
Hematology. 2016;
41. Ruemmele FM. Role of Diet in Inflammatory Bowel Disease. Ann Nutr Metab. 2016;
42. Owczarek D, Rodacki T, Domagała-Rodacka R, Cibor D, Mach T. Diet and nutritional factors in
inflammatory bowel diseases. World Journal of Gastroenterology. 2016.
43. Capuano E. The behavior of dietary fiber in the gastrointestinal tract determines its physiological
effect. Crit Rev Food Sci Nutr. 2017;
44. Choe JW, Joo MK, Kim HJ, Lee BJ, Kim JH, Yeon JE, et al. Foods inducing typical
gastroesophageal reflux disease symptoms in Korea. J Neurogastroenterol Motil. 2017;
45. Haskey N, Gibson D. An Examination of Diet for the Maintenance of Remission in Inflammatory
Bowel Disease. Nutrients. 2017;
46. Ren R, Wang Z, Sun H, Gao X, Sun G, Peng L, et al. The gastric mucosal-associated microbiome in
patients with gastric polyposis. Sci Rep. 2018;
47. Sharma V. Adolescents Knowledge Regarding Harmful Effects of Junk food. IOSR J Nurs Heal Sci.
2013;
48. Mandeep Kaur, (2014, ), Effectiveness Of Planned Teaching Programme On Knowledge Regarding
Health Hazards Of Junk Foods Among Adolescents, American Journal Of Social Science And
Humanities, Vol 1,Page No :110-114.
49. Amoldeep, Kumari P. Effectiveness of planned teaching program on knowledge regarding harmful
effects of junk food among adolescents. Int J Health Sci Res. 2017; 7(5):176-182.
84
50. Sumathy P, Nithyakalyani P. Effectiveness of video assisted teaching programme on knowledge and
practice regarding junk food and its effects among adolescents in selected urban school at
Puducherry. 2017;3(6):574–7.
51. https://www.researchgate.net/publication/308154628_Adolescents'_Knowledge_Regarding_the_Effe
cts_of_fast_food_on_Health [accessed Dec 02 2018].
52. Conlon MA, Bird AR. The impact of diet and lifestyle on gut microbiota and human health.
Nutrients. 2015.
53. Sharma V. Adolescents Knowledge Regarding Harmful Effects of Junk food. IOSR J Nurs Heal Sci.
2013;
54. Amoldeep, Kumari P. Effectiveness of planned teaching program on knowledge regarding harmful
effects of junk food among adolescents. Int J Health Sci Res. 2017; 7(5):176-182.
85
COPY OF THE CONSENT FORM
I am voluntarily participating in the study conducted by Mr. Saif Ullah Sheikh, 2nd year
M.Sc. Nursing student of Varalakshmi college of Nursing, Bengaluru, titled
“ EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING

EFFECT OF JUNK FOOD ON MUCOSAL LAYER OF GI TRACT AMONG NURSING STUDENTS IN
SELECTED NURSING COLLEGES AT BENGALURU”
I will also co- operate with the researcher in providing necessary information. I was
explained that the information provided would be kept confidential and used only for above
mentioned study purpose.
Signature of the researcher Signature of participant
Place:
Date:
86
ETHICAL COMMITTEE CLEARANCE LETTER
87
PROFORMA
STRUCTURED KNOWLEDGE QUESTIONNAIRE

Dear respondents,
I Mr. Saif Ullah student of II Year M.Sc. Nursing, Medical Surgical Nursing specialty, would like to collect
some information about knowledge regarding effect of junk food on the mucosal layer of GI Tract.
Kindly provide your answers. I assure you that all the information furnished by you is only for research
study and will be kept confidential.
Kindly go through the questions and place a tick [√] mark against the appropriate response in the space/box
provided below.
THE QUESTIONNAIRE CONSISTS OF TWO PARTS.
PART-1 DEMOGRAPHIC DATA

PART-2 STRUCTURED KNOWLEDGE QUESTIONNAIRE
PART- I
DEMOGRAPHIC DATA
SAMPLE CODE:
DATA:
1) Age in years
a) 16--17 ( )
b) 18--19 ( )
2) Gender
a) Male ( )
b) Female ( )
3) Religion
a) Hindu ( )
b) Muslim ( )
c) Christian ( )
d) Other____________.
4) Permanent residence
a) Urban ( )
b) Rural ( )
5) Presently residing at
a) Home ( )
b) Hostel ( )
c) Relative’s house ( )
d) Other (Specify if any) ______________.
88
6) Monthly income of the family in rupees
a) 5,000-10,000 ( )
b) 10,001-15000 ( )
c) 15,001-20000 ( )
d) 20,001& above ( )
7) Previous exposure to information on effect of junk food on mucosal layer of GI Tract

a) Yes ( )
b) No ( )
8) If yes source of information regarding effect of junk food on mucosal layer of GI Tract
a) Print media ( )
b) Visual media ( )
c) Health care professionals and friends ( )
d) Internet ( )
9) Do you consume junk food

a) Yes ( )
b) No ( )
PART- II
STRUCTURED KNOWLEDGE QUESTIONNAIRE
Instructions: kindly answer all the question
 There are 30 questions on effect of junk food on mucosal layer of GI Tract and each has 4 options
 Choose the single appropriate option and put (√) mark in the bracket given against each option
SECTION – A
Anatomy and Physiology of Mucosal layer of GI Tract
1. The gastrointestinal tract (GIT or alimentary canal) is about_________ meters long

a) 9 ( )
b) 10 ( )
c) 11 ( )
d) 12 ( )
89
2. The layers of GI tract are
a) Ectoderm, Mesendoderm, Mesoderm, endoderm ( )
b) Perimetrium, Myometrium, Endometrium, Epimetrium ( )
c) Endocardium, Pericardium, Epicardium, Myocardium ( )
d) Mucosa, Submucosa, Muscularis propria, Serosa ( )
3. The inner most layer of mucosa is

