Kids SIPsmartER: A multi-level behavioral and health literacy intervention to reduce sugar-sweetened beverages among Appalachian middle-school students

Kids SIPsmartER：多层次的行为和健康素养干预措施，旨在减少阿巴拉契亚中学生的含糖饮料

• 批准号: 10312773
• 负责人: Jamie Zoellner
• 金额: $ 83万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-03 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10312773
• 关键词: Adolescent; Adoption; Adult; Appalachian Region; Behavior; Behavioral; Body mass index; Cardiovascular Diseases; Caregivers; Child; Chronic; Collaborations; Consumption; County; Data; Dental; Dental caries; Diabetes Mellitus; Disparity; Educational Curriculum; Effectiveness; Enrollment; Environment; Evaluation; Feasibility Studies; Frequencies; Fruit; Gatekeeping; Geography; Goals; Health; Health Promotion; Health education; Heart Diseases; High School Student; Home; Home environment; Individual; Influentials; Institutionalization; Intake; Intervention; Interview; Maintenance; Malignant Neoplasms; Medical; Methods; Middle School Student; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity associated cancer; Odds Ratio; Outcome; Phase; Planning Theory; Population; Prevention; Prevention Research; Prevention program; Prospective Studies; Public Health; Qualitative Research; Quality of life; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Research Personnel; Resources; Review Literature; Rural; Rural Appalachia; Sampling; School-Age Population; Schools; Seminal; Services; Sports; Students; Surveys; System; Tea; Text Messaging; Time; Training; Transportation; Virginia; Voice; Work; Youth; comparison control; digital; effectiveness evaluation; evidence base; health goals; health inequalities; health literacy; hybrid type 1 design; implementation determinants; improved; junior high school; literacy; mathematical ability; medically underserved; process evaluation; programs; public health relevance; response; role model; scale up; school district; seventh grade; soft drink; sugar; sweetened beverage; systematic review; teacher; theories

Project Summary: The intake of sugar-sweetened beverages (SSB, e.g., soda/pop, sweet tea, sports and energy drinks, fruit drinks) is disproportionately high in Appalachia, including among adolescents whose intake is more than double the national average and more than four times the recommended daily amount. There are strong and consistent scientific data and systematic reviews documenting relationships among high SSB consumption and numerous chronic health conditions such obesity, some types of obesity-related cancers, diabetes, cardiovascular disease, and dental erosion and decay. Reaching adolescents with behaviorally- focused health programs where they spend the majority of their time, at school, shows promise. However, engaging caregivers who serve as their child’s most influential role model as well as the gatekeeper for the home environment may be equally as important in changing adolescents’ SSB behaviors. Finally, there is a great need to understand how to support schools and teachers to deliver and maintain evidence-based health education programs, especially among rural schools. Thus, the overarching goal of this proposal is to work in partnership with Appalachian middle schools to implement and evaluate Kids SIPsmartER. Kids SIPsmartER is a 6-month, school-based, behavior and health literacy curriculum aimed at improving SSB behaviors among middle school students. The program also integrates a two-way short service message (SMS) strategy to engage caregivers in SSB role modeling and supporting home SSB environment changes. Kids SIPsmartER is grounded by the Theory of Planned Behavior as well as health literacy, media literacy, numeracy, and public health literacy concepts. In our proposed cluster-randomized controlled trial, we target 12 middle schools in medically underserved Appalachian counties in southwest Virginia. Our study is guided by the RE-AIM (reach, adoption, effectiveness, implementation, and maintenance) framework and is a type 1 hybrid design. The primary aim is to assess changes in SSB behaviors at 7-months among 7th grade students at schools receiving Kids SIPsmartER, as compared to control schools. We will also evaluate changes in secondary student outcomes (e.g., BMI, quality of life, theory-related variables), changes in caregiver outcomes (e.g., SSB behaviors, home SSB environment), and 19-month maintenance of outcomes. The reach and representativeness of Kids SIPsmartER will be assessed. Furthermore, we will use a mixed-methods approach with interviews, surveys, observation, and process evaluation strategies to determine the degree to which teachers implement Kids SIPsmartER as intended and the potential for institutionalization within the schools. The long-term goal of this health promotion and prevention line of research is to establish an effective, scalable, and sustainable multi-level strategy to improve SSB behaviors and reduce SSB-related health inequities and chronic conditions (e.g. obesity, cancer, type II diabetes, heart disease, dental caries) in rural Appalachia.

