The reach and effectiveness of SIPsmartER when implemented by rural public health departments: a pilot dissemination and implementation trial to reduce sugar-sweetened beverages.
The reach and effectiveness of SIPsmartER when implemented by rural public health departments: a pilot dissemination and implementation trial to reduce sugar-sweetened beverages.
复制标题
农村公共卫生部门实施 SIPsmartER 的范围和有效性：减少含糖饮料的试点传播和实施试验。
DOI：
10.1093/tbm/ibz003
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发表时间：
2020
影响因子：
3.6
通讯作者：
Cantrell,EleanorS
中科院分区：
文献类型：
--
作者：
Zoellner,JamieM;Porter,KathleenJ;You,Wen;Estabrooks,PaulA;Perzynski,Katelynn;Ray,PamelaA;Cantrell,EleanorS
SIPsmartER是一项基于理论的、为期6个月的多成分健康素养干预，旨在改善弗吉尼亚州西南部农村成年人的含糖饮料（SSB）行为。该试点试验的目的是了解在公共卫生实践环境中由现有工作人员提供SIPsmartER的范围和有效性。这项事后研究设计是与弗吉尼亚西南部四个医疗服务不足的卫生部（VDH）区合作进行的。采用了经过验证的测量方法和标准化的数据收集技术。分析包括描述性统计和多水平混合效应线性回归模型。在筛选的928人中，586人（63%）符合条件，117人（20%）参加了SIPsmartER（79%保留）。样本主要是女性（71%）和白人（94%），学历不超过高中（59%），年收入约为12,500美元。相对于全县人口，入选的研究样本在年龄和种族上具有代表性，但男性代表性不足，低收入和低教育程度的代表性过高。从基线到6个月，观察到主要SSB结局的显著改善（- 403[置信区间[CI] = - 528, - 278] SSB kcal /day） （p< .001）。ssb相关态度、感知行为控制、行为意图和媒介素养也显著改善（均p< 0.05）。SIPsmartER似乎对VDH和其他医疗服务不足地区的卫生部门很有希望。与以前的有效性试验相比，现有的VDH工作人员在一些（但不是全部）结果上达到了类似的范围和有效性。未来的工作需要在方法上支持卫生部门制定战略，以接触新的参与者，并将SIPsmartER纳入持续的实践。
SIPsmartER is a theory-based, 6-month, multi-component health literacy intervention shown to improve sugar-sweetened beverages (SSB) behaviors among adults in rural, southwest Virginia. The objective of this pilot trial was to understand the reach and effectiveness of SIPsmartER when delivered by existing staff in public health practice settings. This pre-post research design was conducted in partnership with four medically underserved southwest Virginia Department of Health (VDH) districts. Validated measures and standardized data collection techniques were used. Analyses included descriptive statistics and multilevel mixed-effects linear regressions models. Of 928 individuals screened, 586 (63%) were eligible and 117 (20% of eligible) enrolled in SIPsmartER (79% retained). The sample was majority female (71%) and white (94%) and had ≤high school education (59%) and an annual income of approximately $12,500. Relative to the county population, the enrolled study sample was representative for age and race, yet underrepresented for men and overrepresented for low income and low educational attainment. Significant improvements from baseline to 6 months were observed for the primary SSB outcome (−403 [confidence interval [CI] = −528, −278] SSB kcals/day) (p< .001). SSB-related attitudes, perceived behavioral control, behavioral intentions, and media literacy also significantly improved (allp< .05). SIPsmartER appears to be promising for VDH and potentially other health departments in medically underserved areas. When compared to the previous effectiveness trial, existing VDH staff achieved similar reach and effectiveness for some, but not all, outcomes. Future work is needed on methods to support health departments in developing strategies to reach new participants and to integrate SIPsmartER into sustained practice.