a) Muscularis mucosa ( )
b) Lamina propria ( )
c) Epithelium ( )
d) Sub mucosa ( )
4. The function of mucosal layer is

a) Absorption, digestion and secretion ( )
b) Secretion, respiration and absorption ( )
c) Protection, circulation and digestion ( )
d) Absorption, secretion and protection ( )
5. Mucosal layer inhibits inflammation and infection by

a) Attaching bacteria to epithelial cells ( )
b) Separating bacteria from epithelial cells ( )

c) Crossing bacteria through epithelial cells ( )
d) Increasing bacteria count on epithelial cells ( )
SECTION – B
Factors promoting junk food consumption
6. Deep frying and refrying in the same oil are potentially

a) Have no effect on health ( )
b) Beneficial to health ( )
c) Have little effects on health ( )
d) Injurious to health ( )
90
7. Eating while doing other activities is known as
a) Unhealthy eating behavior ( )
b) Healthy eating behavior ( )
c) Psychiatric eating behavior ( )
d) Doesn’t matter ( )
8. Junk food is tasty but it has high calories and

a) High nutritive value ( )
b) Low nutritive value ( )
c) No nutritive value ( )
d) Balanced nutritive value ( )
9. Eating late night is not a good habit because it causes.

a) Weight gain ( )
b) Weight loss ( )
c) Insomnia ( )
d) Night mares ( )
SECTION - C
Health hazards of junk food
10. Eating fast food and leading a sedentary life style leads to
a) Obesity ( )
b) Good health ( )
c) Weight loss ( )
d) Malnutrition ( )
11. The presence of high dense sugar in junk food

a) Decreases the blood glucose level ( )
b) Increases the blood glucose level ( )

c) Maintains the blood glucose level ( )
d) Have no effect on blood glucose level ( )
12. The junk food with high amount of sodium may cause
a) Hypertension ( )
b) Lethargy ( )
c) Seizures ( )
d) Cirrhosis ( )
91
13. Junk food rich in oil causes
a) Increased concentration ( )
b) Lack of concentration ( )
c) Alertness ( )
d) Energetic ( )
SECTION – D
Effects of junk food on mucosal layer of GI Tract
14. Esophagitis the inflammation of

a) Esophagus ( )
b) Trachea ( )
c) Stomach ( )
d) Duodenum ( )
15. GERD refers to

a) General endoscopic radiation diameter ( )
b) Geriatric enema return deficient ( )
c) Gastro esophageal reflux disease ( )

d) Genetically engineered rare disease ( )
16. Gastritis is irritation and inflammation of the

a) Liver ( )
b) Kidneys ( )
c) Uterus ( )
d) Stomach ( )
17. Excess fats and oils along with spices added in junk foods
a) Builds up the mucosal layer ( )

b) Penetrates the mucosal layer ( )
c) Weakens the mucosal layer ( )

d) Strengths the mucosal layer ( )
92
18. Fiber lacking in junk foods is basically a good constituent of
a) Digestion ( )
b) Respiration ( )
c) Circulation ( )
d) Transmission ( )
19. Less fiber in junk foods leads the microbes to feed on
a) Epithelial cells ( )
b) Gastric glands ( )
c) Mucosal layer ( )
d) Lymphoid tissue ( )
20. Irritation and inflammation of the colon is called.

a) Colitis ( )
b) Esophagitis ( )
c) Laryngitis ( )
d) Pharyngitis ( )
21. IBD describes disorders that involve chronic inflammation of
a) Respiratory tract ( )
b) Digestive tract ( )
c) Urinary tract ( )
d) Reproductive tract ( )
22. Ulcerative colitis causes long-lasting inflammation and sores in the innermost lining of
a) Small intestine and stomach ( )

b) Large intestine(colon) and rectum ( )
c) Stomach and large intestine ( )
d) Small intestine and rectum ( )
23. Junk food do not directly cause IBD but they may
a) Aggravate it ( )
b) Suppress it ( )
c) Cause no effect ( )
d) Unknown effect ( )
93
24. Polyp is an abnormal growth of tissue protruding from the lining of
a) Nervous system ( )
b) Hematological system ( )
c) Skeletal system ( )
d) Gastrointestinal system ( )
25. High-fat foods that contain saturated, hydrogenated fats linger in stomach and are
a) Ready to digest ( )
b) Easy to digest ( )
c) Hard to digest ( )
d) None of the above ( )
26. Highly salted food can damage and cause irritation to
a) Nasal mucosa ( )
b) Oral mucosa ( )
c) Gastric mucosa ( )
d) Conjunctival mucosa ( )
27. Foods to be avoided by people who are at risk for gastritis
a) Spicy and deep fried foods ( )

b) Vegetables ( )
c) Fruits ( )
d) Organic foods ( )
28. Milk products increase

a) Acid production in the stomach ( )
b) Alkaline production in the stomach ( )
c) Mucosal production in the stomach ( )
d) Gas production in the stomach ( )
29. The junk food we consume is
a) Good for stomach ( )

b) Bad for stomach ( )
c) Have no effect on stomach ( )
d) All of the above ( )
94
30. We should take foods to
a) Satisfy taste buds ( )

b) Spend money ( )
c) Satisfy nutritional needs ( )
d) Increase weight ( )
95
MASTER CHART
96
97
98
ANNEXURE - A
Copy of Letter Seeking Permission to Conduct the Pilot Study
99
ANNEXURE – B
Copy of Letter Seeking Permission to Conduct the Main Study
100
ANNEXURE – C
Copy of Certificate for Statistical Verification
101
ANNEXURE-D
Copy of Certificate form English Expert
102
ANNEXURE – E
Letter Seeking Expert Guidance for Content Validity of the Research Study Tool
From,
Mr. Saif Ullah Sheikh
II yr. M. Sc Nursing student,
Varalakshmi College of Nursing,
T. Dasarahalli, Bengaluru -57
To,
.........................................
.........................................
Respected Sir/ Madam,

