Effects of a behavioral and health literacy intervention to reduce sugar-sweetened beverages: a randomized-controlled trial

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dc.contributor.authorZoellner, Jamie M.en
dc.contributor.authorHedrick, Valisa E.en
dc.contributor.authorYou, Wenen
dc.contributor.authorChen, Yi-Chun Yvonnesen
dc.contributor.authorDavy, Brenda M.en
dc.contributor.authorPorter, Kathleen J.en
dc.contributor.authorBailey, Angelaen
dc.contributor.authorLane, Hannahen
dc.contributor.authorAlexander, Ramine C.en
dc.contributor.authorEstabrooks, Paul A.en
dc.contributor.departmentHuman Nutrition, Foods, and Exerciseen
dc.date.accessioned2017-01-08T21:43:26Zen
dc.date.available2017-01-08T21:43:26Zen
dc.date.issued2016-03-22en
dc.description.abstractBackground: Despite excessive consumption of sugar-sweetened beverages (SSB), little is known about behavioral interventions to reduce SSB intake among adults, particularly in medically-underserved rural communities. This type 1 effectiveness-implementation hybrid RCT, conducted in 2012–2014, applied the RE-AIM framework and was designed to assess the effectiveness of a behavioral intervention targeting SSB consumption (SIPsmartER) when compared to an intervention targeting physical activity (MoveMore) and to determine if health literacy influenced retention, engagement or outcomes. Methods: Guided by the Theory of Planned Behavior and health literacy strategies, the 6 month multi-component intervention for both conditions included three small-group classes, one live teach-back call, and 11 interactive voice response calls. Validated measures were used to assess SSB consumption (primary outcome) and all secondary outcomes including physical activity behaviors, theory-based constructs, quality of life, media literacy, anthropometric, and biological outcomes. Results: Targeting a medically-underserved rural region in southwest Virginia, 1056 adult participants were screened, 620 (59 %) eligible, 301 (49 %) enrolled and randomized, and 296 included in these 2015 analyses. Participants were 93 % Caucasian, 81 % female, 31 % ≤ high-school educated, 43 % < $14,999 household income, and 33 % low health literate. Retention rates (74 %) and program engagement was not statistically different between conditions. Compared to MoveMore, SIPsmartER participants significantly decreased SSB kcals and BMI at 6 months. SIPsmartER participants significantly decreased SSB intake by 227 (95 % CI = −326,−127, p < 0.001) kcals/day from baseline to 6 months when compared to the decrease of 53 (95 % CI = −88,−17, p < 0.01) kcals/day among MoveMore participants (p < 0.001). SIPsmartER participants decreased BMI by 0.21 (95 % CI = −0.35,−0.06; p < 0.01) kg/m2 from baseline to 6 months when compared to the non-significant 0.10 (95 % CI = −0.23, 0.43; NS) kg/m2 gain among MoveMore participants (p <0.05). Significant 0–6 month effects were observed for about half of the theory-based constructs, but for no biological outcomes. Health literacy status did not influence retention rates, engagement or outcomes. Conclusions: SIPsmartER is an effective intervention to decrease SSB consumption among adults and is promising for translation into practice settings. SIPsmartER also yielded small, yet significant, improvements in BMI. By using health literacy-focused strategies, the intervention was robust in achieving reductions for participants of varying health literacy status.en
dc.description.versionPublished versionen
dc.format.extent? - ? (12) page(s)en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1186/s12966-016-0362-1en
dc.identifier.issn1479-5868en
dc.identifier.urihttp://hdl.handle.net/10919/74023en
dc.identifier.volume13en
dc.language.isoenen
dc.publisherBiomed Centralen
dc.relation.urihttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000372741000001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=930d57c9ac61a043676db62af60056c1en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.holderThe Author(s)en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectNutrition & Dieteticsen
dc.subjectPhysiologyen
dc.subjectBeveragesen
dc.subjectHealth literacyen
dc.subjectBehavioral researchen
dc.subjectRandomized controlled trialen
dc.subjectRural populationen
dc.subjectRE-AIM FRAMEWORKen
dc.subjectPLANNED BEHAVIORen
dc.subjectPHYSICAL-ACTIVITYen
dc.subjectCLINICAL-TRIALen
dc.subjectUNITED-STATESen
dc.subjectWEIGHT-GAINen
dc.subjectCONSUMPTIONen
dc.subjectADULTSen
dc.subjectOBESITYen
dc.subjectQUESTIONNAIREen
dc.titleEffects of a behavioral and health literacy intervention to reduce sugar-sweetened beverages: a randomized-controlled trialen
dc.title.serialInternational Journal of Behavioral Nutrition and Physical Activityen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/Agriculture & Life Sciencesen
pubs.organisational-group/Virginia Tech/Agriculture & Life Sciences/CALS T&R Facultyen
pubs.organisational-group/Virginia Tech/Agriculture & Life Sciences/Human Nutrition, Foods, & Exerciseen
pubs.organisational-group/Virginia Tech/All T&R Facultyen

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