Zoellner Jamie M, You Wen, Porter Kathleen, Reid Annie L, Brock Donna-Jean P, Markwalter Theresa, Frederick Christina, Tate Deborah F, Ritterband Lee
Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia, Christiansburg, VA, United States.
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States.
Am J Clin Nutr. 2025 Jun 11. doi: 10.1016/j.ajcnut.2025.06.010.
Reducing sugar-sweetened beverages (SSB) is a worldwide public health priority. There are United States regions with notable SSB consumption pattern disparities, including Appalachia.
We aimed to measure the efficacy of a digital behavioral intervention in reducing SSB consumption. Weight and quality of life (QOL) were also explored.
In this 2-group randomized-controlled trial targeting adults living in Appalachia, participants were randomly assigned to either an interactive, structured, digital intervention comprised of 6 cores, behavioral tracking, and personalized action planning, or a static patient education website. At baseline and at 9-wk and 6-mo postintervention, validated measures were used to assess SSB intake and QOL. Weight was captured using cellular-enabled scales.
Participants (n = 249) were 88% Caucasian, 83% female, 52% with income <$55,000/y, 86% from more rural counties, and 84% with overweight or obesity. In the digital intervention group, the mean core completion was 5.2 [standard deviation (SD) = 1.6] of 6 cores, and participants tracked a mean of 76% (SD = 29%) of daily SSB diaries and 57% (SD = 31%) of daily weights. At 9-wk, digital intervention participants [-896.1 mL/d; 95% confidence interval (CI): -1043.9, -748.2 mL/d] consumed 289.8 (95% CI: -493.9, -88.7) less SSB mL/d than comparison participants (-606.3 mL/d; 95% CI: -745.3, -467.9 mL/d) [effect size (ES) = 0.37; P = 0.005]. The 6-mo assessment was similar, with digital intervention participants consuming an average of 280.9 (95% CI: -490.9, -68.0) less SSB mL/d than comparison participants (ES = 0.35; P = 0.009). There was no significant between-condition QOL effects, yet QOL improved within both conditions (P < 0.001). At 6-mo, body weight was significantly reduced for digital intervention relative to comparison participants (ES = 0.23; P = 0.046).
A digital behavioral intervention was efficacious in reducing SSB consumption among Appalachian adults and yielded high engagement and retention rates. This intervention should be evaluated in other populations with excessive SSB consumption. This trial was registered at clincialtrials.gov as NCT05030753.
减少含糖饮料（SSB）的摄入是一项全球公共卫生重点工作。美国有些地区，包括阿巴拉契亚地区，存在显著的含糖饮料消费模式差异。
我们旨在衡量一种数字行为干预措施在减少含糖饮料消费方面的效果。同时还探讨了体重和生活质量（QOL）情况。
在这项针对居住在阿巴拉契亚地区成年人的两组随机对照试验中，参与者被随机分配到一个由6个核心部分、行为追踪和个性化行动计划组成的交互式、结构化数字干预组，或一个静态的患者教育网站组。在基线、干预后9周和6个月时，使用经过验证的测量方法来评估含糖饮料摄入量和生活质量。使用具备蜂窝功能的秤测量体重。
参与者（n = 249）中88%为白人，83%为女性，52%的年收入低于55,000美元，86%来自农村县，84%超重或肥胖。在数字干预组中，6个核心部分的平均完成数为5.2（标准差[SD] = 1.6），参与者平均记录了76%（SD = 29%）的每日含糖饮料日记和57%（SD = 31%）的每日体重。在9周时，数字干预组参与者[ -896.1 mL/天；95%置信区间（CI）：-1043.9，-748.2 mL/天]比对照组参与者（-606.3 mL/天；95% CI：-745.3，-467.9 mL/天）每天少摄入289.8（95% CI：-493.9，-88.7）毫升含糖饮料[效应量（ES） = 0.37；P = 0.005]。6个月的评估结果相似，数字干预组参与者比对照组参与者每天平均少摄入280.9（95% CI：-490.9，-68.0）毫升含糖饮料（ES = 0.35；P = 0.009）。不同组间生活质量没有显著影响，但两组内生活质量均有所改善（P < 0.001）。在6个月时，与对照组参与者相比，数字干预组的体重显著降低（ES = 0.23；P = 0.046）。
数字行为干预措施在减少阿巴拉契亚地区成年人的含糖饮料消费方面有效，且参与率和留存率较高。应在其他含糖饮料消费过量的人群中对该干预措施进行评估。本试验已在clinicaltrials.gov上注册，注册号为NCT05030753。