Sub: Request for opinion and suggestions of experts for establishing content validity of the research
tool.
I, Mr. SAIF ULLAH SHEIKH has selected the below mentioned topic for research project in
partial fulfillment of the university requirement for the award of Master of Science in nursing
programme.
I have developed structured knowledge questionnaire for data collection on knowledge on effect
of junk food on mucosal layer of GI Tract. I request you to kindly examine the tool for the content
validity and give your expert opinion as per the evaluation checklist enclosed.
I would be highly obliged & remain thankful for your great help if you could validate as early as
possible.
Thanking you,
Enclosures: Yours faithfully

1. Problem statement and objectives of the study (Mr. SAIF ULLAH SHEIKH)
2. Blue Print.
3. Structured knowledge questionnaire
4. Evaluation criteria rating scale for validation of tool
5. Content validity certificate
103
ANNEXURE – F
Evaluation Criteria Checklist for Validation of Tool
Respected Sir/Madam,
I request you to evaluate the research tool and give your valuable opinion and suggestions on
the developed structured knowledge questionnaire. There are four responses. Please tick (√) mark in the
appropriate column and give your remarks in the columns.
Interpretation of columns:
1. Column 1:Relevant
2. Column 2:Need modification
3. Column 3:Not relevant
4. Remarks
Your valuable opinion and kind co-operation will be highly appreciated
Thanking you in anticipation
PART - I
Socio Demographic Data
Item No. Relevant Need Not Remarks
Relevant
Modification
1. Age in years
2. Gender
3. Religion
4. Permanent residence
5. Presently residing at
6. Monthly income of the

family
7. Previous exposure to
knowledge
8. Source of information
9. Do you consume junk food
104
PART- II
A Structured Knowledge Questionnaire Regarding Effect of Junk Food on Mucosal Layer of GI
Tract
Item no. Relevant Need modification Not relevant Remarks
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
105
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Maximum Score – 30 Signature of the evaluator
Suggestions if any: Designation
106
ANNEXURE – G
Evaluation Criteria Checklist for Validation of Tool and content on Effect of Junk Food on
Mucosal Layer of GI Tract
Sl. Very Needs Not

Content Relevant Remarks
No relevant modification relevant
OBJECTIVES:
1. General objectives
2. Specific objectives
1. 3. Realistic to achieve
outcome
4. Specific to measure
the outcome
SELECTION OF
CONTENT:
1. Adequate to achieve
the objectives.
2. According to
cognitive level of
2.
nursing students.
3. Aims at improving
the knowledge level
of nursing students.
4. Continuity of
content.
ORGANIZATION OF
CONTENT:
1. Arranged in a
sequence from
3.
general to specific
2. Integration of
content from simple
to complex
LANGUAGE:
4.
1. Simple to comprehend
107
2. Clear to perceive the
meaning of content
PRACTICABILITY
AND FEASIBILITY:
1. Content motivates the
participants
2. Content improves the
knowledge level of
5.
participants.
3. Content presented in
interesting manner
4. Content is structured
and adheres to provide
adequate information
SUGGESTIONS: _______________________
Date: Signature of the Evaluator

Place:
Name and Designation
108
ANNEXURE – H
Content Validity Certificate
This is to certify that the tool developed by Mr. Saif Ullah Sheikh, II year M.Sc Nursing student
of Varalakshmi college of nursing Bengaluru (Affiliated to Rajiv Gandhi University Of Health
Sciences) is validated by undersigned and can proceed to conduct the main study for dissertation entitled
''“EFFECTIVENESS OF STRUCTURED TEACING PROGRAMME ON KNOWLEDGE
REGARDING EFFECT OF JUNK FOOD ON MUCOSAL LAYER OF GI TRACT AMONG
NURSING STUDENTS IN SELECTED NURSING COLLEGES AT BENGALURU”.
Date: Signature and seal of the expert
Place: Name and Designation
109
ANNEXURE – I
1. Dr. K. Ramu 8. Dr. Javaid

Principal Block Medical Officer
RR College of nursing Rajpora Pulwama
Bengaluru Jammu and Kashmir
2. Dr. Uma Devi 9. Mr. Preetham

Professor Professor, Medical Surgical Nursing
Kempegowda college of nursing, Kempegowda college of nursing,
Bengaluru. Bengaluru
3. Mrs. Mamatha G. C 10. Mr. Harish B
Associate Professor, Medical-Surgical Professor & HOD Medical Surgical Nursing
Nursing Cauvery College of Nursing Mysore
Govt. College of Nursing
Fort, Bengaluru-02.
4. Mrs. K. Shanmuga Priya 11. Mrs. Devi Nanjappan
Professor and HOD Medical Surgical Principal, HOD Medical Surgical Nursing
Nursing
St. Philomena’s College of Nursing Acharya College of Nursing, Bengaluru
Bengaluru
5. Mr. T.E.Sathyanarayana 12. Mr. Siddeshwar Angadi

Principal & Professor, Medical Vice Principal & Associate Professor,
Surgical Nursing Medical Surgical Nursing
Kidwai College of Nursing Bengaluru School of Nursing-Chitwan Medical College
Bharatpur, Nepal
6. Mrs. Jaya D. Shjrshetty 13. Mrs. Mahalakshmi Murthy

Principal & Professor, Medical Associate Professor, Medical Surgical
Surgical Nursing Nursing
Adarsh College of Nursing Patiala
Dhanwantari Nursing College, Bengaluru
Punjab
7. Mr. Pradeepa S 14. Mr. H.S. Surendra