项目摘要：含糖饮料（SSB，例如，汽水/汽水、甜茶、运动饮料和 能量饮料，水果饮料）在阿巴拉契亚不成比例地高，包括青少年， 是全国平均水平的两倍多，是建议每日摄入量的四倍多。有 强有力和一致的科学数据和系统性综述，记录了高SSB之间的关系。 消费和许多慢性健康状况，如肥胖，某些类型的肥胖相关癌症， 糖尿病、心血管疾病和牙齿腐蚀和腐烂。在行为上影响青少年- 他们大部分时间在学校度过的重点健康项目显示出了希望。然而，在这方面， 让照顾者参与进来，他们是孩子最有影响力的榜样，也是 家庭环境在改变青少年SSB行为方面可能同样重要。最后还有一个 非常需要了解如何支持学校和教师提供和维护基于证据的健康 教育项目，特别是农村学校。因此，本提案的总体目标是， 与阿巴拉契亚中学合作，实施和评估Kids SIPsmartER。儿童SIPsmartER是 一个为期6个月的，以学校为基础的，行为和健康素养课程，旨在改善SSB的行为， 中学生。该计划还集成了双向短信息（SMS）策略， 让护理人员参与SSB角色建模并支持家庭SSB环境的变化。Kids SIPsmartER是 基于计划行为理论以及健康素养，媒体素养，计算能力和公众 健康素养概念。在我们提出的随机分组对照试验中，我们针对12所中学， 弗吉尼亚州西南部医疗条件差的阿巴拉契亚县。我们的研究是由RE-AIM（达到， 采用、有效性、实施和维护）框架，并且是类型1混合设计。的 主要目的是评估在7个月的SSB行为的变化在7年级的学生在学校接受 孩子们SIPsmartER，与对照学校相比。我们还将评估中学学生的变化， 结果（例如，BMI、生活质量、理论相关变量）、护理者结果的变化（例如，SSB 行为，家庭SSB环境）和19个月的结果维持。范围和 将评估Kids SIPsmartER的代表性。此外，我们将使用混合方法 通过访谈、调查、观察和过程评估策略， 教师按计划实施Kids SIPsmartER，并在学校内实现制度化。 这项健康促进和预防研究的长期目标是建立一个有效的， 可扩展的、可持续的多层次战略，以改善SSB行为并减少SSB相关的健康 农村地区的不平等和慢性病（如肥胖、癌症、II型糖尿病、心脏病、龋齿） 阿巴拉契亚。

项目成果

Retention and engagement of rural caregivers of adolescents in a short message service intervention to reduce sugar-sweetened beverage intake.

• DOI: 10.1177/20552076231160324
• 发表时间: 2023-01
• 期刊: DIGITAL HEALTH
• 影响因子: 3.9
• 作者: Yuhas, Maryam;Brock, Donna-Jean P.;Ritterband, Lee M.;Chow, Philip, I;Porter, Kathleen J.;Zoellner, Jamie M.
• 通讯作者: Zoellner, Jamie M.

Applying the socio-ecological model to understand factors associated with sugar-sweetened beverage behaviours among rural Appalachian adolescents.

• DOI: 10.1017/s1368980021000069
• 发表时间: 2021-08
• 期刊: Public health nutrition
• 影响因子: 3.2
• 作者: McCormick BA;Porter KJ;You W;Yuhas M;Reid AL;Thatcher EJ;Zoellner JM
• 通讯作者: Zoellner JM

Outcomes of a Caregiver-Focused Short Message Service (SMS) Intervention to Reduce Intake of Sugar-Sweetened Beverages in Rural Caregivers and Adolescents.

• DOI: 10.3390/nu15081957
• 发表时间: 2023-04-19
• 期刊: Nutrients
• 影响因子: 5.9
• 作者: Brock DP;Yuhas M;Porter KJ;Chow PI;Ritterband LM;Tate DF;Zoellner JM
• 通讯作者: Zoellner JM

Factors Influencing the Sugar-Sweetened Beverage Intake of Caregivers of Adolescents in Appalachia.

• DOI: 10.1016/j.jneb.2021.09.010
• 发表时间: 2022-03
• 期刊: Journal of nutrition education and behavior
• 影响因子: 2.6
• 作者: Porter KJ;You W;Kirkpatrick BM;Thatcher EJ;Reid AL;Yuhas M;Zoellner JM
• 通讯作者: Zoellner JM

Low Health Literacy Is Associated With Energy-Balance-Related Behaviors, Quality of Life, and BMI Among Rural Appalachian Middle School Students: A Cross-Sectional Study.

• DOI: 10.1111/josh.13051
• 发表时间: 2021-08
• 期刊: JOURNAL OF SCHOOL HEALTH
• 影响因子: 2.2
• 作者: Reid, Annie L.;Porter, Kathleen J.;You, Wen;Kirkpatrick, Brittany M.;Yuhas, Maryam;Vaught, Shannon S.;Zoellner, Jamie M.
• 通讯作者: Zoellner, Jamie M.