Schwartz Marlene B, Schneider Glenn E, Choi Yoon-Young, Li Xun, Harris Jennifer, Andreyeva Tatiana, Hyary Maia, Highsmith Vernick Nicolette, Appel Lawrence J
Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford.
The Horizon Foundation, Columbia, Maryland.
JAMA Intern Med. 2017 May 1;177(5):666-674. doi: 10.1001/jamainternmed.2016.9650.
Data are needed to evaluate community interventions to reduce consumption of sugary drinks. Supermarket sales data can be used for this purpose.
To compare beverage sales in Howard County, Maryland (HC), with sales in comparison stores in a contiguous state before and during a 3-year campaign to reduce consumption of sugary beverages.
DESIGN, SETTING, AND PARTIPICANTS: This observational experiment with a control group included 15 HC supermarkets and 17 comparison supermarkets. Weekly beverage sales data at baseline (January 1 to December 31, 2012) and from campaign years 1 to 3 (January 1, 2013, through December 31, 2015) were analyzed. A difference-in-differences (DID) regression compared the volume sales per product per week in the HC and comparison stores, controlling for mean product price, competitor's product price, product size, weekly local temperature, and manufacturer.
The campaign message was to reduce consumption of all sugary drinks. Television advertising, digital marketing, direct mail, outdoor advertising, social media, and earned media during the 3-year period created 17 million impressions. Community partners successfully advocated for public policies to encourage healthy beverage consumption in schools, child care, health care, and government settings.
Sales were tracked of sugary drinks highlighted in the campaign, including regular soda, sports drinks, and fruit drinks. Sales of diet soda and 100% juice were also tracked. Sales data are expressed as mean fluid ounces sold per product, per store, per week.
Regular soda sales in the 15 HC supermarkets decreased (-19.7%) from 2012 through 2015, whereas sales remained stable (0.8%) in the 17 comparison supermarkets (DID adjusted mean, -369 fl oz; 95% CI, -469 to -269 fl oz; P < .01). Fruit drink sales decreased (-15.3%) in HC stores and remained stable (-0.6%) in comparison stores (DID adjusted mean, -342 fl oz; 95% CI, -466 to -220 fl oz; P < .001). Sales of 100% juice decreased more in HC (-15.0%) than comparison (-2.1%) stores (DID mean, -576 fl oz; 95% CI, -776 to -375 fl oz; P < .001). Sales of sports drinks (-86.3 fl oz; 95% CI, -343.6 to 170.9 fl oz) and diet soda (-17.8 in HC stores vs -11.3 in comparison stores; DID adjusted mean, -78.9 fl oz; 95% CI, -182.1 to 24.4 fl oz) decreased in both communities, but the decreases were not significantly different between groups.
A locally designed, multicomponent campaign to reduce consumption of sugary drinks was associated with an accelerated decrease in sales of regular soda, fruit drinks, and 100% juice. This policy-focused campaign provides a road map for other communities to reduce consumption of sugary drinks.
需要数据来评估减少含糖饮料消费的社区干预措施。超市销售数据可用于此目的。
比较马里兰州霍华德县（HC）的饮料销售情况与毗邻州对照商店在为期3年的减少含糖饮料消费活动之前及期间的销售情况。
设计、背景和参与者：这项有对照组的观察性实验包括15家HC超市和17家对照超市。分析了基线期（2012年1月1日至12月31日）以及活动第1年至第3年（2013年1月1日至2015年12月31日）的每周饮料销售数据。采用差异-in-差异（DID）回归比较了HC超市和对照商店中每种产品每周的销售量，并控制了平均产品价格、竞争对手的产品价格、产品尺寸、每周当地温度和制造商。
活动信息是减少所有含糖饮料的消费。在这3年期间，电视广告、数字营销、直邮、户外广告、社交媒体和口碑媒体产生了1700万次曝光。社区合作伙伴成功倡导了公共政策，以鼓励在学校、儿童保育、医疗保健和政府场所消费健康饮料。
追踪活动中突出强调的含糖饮料的销售情况，包括常规汽水、运动饮料和果汁饮料。还追踪了无糖汽水和100%果汁的销售情况。销售数据以每家商店每周每种产品销售的平均液量盎司数表示。
2012年至2015年，15家HC超市的常规汽水销售额下降了（-19.7%），而17家对照超市的销售额保持稳定（0.8%）（DID调整后均值为-369液量盎司；95%置信区间为-469至-269液量盎司；P < .01）。HC商店的果汁饮料销售额下降了（-15.3%），对照商店保持稳定（-0.6%）（DID调整后均值为-342液量盎司；95%置信区间为-466至-220液量盎司；P < .001）。100%果汁在HC商店的销售额下降幅度（-15.0%）大于对照商店（-2.1%）（DID均值为-576液量盎司；95%置信区间为-776至-375液量盎司；P < .001）。两个社区的运动饮料（-86.3液量盎司；95%置信区间为-343.6至170.9液量盎司）和无糖汽水（HC商店下降17.8，对照商店下降11.3；DID调整后均值为-78.9液量盎司；95%置信区间为-182.1至24.4液量盎司）销售额均下降，但两组之间的下降幅度无显著差异。
一项本地设计的多成分活动，旨在减少含糖饮料的消费，与常规汽水、果汁饮料和100%果汁销售额的加速下降相关。这项以政策为重点的活动为其他社区减少含糖饮料的消费提供了路线图。