Asst. Professor, Medical Surgical Associate professor, Department of
Nursing
Agril.statistics, Applied mathematics and
Kempegowda college of nursing,
Bengaluru computer sciences, university of GKVK,
Bengaluru
List of Experts Who Validated the Tool
110
ANNEXURE – J
Key Answers for the structured knowledge questionnaire

Number of Items: 30 Right Answers: 1 Mark
Total Marks: 30 Mark Wrong Answer: 0 Mark
ITEM CORRECT ITEM CORRECT
RESPONSE RESPONSE
1 A 16 D
2 D 17 C
3 C 18 A
4 D 19 C
5 B 20 A
6 D 21 B
7 A 22 B
8 B 23 A
9 A 24 D
10 A 25 C
11 B 26 C
12 A 27 A
13 B 28 A
14 A 29 B
15 C 30 C
111
ANNEXURE-K
BLUE PRINT OF STRUCTURED KNOWLEDGE QUESTIONNARE
The blue print of the structured knowledge questionnaire on effect of junk food on mucosal layer of GI
Tract
Area Knowledge Comprehension Application Total %
No. of
Item Total Item Total Item Total items
SECTION A 1 1 2,3 2 4,5 2 5 16.7%

Anatomy and Physiology
of mucosal layer of GI
Tract
SECTION B 6 1 8,9 2 7 1 4 13.3%
Factors promoting junk
food consumption
SECTION C 10 1 11,12 2 13 1 4 13.3%

Health hazards of junk
food
SECTION D 14,16, 5 15,22, 7 17,19, 5 17 56.7%

Effect of junk food on 20,21, 26,28, 27,25,
23 18,24,
30
29
Total 8 13 9 30 100%
Percentage 26.7% 43.3% 30% 100%
112
ANNEXURE – L
NAME OF THE STUDENT TEACHER : MR. SAIF ULLAH SHEIKH
SUBJECT : MEDICAL SURGICAL NURSING
TOPIC : EFFECT OF JUNK FOOD ON MUCOSAL LAYER OF GI TRACT
GROUP : NURSING STUDENTS IN SELECTED NURSING COLLEGES AT

BENGALURU
SIZE OF THE GROUP : 60
DURATION : 45 MINUTES
PREVIOUS KNOWLEDGE OF STUDENTS : NURSING STUDENTS POSSESSES SOME KNOWLEDGE ON EFFECT OF JUNK FOOD ON
MUCOSAL LAYER OF GI TRACT
METHODS OF TEACHING : STRUCTURED TEACHING PROGRAMME
A.V. AIDS : AUDIO VISUAL IMAGES ON JUNK FOOD AND THEIR EFFECTS
CENTRAL OBJECTIVE : At the end of the structured teaching programme, the participants will gain adequate knowledge regarding effect of junk food
on mucosal layer of GI Tract and accept to adopt healthy eating practices limiting the junk food use.
113
SPECIFIC OBJECTIVE:
Nursing students will be able to:
 Review anatomy and physiology of mucosal layer GI Tract.

 Define Junk food.
 Enlist the types of Junk food.
 Discuss about the category of people consuming Junk food.
 Describe the contributing factors.
 Discuss the factors promoting junk food consumption.
 List the health hazards of junk food.
 Explain the effect of junk food on mucosal layer of GI Tract.
 Enlist the factors contributing to healthy digestion.
114
TIM SPECIFIC CONTENT TEACHER’ LEARNER’S A.V EVALUA
E OBJECTIVE S ACTIVITY ACTIVITY AIDS TION
INTRODUCTION:
Group watches Power Is junk food
To introduce the Introduces the attentively healthy or
point
2 min topic Good digestion is very crucial for maintaining topic to the group unhealthy for
digestive
system?
healthy body functions. A healthy digestive
system depends on a healthy diet. The food that
has poor nutritional value is considered
unhealthy and may be called as junk food. Junk
food is unhealthy for digestive system as they
slowdown the digestion process. Junk foods have
empty calorie, i.e. the energy content is not
complemented with proteins and lipids required
for a nutritious diet. These foods do not contain
the nutrients that our body needs to stay healthy.
India’s Junk food industry is growing by 40
percent a year. Statistics place India in 10th
place in fast food per capita spending figures
115
with 2.1% of expenditure of annual total
spending
ANATOMY AND PHYSIOLOGY OF
MUCOSAL LAYER OF GI TRACT:
Review The gastrointestinal tract (digestive tract,

3 min anatomy and
physiology of digestional tract, GI tract, GIT, gut, or Reviews the Watching and
mucosal layer anatomy and listening What is GI
of GI Tract alimentary canal) is about nine meters (30 feet) physiology of Tract?
mucosal layer of
long organ system which takes in food, digests it GI Tract
to extract and absorb energy and nutrients, and
expels the remaining waste as feces. It consists
of oral cavity, where food enters the mouth,
continuing through the pharynx, oesophagus,
stomach and intestines to the rectum and anus,
where food is expelled. The GI tract contains
four layers:
a) The innermost layer is the mucosa

b) Underneath mucosa is the submucosa
c) Then muscularis propria
116
d) Outermost layer - the
adventitia/serosa.
The structure of these layers
varies, in different regions of the digestive
system, depending on their function. The
mucosal layer inhibits inflammation and
infection by separating bacteria from epithelial
cells. The mucosa further consists of three layers
of tissue:
1. Mucous membrane formed by columnar

epithelium is the inner most layer, and
has three main functions: protection,
secretion, and absorption.
2. Lamina propria consisting of loose
connective tissue, which supports the
blood vessels that nourish the inner
epithelial layer, and varying amounts of
lymphoid tissue that protects against
microbial invaders.
3. Muscularis mucosa, a thin outer layer of

smooth muscle that provides involutions
of the mucosal layer, e.g. gastric glands
117
DEFINITION:
Those commercial products, including candy,

