SIPsmartER: A nutrition literacy approach to reducing sugar-sweetened beverages

SIPsmartER：减少含糖饮料的营养素养方法

• 批准号: 8300091
• 负责人: Jamie Zoellner
• 金额: $ 58.5万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-12 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8300091
• 关键词: Accounting; Adoption; Adult; Affect; American; Attitude; Behavior; Behavior Control; Behavior Therapy; Beverages; Biological Markers; Body Weight; Cardiovascular Diseases; Communication; Communities; Complex; Consumption; Control Groups; Coronary heart disease; County; Cross-Sectional Studies; Data; Dental caries; Diabetes Mellitus; Dietary intake; Dimensions; Effectiveness; Energy Intake; Environment; Focus Groups; Goals; Health; Health behavior; Health behavior change; Individual; Intake; Intention; Intervention; Life Style; Literature; Low income; Maintenance; Malignant Neoplasms; Measures; Mediating; Methodology; Methods; Modeling; Monitor; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Oral; Outcome; Participant; Pathway interactions; Patient Self-Report; Persons; Phase; Planning Theory; Population; Process; Public Health; Randomized Controlled Trials; Reading; Relative (related person); Reliance; Research; Risk; Rural; Rural Population; Target Populations; Techniques; Technology; Testing; Time; Virginia; Voice; Walking; age group; arm; base; behavior change; behavior influence; cost; cost effective; cost effectiveness; design; effective intervention; efficacy trial; health literacy; improved; knowledge base; literacy; literate; meetings; nutrition; post intervention; primary outcome; programs; public health relevance; research study; response; secondary outcome; skills; socioeconomics; sugar; sweetened beverage; theories; therapy development

DESCRIPTION (provided by applicant): Despite the substantial impact sugar-sweetened beverages (SSB) have on total energy intake and the fact that consumption has doubled in the US over the past 25 years; there are no known efficacy trials that have specifically targeted reducing SSB intake among adults. Furthermore, adults with lower health literacy consume higher amounts of SSB and the field lacks theory-based interventions to support behavior change in this population. This research explicitly targets changes in SSB intake through improvements in health literacy, defined within a nutrition context as nutrition numeracy (the ability to read, understand, and apply numbers to make appropriate dietary decisions) and nutrition-related media literacy (the ability to access, analyze, and evaluate nutrition-related media). Phase 1 of the project utilizes focus groups and pilot testing methodologies to guide development of the interventions. The primary objective for Phase 2 is to conduct a three group randomized controlled trial to determine the relative effectiveness of a Theory of Planned Behavior (TPB)-based SSB intervention with (SIPmatE) and without (SIPmart) an enhanced and integrated nutrition literacy component targeting nutrition numeracy and nutrition-related media literacy, as compared to a matched-contact control condition. All three 6-month interventions will be delivered using in- person, small-group communication channels and automated self-monitoring through interactive voice response (IVR) technology. The target population includes 639 low socioeconomic participants residing in 11 at-risk, rural southwest Virginia counties. All outcomes will be assessed at baseline, 6 months, and 12 months post intervention (i.e., 18 months post baseline). The primary outcome is SSB consumption, and secondary outcomes include body weight and a new non-invasive 13C biomarker technique for added sugar intake. Changes in the primary and secondary outcomes will be determined using a mixed effect model to account for individual, time, and group differences within a multitreatment framework. Components from the RE-AIM framework (i.e. reach, effectiveness, adoption, implementation, & maintenance) will also be assessed and evaluated, along with cost-effectiveness models for each arm. This study fills an important void in the health literacy literature by integrating motivation/intention processes with skill-based nutrition literacy processes to understand causal pathways and complex relationships impacting a life-style behavior under real world and naturally occurring community environments. The long-term goals of this research are to improve nutrition literacy among health disparate populations, reduce SSB consumption and the associated adverse health consequences related to excessive caloric and added sugar consumption (i.e. obesity, type II diabetes, coronary heart disease, dental caries, and cancer), bridge the conceptual gap among concepts in health behavior theory and health literacy, expand the reach of simple and cost-effective interventions among hard-to- reach populations, and reduce the reliance on self-reported measures of dietary intake.

描述（由申请人提供）：尽管含糖饮料 (SSB) 对总能量摄入量产生重大影响，而且过去 25 年美国的消费量翻了一番；目前尚无专门针对减少成人 SSB 摄入量的已知疗效试验。此外，健康素养较低的成年人会消耗较多的 SSB，并且该领域缺乏基于理论的干预措施来支持该人群的行为改变。这项研究明确地通过提高健康素养来改变 SSB 摄入量，在营养背景下定义为营养计算能力（阅读、理解和应用数字以做出适当饮食决定的能力）和营养相关媒体素养（访问、分析和评估营养相关媒体的能力）。该项目的第一阶段利用焦点小组和试点测试方法来指导干预措施的制定。第 2 阶段的主要目标是进行三组随机对照试验，以确定与匹配接触控制条件相比，基于计划行为理论 (TPB) 的 SSB 干预的相对有效性，其中有（SIPmatE）和没有（SIPmart）针对营养计算和营养相关媒体素养的增强和综合营养素养成分。所有三项为期 6 个月的干预措施都将通过面对面的小组沟通渠道以及通过交互式语音应答 (IVR) 技术的自动自我监控来进行。目标人群包括居住在弗吉尼亚州西南部 11 个高危农村县的 639 名低社会经济参与者。所有结果将在基线、干预后 6 个月和 12 个月（即基线后 18 个月）进行评估。主要结果是 SSB 消耗量，次要结果包括体重和用于添加糖摄入量的新型非侵入性 13C 生物标记技术。主要和次要结果的变化将使用混合效应模型来确定，以考虑多重治疗框架内的个体、时间和群体差异。 RE-AIM 框架的组成部分（即覆盖范围、有效性、采用、实施和维护）以及每个部门的成本效益模型也将得到评估和评价。这项研究通过将动机/意图过程与基于技能的营养素养过程相结合，以了解在现实世界和自然发生的社区环境下影响生活方式行为的因果路径和复杂关系，填补了健康素养文献中的一个重要空白。这项研究的长期目标是提高健康不同人群的营养素养，减少SSB消耗以及与过量热量和添加糖消耗相关的不良健康后果（即肥胖、II型糖尿病、冠心病、龋齿和癌症），弥合健康行为理论和健康素养概念之间的概念差距，扩大在难以接触的人群中简单且具有成本效益的干预措施的覆盖范围，以及 减少对自我报告的饮食摄入量测量的依赖。