Sugar Alert - Evaluating San Francisco's Sugar Sweetened Beverage Advertising Warning Label Ordinance

项目摘要 糖警报是一项为期4年的研究，旨在评估有史以来第一次加糖的影响 饮料(SSB)关于知识、态度和消费的警告标签政策。SSB 消费是美国肥胖症和糖尿病双重流行的主要原因1 从2016年7月25日开始，旧金山市将要求在大多数 SSB广告：“警告：饮用加糖饮料(S)有助于 肥胖、糖尿病和龋齿。这是来自三星市和县的消息 弗朗西斯科。“由于旧金山是第一个对SSB贴上警告标签的司法管辖区， 拟议的研究提供了一个前所未有的机会来记录这种方法是否以及如何 可以为预防肥胖提供一种可行的工具。警告标签是证据中的支柱- 基于烟酒政策的制定。事实证明，它们在改变态度方面是有效的， 知识和烟草的消费，以及较小程度的酒精消费，因此持有 预防肥胖症大有希望。 拟议的研究将考察消费者如何理解和反应警告标签 广告，无论这是否增加了对SSB健康危害的了解，都会促进 对SSB持负面态度，或减少SSB消费。种族/民族的影响， 将对信息的收入、健康意识和认知加工进行评估。我们 提出了具有代表性的电话面板调查的前置准实验设计， 包括实施前基线观察和6、12和24个月的跟踪 基线后。我们将跟踪调查具有代表性的1100名旧金山成年人和1100名 圣何塞的居民被视为控制司法管辖区。拉美裔和黑人，这两个民族的 SSB消费率、肥胖率和糖尿病率将被过度抽样，以分析是否 警告标签对这些弱势群体的影响不成比例。主题将是 通过旅行对交叉污染进行筛查。补充性研究部分， 记录在SF和SJ地点可见的所有形式的广告将评估合规性 以及广告商对警告标签的响应，验证实施是否发生为 立法者的意图，并将检测广告商对受监管广告的偏离 试图绕过标签效应。这项研究的具体目的是： 1)目标1.通过以下方式评估旧金山居民对警告标签消息的暴露程度 记录随时间推移的实施情况。 2)目标2.评估SF(和SJ)成年人随着时间的推移暴露在警告标签下，以及 暴露与有关SSB的知识、态度和行为的变化有关 以及变化是否以不同的方式影响亚群， 3)目标3.检查旧金山人是否接触到SSB广告上的警告标签 报告称，与SAN相比，SSB每天消耗的卡路里减少得更多 何塞居民随着时间的推移。

Project Abstract Sugar Alert is a 4-year study to assess the impact of the first-ever sugar-sweetened beverage (SSB) warning labeling policy on knowledge, attitudes and consumption. SSB consumption is a major contributor to the twin epidemics of obesity and diabetes in America.1 Starting July 25 2016, the City of San Francisco will require prominent warning labels on most SSB advertisements: "WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay. This is a message from the City and County of San Francisco.” Because San Francisco is the first jurisdiction to apply a warning label to SSBs, the proposed study offers an unprecedented opportunity to document if and how this approach could provide a viable tool for obesity prevention. Warning labels are a mainstay in evidence- based tobacco and alcohol policymaking. They have proven effective in changing attitudes, knowledge and the consumption of tobacco and to a lesser extent, alcohol, and therefore hold great promise for obesity prevention. The proposed study will examine how consumers understand and react to warning labels on advertisements, whether this increases knowledge about the health harms of SSBs, promotes negative attitudes towards SSBs, or reduces SSB consumption. The effects of race/ethnicity, income, health consciousness and cognitive processing of the message will be assessed. We propose a pre-post quasi-experimental design with a representative telephone panel survey, including a pre-implementation baseline observation and follow-ups at 6, 12 and 24 months post-baseline. We will follow a representative sample of 1100 San Francisco adults and 1100 residents of San Jose as a control jurisdiction. Latinos and blacks, two ethnic groups with higher rates of SSB consumption, obesity and diabetes, will be oversampled to analyze whether warning labels disproportionately impact these vulnerable populations. Subjects will be screened for cross-contamination through travel. A complementary study component that documents all forms of advertising visible in both SF and SJ locations will assess compliance and advertiser responses to the warning label, validate whether implementation occurs as intended by lawmakers, and will detect shifts away from regulated advertising by advertisers seeking to circumvent the label effects. Specific Aims of the study are to: 1) Aim 1. Assess the exposure of San Francisco’s residents to the warning label message by documenting implementation over time. 2) Aim 2. Assess exposure to warning labels in SF (and SJ) adults over time, and whether exposure is associated with changes in knowledge, attitudes and behavior pertaining to SSBs and whether changes affect subpopulations differently, 3) Aim 3. Examine whether San Franciscans exposed to warning labels on SSB advertising report more pronounced reductions in daily calories consumed from SSBs compared to San Jose residents over time.