2 min
Define junk bakery goods, ice cream, salty snacks, and soft Defines junk food Listening PowerPoi What is Junk
food carefully nt food?
drinks, which have little or no nutritional value
but do have plenty of calories, salt, and fats.
- Andrew F. Smith
TYPES OF JUNK FOOD:
1. Fast food: Fish & Chips, Pizza, Burger,

Fried chicken, Sausages, Noodles, Pasta, Enlists the
4 min Enlist the types Noodles, etc. Listening and What are the
of Junk food types of Junk discussing
2. Snacks &, Desserts: Hot-dogs, Donuts, food different
Potato chips, French fries, Crisps, types of Junk
Popcorn, Sweets, Biscuits, Tacos, Potato foods?
wedges, Pancakes, Biscuits, Cookies, etc.
French Fries, Potato Chips and other
deep fried snacks are sources of
cholesterol, trans fats, and salt that work
towards clogging the arteries. French
fries are full of fat. So, when you eat a
large serving of 220 g, you are exceeding
the safe limit for trans fats. In fried potato
chips 50-60 % of calories come from
fats.
A packet of Maggi noodles has around 3
g of salt, whereas the recommended salt
118
intake is 6 g daily. Maggi has a lot of
empty calories, with 70 % of it being just
carbohydrates!
3. Carbonated Beverages contain a very

high concentration of sugar. Their sugar-
free or zero varieties contain sweeteners
like aspartame that are harmful if
consumed over a period.
4. Burgers are the worst among junk food.
They contain everything we shouldn't eat.
They contain sauces high in sugar and
sodium, fried patties loaded with trans-
fats, cheese containing high amount of
dairy fat and mayonnaise with
preservatives and egg yolks.
Vegetarian burgers contain 35 %
calories, while non-vegetarian burgers 47
% calories that come from fats.
5. Ice Creams: Creamier ice creams are
the worst junk foods. A single serving of
most ice creams can contain more than
15 g of fat and high amounts of sugar,
increasing waistline.
6. Pizzas: They are relatively safe as they
had low levels of salt and fats. But, those
packed with cheese were in the danger
zone.
7. Drinks & Soft drinks containing sugar:
Coke, Pepsi, Fanta, Dr. Pepper, Sprite,
Lemonade, Hot chocolate, Milkshake are
high in sugar and are carbonated.
8. Cakes: Creamy cakes contain a highly
119
processed, uncooked form of
carbohydrate. This kind of white bread
has a high glycaemic index which in
combination with the high amount of
sugar ensures that the blood sugar levels
are boosted instantly.
9. Sugary Cereals: Most of the popular
brands of so called healthy cereals coated
with sugar, like fruit loops that contains a
high concentration of synthetic sugar, are
actually not healthy.
CATEGORY OF PEOPLE
CONSUMING JUNK FOOD:
India is experiencing “nutrition
Discuss about transition” characterized by increasing

2 min the category Listening power Who
Discusses
of people consumption of Junk food and a growing number about carefully point consume
the
consuming category of more Junk
Junk food of meals purchased and/or consumed away from people food as per
consuming age group?
home. High fat and sugary products being Junk food
addictive in nature attract children over healthy
foods. The ready availability, taste, low cost,
commercial marketing strategies, and peer
pressure makes Junk food popular among
120
children and adolescents.
According to a study conducted during
2014–2015 in Himachal Pradesh it was found
that 36% of school aged children consume junk
foods. Out of the total children who consumed
Junk food items (n = 153), 44% (n = 68) were
males and 56% (n = 85) were females.
According to the Socio economic status(SES)
junk food consumption was higher in high SES
(48%) and middle (45%) and least in low SES
(6%). High cost of energy-dense diets makes
these food items popular among School aged
children belonging to high- and middle-income
groups.
Listening and Power What are the

CONTRIBUTING FACTORS: Describes the discussing point factors
4 min contributing contributing
factors to the
1. Skipping meals consumption
of Junk food?
121
Describe the Teenagers may influence their nutrient
contributing intake by skipping meals. It has been shown that
factors teenagers who regularly eat breakfast tend to
have more adequate diets than those who miss
breakfast once a week or more. Busy schedules,
dieting, or a lack of food resources may lead to
meal skipping and is not effective way to lose
weight.
2. Snacking
Adolescents like to eat snacks and
confectionery. These provide mostly empty
calories, lead to micronutrient deficiencies and
caries tooth. Some adolescents skip their major
meals and eat only snacks. Snacks are
synonymous with “junk foods’” that will spoil
the appetite for meals.
3. Fast food
These provide some nutrition, but are not
a balanced diet. Deep frying and refrying in the
same oil are potentially injurious to health. Food
122
additives like ajinomoto and certain coloring
agents and dyes are anti-nutrients.
4. Soft drinks and other fun drinks
These supply only empty calories and
may also contain anti-nutrients. Moreover, these
kill the appetite and promote skipping of meals.
These act as ‘preload’ that lead to skipping of
meals.
5. Eating during other Activities
Eating during watching television, while
working, while reading or even while cooking is
developing an unhealthy eating behavior. When
adolescents eat while doing other activities, they
become unable to measure how much they eat.
As a result, they tend to overeat without knowing
it.
123
6. Eating Late at Night
Eating late night is not a good habit
because it causes weight gain tendency and
causes sleeping difficulties since body will be
busy in digesting food.
7. Eating disorders
Disordered eating behaviors are another
common factor and are mostly found among
adolescent females e.g. Anorexia nervosa,
bulimia nervosa and binge eating disorder.
FACTORS PROMOTING JUNK
FOOD CONSUMPTION:
Discuss the Discusses the Listening
6 min
factors factors carefully and PowerPoi What are the
promoting junk Junk foods are tasty with high calories but low in promoting junk discussing nt factors
food food promoting
consumption nutrient value. Traditional foods rich in nutrition consumption Junk food
consumption
are slowly fading out of Indian kitchens. Non- ?
124
availability of traditional foods coupled with
lack of awareness is resulting in westernization
of eating habits. Multinational food chains are
targeting children and teenagers. Modern-day
life can be extremely busy and hectic. Parents
have full-time jobs and a number of other
personal commitments, leaving them with no
time to pay attention to their children’s diet. The
main promoting factors are:
Availability
Adolescence brings increased independence and
freedom for teenagers to make their own
decisions about what they will eat.
Unfortunately, teenagers tend to be motivated in
their food choices not by nutritional or health
concerns but by factors of availability,
sociability, and status.
Mass media
Mass media and advertising also exert a
tremendous influence on the teen’s diet.
125
Advertising creates the image that certain foods
are “fun,” “glamorous,” or “sexy,” and
unfortunately, these foods are generally not
highly nutritious.
Figure conscious
A further motivating factor for food choices is
the teenage tendency to have slim figure. Female
adolescent often diet to lose weight even when
they are within or below the average range for
body weight.
Peer influence
.
Adolescents are undergoing not only physical
.
maturation, but are experiencing tremendous
social and psychological changes as well. This
age group is extremely sensitive to peer
acceptance. This desire to “fit” or be accepted
126
influence dietary habits.
Other factors may include:
1. Eating while doing other activities

