Adolescents’ spontaneous recall of food and beverage advertisements on digital media: A cross-sectional survey in Montevideo, Uruguay

Objective: Explore adolescents’ recall of food and beverage advertisements in digital media, while evaluating associations between socio-demographic characteristics and advertisement recall. Design Recruitment took place using a two-stage cluster probability-based sampling approach. Thirty-nine high schools stratified by type (public vs. private) were included, with one class within each grade randomly selected, wherein attending students (N=1542; age range: 11–19 years) received a paper-and-pencil questionnaire for completion in their homes. Setting: The study was conducted in Montevideo, the capital city of Uruguay, which is a high-income South American country with a high prevalence of overweight and obesity among adolescents. Participants indicated their spontaneous recall of food and beverage advertisements on social media and provided socio-demographic information. Individual responses to an open-ended question were graphically represented using a world cloud, after which the data were analyzed through content analysis based on inductive coding. Participants: A total of 1452 adolescents attending public and private high schools participated. Results: Almost 9 of 10 adolescents (87.6%) reported having seen a food or beverage advertisement on digital media and more than 3 of 4 (76.1%) could spontaneously recall at least one such advertisement. The three most frequently used words for spontaneous recall were 'McDonalds,' 'Coke,' and 'burgers,' whereas the three most frequently mentioned product categories were 'Fast-food and fast-food restaurants,' 'soft drinks,' and 'savoury snacks.' Some socio-demographic differences emerged. Conclusions: The findings stress the need to implement mandatory regulatory approaches to reduce adolescent exposure to digital marketing of unhealthy foods and beverages.