Zoellner Jamie, Cook Emily, Chen Yvonnes, You Wen, Davy Brenda, Estabrooks Paul
Department of Human Nutrition Foods and Exercise, Virginia Tech, Blacksburg, USA.
Open J Prev Med. 2013 Feb 1;3(1):51-57. doi: 10.4236/ojpm.2013.31007.
This Excessive sugar-sweetened beverage (SSB) consumption and low health literacy skills have emerged as two public health concerns in the United States (US); however, there is limited research on how to effectively address these issues among adults. As guided by health literacy concepts and the Theory of Planned Behavior (TPB), this randomized controlled pilot trial applied the RE-AIM framework and a mixed methods approach to examine a sugar-sweetened beverage (SSB) intervention (SipSmartER), as compared to a matched-contact control intervention targeting physical activity (MoveMore). Both 5-week interventions included two interactive group sessions and three support telephone calls. Executing a patient-centered developmental process, the primary aim of this paper was to evaluate patient feedback on intervention content and structure. The secondary aim was to understand the potential reach (i.e., proportion enrolled, representativeness) and effectiveness (i.e. health behaviors, theorized mediating variables, quality of life) of SipSmartER. Twenty-five participants were randomized to SipSmartER (n=14) or MoveMore (n=11). Participants' intervention feedback was positive, ranging from 4.2-5.0 on a 5-point scale. Qualitative assessments reavealed several opportunties to improve clarity of learning materials, enhance instructions and communication, and refine research protocols. Although SSB consumption decreased more among the SipSmartER participants (-256.9 ± 622.6 kcals), there were no significant group differences when compared to control participants (-199.7 ± 404.6 kcals). Across both groups, there were significant improvements for SSB attitudes, SSB behavioral intentions, and two media literacy constructs. The value of using a patient-centered approach in the developmental phases of this intervention was apparent, and pilot findings suggest decreased SSB may be achieved through targeted health literacy and TPB strategies. Future efforts are needed to examine the potential public health impact of a large-scale trial to address health literacy and reduce SSB.
过量饮用含糖饮料（SSB）和健康素养技能低下已成为美国的两个公共卫生问题；然而，关于如何在成年人中有效解决这些问题的研究有限。在健康素养概念和计划行为理论（TPB）的指导下，这项随机对照试验性研究应用了RE-AIM框架和混合方法，来检验一种含糖饮料（SSB）干预措施（SipSmartER），并与针对身体活动的匹配接触式对照干预措施（MoveMore）进行比较。这两种为期5周的干预措施都包括两次互动小组会议和三次支持性电话。通过执行以患者为中心的开发过程，本文的主要目的是评估患者对干预内容和结构的反馈。次要目的是了解SipSmartER的潜在影响范围（即登记比例、代表性）和有效性（即健康行为、理论中介变量、生活质量）。25名参与者被随机分配到SipSmartER组（n = 14）或MoveMore组（n = 11）。参与者对干预的反馈是积极的，在5分制量表上的评分为4.2至5.0。定性评估揭示了几个改进学习材料清晰度、加强指导和沟通以及完善研究方案的机会。尽管SipSmartER组参与者的含糖饮料摄入量下降幅度更大（-256.9±622.6千卡），但与对照组参与者（-199.7±404.6千卡）相比，两组之间没有显著差异。在两组中，含糖饮料态度、含糖饮料行为意图和两种媒体素养指标都有显著改善。在该干预措施的开发阶段采用以患者为中心的方法的价值是显而易见的，试验结果表明，通过有针对性的健康素养和TPB策略，可以减少含糖饮料的摄入量。未来需要努力研究大规模试验对解决健康素养和减少含糖饮料摄入量的潜在公共卫生影响。