2. Increased mobility
3. Greater time spent at
school/college and/or work activities
4. Preoccupation with self-image
5. Junk foods are convenient, tasty, and
fashionable
6. Early school and college timings
7. Sports team participation
8. Attractiveness
9. Easy to carry, purchase and consume
10. Late night eating.
These contribute to the erratic and unhealthy
eating behaviors that are common during
adolescence.
HEALTH HAZARDS OF JUNK
FOOD:
6 min List the health Lists the health Listening
hazards of junk hazards of junk attentively PowerPoi What are the
food Adolescents suddenly seem to have stepped into food nt health
hazards of
a world of fast food and vending machines, Junk food?
127
totally unaware of the havoc they are creating for
themselves. For adolescents who have less vision
of the heart disease, nutritional deficiencies,
obesity, increased cholesterol levels, cancer, or
diabetes that might befall them decades later, the
tentacles of a junk food environment are
virtually inescapable. Eating junk food cause:
Weight Gain (Obesity)
Eating fast food and leading a sedentary lifestyle
leads to obesity. Obesity leads to other
complications like increase in the cholesterol
level, blocking of the arteries, the increased risk
of coronary diseases, in addition to the general
physical discomfort posed by the extra weight.
Fast food is also addictive and hence it is very
difficult to give up on their greasy and fatty
foods and carbonated drinks and switch to
128
healthier option.
Diabetes
Dense sugar content can cause type 2 diabetes
mellitus and dental cavities. Meals consisting of
junk food are rated high on the glycaemic index,
which means they provide a quick rise in blood
sugar.
Heart Disease
High content of trans fat in commercially
available fast foods predispose to risk of future
heart diseases. Fried and processed food contain
high amounts of trans fats, saturated fats in
addition to ox cholesterol. Ox cholesterol is a
little-known type of cholesterol which may
prove to be a lethal compound to heart health.
129
Hypertension
Most of the quick and convenient meals contain
high amount of sodium, which increases and
aggravates the risks of high blood pressure.
Although the body requires minimum quantities
of sodium, too much sodium contributes to high
blood pressure and can also lead to building-up
of fluids in people who are suffering with
congestive heart failure, cirrhosis, or kidney
disease.
Digestion
A healthy digestive system depends on a healthy
diet. Junk foods affect digestive system, their
effects can emerge after many years. Because of
the long supply chain through which fast food
chains operate in, the handling and sourcing of
130
junk meal is very hard to monitor.
Carcinogenic
Most of the times these junk foods contain
colours which are often inedible, carcinogenic
and harmful to the body. What children eat from
puberty affects their risks of prostate and breast
cancer. Flavorings and colorings can be allergic
causing asthma, rashes and hyperactivity.
Affecting fetal health
Animal studies on rats have demonstrated the ill
effects of consuming junk foods during
pregnancy which affects the health of foetus.
Lack of concentration
When a sumptuous junk meal rich in oil is taken,
there is a feeling of drowsiness and failure to
131
concentrate. The junk food eating over a
sustainable period of time can drop blood
circulation due to fat accumulation. Lack of vital
oxygen, nutrients and proteins particularly can
stale the grey (brain) cells temporarily.
6 min Listening and

Power What is the
Explain the Explain the
effect of junk EFFECT OF JUNK FOOD ON effect of junk discussing point effect of Junk
food on food on food on
mucosal layer MUCOSAL LAYER OF GI TRACT: mucosal layer mucosal
of GI Tract of GI Tract layer of GI
Tract?
Junk food is unhealthy for digestive system as
they slowdown the digestion process. In order to
digest food, GI Tract needs enzymes and fast
food does not have them. The mucosal layer is
an efficient system for protecting the epithelium
from bacteria by promoting their clearance and
separating them from the epithelial cells, thereby
inhibiting inflammation and infection. The
effects of junk foods on mucosal layer of GI
Tract are:
Esophagitis
Junk food during the long chain of processing
period gets infected and in turn infects the
esophagus. Also junk foods cause acidity of the
stomach and as a result the excess acid in the
stomach leads to GERD (gastroesophageal reflux
132
disease), a condition where the esophageal
sphincter allows the acidic contents of the
stomach to move back up into the esophagus,
thus causing inflammation.
Gastritis and Peptic ulcers
Usually the stomach and the duodenum are

