Gowland-Ella Justine, Batchelor Samantha, David Michael, Lewis Peter, Kajons Nicole
Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia.
Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, NSW, Australia.
Health Promot J Austr. 2023 Apr;34(2):410-419. doi: 10.1002/hpja.623. Epub 2022 Jun 22.
Childhood obesity is a serious public health challenge. Consumption of sugar-sweetened beverages (SSBs) is one contributing factor, with adolescents being the highest consumers.
This study used a randomised controlled trial and two-by-two factorial design to determine the effectiveness of a school-based behavioural intervention (including education/promotional messages) and/or environmental intervention (chilled water station), on encouraging adolescents to choose water instead of SSBs. Sixty-one secondary schools (n = 8992 eligible students year 7 student) were recruited and randomly allocated to one of four study groups, the behavioural intervention, the environmental intervention, both interventions or neither.
The primary outcome was increased water consumption; secondary outcomes included changes in students' knowledge and attitudes about water and SSBs and changes in SSB consumption. For students who received at least one intervention there was an increased odds (though not statistically significant) of higher water consumption compared to those that received no intervention. There was a decrease in SSB consumption for students who received both interventions combined (OR: 0.67; 95% confidence interval: 0.55-0.082; P < .01).
The combined intervention had a greater effect on decreasing SSBs consumption. This is noteworthy given SSBs are a key contributor to overweight and obesity. SO WHAT?: To our knowledge this is the first Australian study examining combined school-based interventions to specifically promote the consumption of water and decrease the consumption of SSBs in adolescents. The study findings add to the evidence regarding the benefits of delivering multicomponent school-based interventions which add value to existing interventions that address the complex public health issue of overweight and obesity.
儿童肥胖是一项严峻的公共卫生挑战。饮用含糖饮料（SSB）是一个促成因素，青少年是这类饮料的最大消费群体。
本研究采用随机对照试验和二乘二析因设计，以确定一项基于学校的行为干预措施（包括教育/宣传信息）和/或环境干预措施（冷水供应站）在鼓励青少年选择水而非含糖饮料方面的有效性。研究招募了61所中学（n = 8992名符合条件的7年级学生），并将其随机分配到四个研究组之一：行为干预组、环境干预组、两种干预措施都采用组或两种干预措施都不采用组。
主要结果是饮水量增加；次要结果包括学生对水和含糖饮料的知识及态度的变化，以及含糖饮料消费量的变化。与未接受任何干预的学生相比，接受至少一项干预的学生饮水量增加的几率更高（尽管无统计学意义）。接受两种干预措施相结合的学生的含糖饮料消费量有所下降（比值比：0.67；95%置信区间：0.55 - 0.082；P < 0.01）。
联合干预措施在减少含糖饮料消费方面效果更佳。鉴于含糖饮料是超重和肥胖的一个关键促成因素，这一点值得关注。那又如何？据我们所知，这是澳大利亚第一项研究联合学校干预措施以专门促进青少年饮水并减少其含糖饮料消费的研究。该研究结果补充了有关实施多成分学校干预措施益处的证据，这些措施为解决超重和肥胖这一复杂公共卫生问题的现有干预措施增添了价值。
