Junk food consumption and associated factors among high school adolescents in Harar City, Harari Regional State, Eastern Ethiopia: institutional-based cross-sectional study

Excessive junk food consumption among adolescents has emerged as a global public health concern, with ultra-processed foods accounting for up to 60% of total daily caloric intake in urbanizing settings. However, there is limited and context-specific evidence regarding these dietary patterns in Ethiopia. This study aimed to assess the prevalence and associated factors of junk food consumption among high school adolescents in Harar City ,Harari Regional State, Eastern Ethiopia. A school-based cross-sectional study was conducted from April 25 to June 6, 2025, among 747 high school adolescents selected through a multistage sampling method. Data were collected using a structured self-administered questionnaire. Bivariable and multivariable logistic regression models were used to identify factors associated with junk food consumption. Statistical significance was set at p < 0.05, and the strength of association was reported using adjusted odds ratios (AOR) with 95% confidence intervals. The overall prevalence of junk food consumption among adolescents was 360 (48.2%) (95% CI: 44.6–51.8%). In the multivariable analysis, the strongest independent risk factor for consumption was female sex (AOR = 1.56, 95% CI: 1.14–2.14), followed by regular receipt of pocket money (AOR = 1.43, 95% CI: 1.02–1.99) and joint family structures (AOR = 1.42, 95% CI: 1.02–1.99). Conversely, strong protective factors against consumption included home unavailability of junk food (AOR = 0.27, 95% CI: 0.19–0.38), having neither parent alive (AOR = 0.33, 95% CI: 0.13–0.85), having only the father alive (AOR = 0.34, 95%CI: 0.14–0.81) and enrollment in private schools (AOR = 0.62, 95% CI: 0.42–0.92). Nearly half of the surveyed adolescents routinely consume junk food, with this pattern driven primarily by gender (female), financial autonomy, and food accessibility. Interventions should focus on modifying immediate adolescent environments by regulating food availability inside school compounds and promoting supportive domestic dietary habits.