resistant to irritation because of the strong acids
produced by the stomach. Excess fats and oils
along with spices added in junk foods weakens
the mucous layer that coats the stomach and the
duodenum, allowing acid to get through the
sensitive lining beneath. It causes irritation and
inflammation of the lining of the stomach, called
gastritis or cause peptic ulcers, which are holes
or sores that form in the lining of the stomach
and duodenum and cause pain and bleeding.
Infection and Inflammation
Fiber is good for GI Tract however often it can

be the hardest item to find on the food label. The
primary role of microbes in our GI Tract is to
digest high-fiber food (that we can’t) to extract
the key nutrients. Less fiber in food led the
microbes to change their normal eating habits
and instead feed on the natural layer of mucus
that lines the gut, making it much more
susceptible to infections and inflammation.
133
Inflammatory Bowel Disease
 Ulcerative colitis. This condition causes

long-lasting inflammation and sores
(ulcers) in the innermost lining of your
large intestine (colon) and rectum.
 Crohn's disease. This type of IBD is
characterized by inflammation of the
lining of digestive tract, which often
spreads deep into affected tissues.
Junk food are believed to aggravate IBD.

“Indians are genetically prone to IBD, when they
adopt western lifestyle and eating habits, In fact,
IBD is a western ailment; therefore, it doesn’t
find a mention in our medical syllabus.
Irritable bowel syndrome (IBS)
IBS is a non-inflammatory condition. Junk food

cause inflammation, infection and changes in
bacteria in the gut (microflora), thus resulting in
IBS.
Polyp
A polyp is an abnormal growth of tissue (tumor)

projecting from a mucous membrane. If it is
attached to the surface by a narrow elongated
stalk it is said to be pedunculated. If no stalk is
present it is said to be sessile.
134
Indigestion
High-fat foods that contain saturated,

hydrogenated and partially hydrogenated fats
linger in stomach and are hard to digest. Avoid
high-fat foods such as fatty meats, processed
foods, french fries, onion rings and doughnuts.
Stomach lining damage
Junk food and processed foods, often containing

chemicals and high salt which can serve as
stomach irritants, resulting in its damage and
cause severe problems.
Enlists the
5 min Enlist the Listening Power Which
FACTORS CONTRIBUTING TO factors
factors carefully point factors
HEALTHY DIGESTION: contributing
contributing to healthy contribute to
to healthy healthy
 Keep a count on calories intake. One digestion
digestion digestion?
should not have food just for the purpose
of satisfying taste buds, but should be
aware of the nutritional value it provides.
 Cut down on refined sugar. Don’t have
sweets and chocolates on an empty
stomach as it sharply affects the body's
biochemistry.
 Cut down caffeine. Caffeinated drinks
like tea, coffee etc dehydrate the body;
thus look out for alternatives such as
juices, green tea etc as a healthier way
135
out.
 Exercise regularly. Make exercise part of
your daily routine.
 Increase intake of seasonal fruits and
vegetables. One can have fruits like apple
or any other seasonal fruit as part of mid-
day snacks.
 Take time to enjoy food. Eat slowly and
allow yourself to focus on the task of
eating, letting the body concentrate on
the job of digestion. A meal that's not
completely digested can stress and
overload the body.
 Adequate sleep. It is advisable to sleep
for at least seven to eight hours a day as
an exhausted body leads to poor health.
 Eat small meals. It is always better to
take small frequent meals rather than
larger infrequent meals.
SUMMARY:
About one fourth of the adolescents are skipping

breakfast during the school. Adolescents who go
out for dinner have a two times higher chance of
consuming junk food as compared to those who
never dined out. Early school timings act as a
barrier to having regular breakfast that results in
skipping of breakfast by the adolescents.
Majority of the adolescents feel that the benefits
136
of eating more vegetables and fruits were not
taught at school, place of lunch, family meal
(dinner), eating dinner out and moderate
consumption of vegetables and fruits are
important factors influencing junk food
consumption by adolescents. Last but certainly
not the least, better economic status, bringing
lunch to school, family meal (dinner), parental
modelling of eating, availability and accessibility
contribute to moderate consumption of
vegetables and fruits by adolescents.
CONCLUSION:
In short, eating too much junk food stresses

digestive system, resulting in poor nutrition and
a host of health problems that can be avoided by
eating more foods that are nutritious and
prepared naturally at home.
BIBILIOGRAPHY:
1. Junk Food Trap, Consumer International,

[ISBN 978-0-9560297-0-6], 2008
2. Fast Food Impact on health, Deptt of

137
Community Medicine, Sri Devraj Urs Medical
College, [ISSN 2231-4261], 2012
3.IOSR Journal of Nursing and Health Science

(IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN:
2320–1940 Volume 1, Issue 6 (Jul – Aug 2013),
PP 26-32 www.iosrjournals.org
4. Flouris, A. D., Bouziotas, C., Christodoulos,

A. D. & Koutedakis, Y. (2008): Longitudinal
preventive-screening cutoffs for metabolic
syndrome in adolescents, International Journal of
Obesity, Volume 32, Page No. 1506-1512.
5.https://www.livestrong.com/article/509349-
food-that-is-an-irritant-to-the-stomach-lining/
6.https://www.indiatimes.com/health/healthylivi
ng/how-junk-food-affects-our-digestion
238614.html
7. Michael A. Conlon, Anthony R. Bird

Nutrients. 2015 Jan; 7(1): 17–44. Published
online 2014 Dec 24. doi: 10.3390/nu7010017
8. Gupta A, Kapil U, Singh G. Consumption of

junk foods by school-aged children in rural
Himachal Pradesh, India. Indian J Public Health
[serial online] 2018 [cited 2018 Oct 11]; 62:65-
7.
9.Singh, A. K., Maheshwari, A., Sharma, N. &
Anand, K. (2006): Lifestyle Associated Risk
Factors in Adolescents, Indian Journal of
138
Pediatrics, Volume 73, Page No. 901-906.
10. Vereecken, C. A., Inchley, J., Subramanian,

S. V., Hublet, A. & Maes, L. (2005): The
relative influence of individual and contextual
socio-economic status on consumption of fruit
and soft drinks among adolescents in Europe,
European Journal of Public Health, Volume. 15,
No. 3, Page No. 224–232.
11.www.cseindia.org/content/watch-out-what-
you-eat-it-could-be-killing-youslowlyand-
sweetly-says-new-cse-junk-food-and nutrition
study
12.Aggarwal, T., Bhatia, R. C., Singh, D. &
Sobti, P. C. (2008): Prevalence of obesity and
overweight in affluent adolescents from
Ludhiana, Punjab, Indian Pediatrics,
Volume 45, Page No. 500-502.
13.Bergstrom KSB, Kissoon-Singh V, Gibson
DL, Ma C, Montero M, Sham HP, Ryz N, Huang
T,
Velcich A, Finlay BB, Chadee K, Vallance BA.
Muc2 Protects against Lethal Infectious Colitis
by disassociating Pathogenic and Commensal
Bacteria from the Colonic Mucosa. PLoS
Pathog.2010; 6:e1000902. [PMC free article]
[PubMed]
14. Banerjee, I., Ghia, N., Bandopadhyay, S.,
Sayed, H. N. & Mukherjee, D. (2005): Body
mass index in Bengali adolescents, Indian
139
Pediatrics. Volume 42, 262-267.
15. Kaushik, J. S., Narang, M. & Parakh, A.
(2011): Fast Food Consumption in Children,
Indian Pediatrics, Volume 48, Page No. 97-101.
140
ANNEXURE – M
Statistical Formulae
1. Simplified Split Half Karl Pearson’s formula (Raw score method)
r= ∑XY
√ ∑X2 .∑Y2
2. Brown prophecy formula for Validity coefficient
r 1= 2r
1+ r
3. Analysis of Chi-Square Test:
χ2 = ∑ [(O-E)2]/E ̴ χ2 (r-1) (c-1) df
4. Paired ‘t’ Test:
t= D ̴ t (n-1) df,
Sd/√n
141
ANNEXURE – N
Interactive Session with Nursing Students
142
143

Effectiveness of structured teaching programme on knowledge regarding effect of junk food

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“EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON

KNOWLEDGE REGARDING EFFECT OF JUNK FOOD ON MUCOSAL LAYER

MR. SAIF ULLAH SHEIKH

D ISSERTATION S UBMITTED TO THE

R AJIV G ANDHI U NIVERSITY OF H EALTH S CIENCES , B ENGALURU

MASTER OF SCIENCE IN NURSING

Medical Surgical Nursing

Under the guidance of

VARALAKSHMI COLLEGE OF NURSING

T. DASARAHALLI, BENGALURU-560 057

I as a researcher convey my sincere indebtedness to Varalakshmi College of Nursing, T.

I am extremely grateful to Mr. Surendra, Associate Professor, Department of Statistics, Applied

I extend my sincere thanks to Principal, Varalakshmi College of Nursing for granting me

4. > Greater than

5. H1 Research Hypothesis one

6. H2 Research Hypothesis two

7. < Less than

11. SD Standard deviation

12. STP Structured Teaching Programme

13. WHO World Health Organization

SI.NO NAME OF THE TABLE PAGE

2. Classification of knowledge scores 26

3. Classification of Respondents by Age 34

4. Classification of Respondents by Gender 35

5. Classification of Respondents by Religion 36

6. Classification of Respondents by Permanent residence 37

7. Classification of Respondents Presently residing at 38

8. Classification of Respondents Monthly family income 39

9. Classification of Respondents by Previous exposure to information 40

10. Classification of Respondents by Source of information 41

11. Classification of Respondents by Do you consume junk food 42

12. Overall aspect wise Pre-test Knowledge scores of Respondents on level on 44

15. Aspect wise Post-test Mean Knowledge scores of Respondents on effect of 47

16. Over all Pre-test and Post-test Mean Knowledge scores 48

23. Association between Permanent residence and Pre-test Knowledge level on 59

24. Association between Presently residing at and Pre-test Knowledge level on 61

26. Association between Previous exposure to information on effect of junk food on 64

27. Association between Source of information and Pre-test Knowledge level on 66

Conceptual framework based on General System Theory by

2. Schematic representation of the study design 22

3. Classification of Respondents by Age 34

4. Classification of Respondents by Gender 35

5. Classification of Respondents by Religion 36

6. Classification of Respondents by Permanent residence 37

7. Classification of Respondents by Presently residing at 38

8. Classification of Respondents by Monthly family income 39

Classification of Respondents by Previous exposure to

10. Classification of Respondents by Source of information 41

11. Classification of Respondents by Do you consume junk food 42

Overall aspect wise Pre-test Knowledge scores of

12. Respondents on effect of junk food on mucosal layer of GI 44

Overall aspect wise Post-test Mean Knowledge scores of

Over all Pre-test and Post-test Mean Knowledge scores on

Classification of Respondents on Pre-test and Post-test

Association between Age and Pre-test Knowledge level on

Association between Gender and Pre-test Knowledge level

Association between Permanent residence and Pre-test

Association between Presently residing at and Pre-test

Association between Previous exposure to information on

“Effectiveness of structured teaching programme on knowledge regarding effect of junk food on

Interpretation and conclusion:

Eat of the good things which we have provided for you.