Share This Article:

Mixed methods evaluation of a randomized control pilot trial targeting sugar-sweetened beverage behaviors

Full-Text HTML Download Download as PDF (Size:647KB) PP. 51-57
DOI: 10.4236/ojpm.2013.31007    4,064 Downloads   6,377 Views   Citations

ABSTRACT

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 (Move-More). 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 SipS- martER. 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 opportuneties to improve clarity of learning materials, enhance instructions and communication, and refine research protocols. Although SSB consumption decreased more among the SipS-martER 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.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Zoellner, J. , Cook, E. , Chen, Y. , You, W. , Davy, B. and Estabrooks, P. (2013) Mixed methods evaluation of a randomized control pilot trial targeting sugar-sweetened beverage behaviors. Open Journal of Preventive Medicine, 3, 51-57. doi: 10.4236/ojpm.2013.31007.

References

[1] Duffey, K.J. and Popkin, B.M. (2007) Shifts in patterns and consumption of beverages between 1965 and 2002. Obesity, 15, 2739-2747. doi:10.1038/oby.2007.326
[2] Vartanian, L.R, Schwartz, M.B. and Brownell, K.D. (2007) Effects of soft drink consumption on nutrition and health: A systematic review and meta-analysis. American Journal of Public Health, 97, 667-675. doi:10.2105/AJPH.2005.083782
[3] Nielsen-Bohlman, L., Panzer, A.M. and Kindig, D.A. (2004) Health Literacy: A Prescription to End Confusion. National Academies Press,Washington DC.
[4] Berkman, N.S.S., Donahue, K., et al. (2011) Health literacy interventions and outcomes: An update of the literacy and health outcomes systematic review of the literature. RTI International-University of North Carolina Evidence-Based Practice Center, Chapel Hill.
[5] Zoellner, J., You, W., Connell, C., et al. (2011) Health literacy is associated with Healthy Eating Index scores and sugar-sweetened beverage intake: Findings from the rural lower Mississippi Delta. Journal of American Dietetic Association, 111, 1012-1020. doi:10.1016/j.jada.2011.04.010
[6] Allen, K., Zoellner, J., Motley, M., et al. (2010) Understanding the internal and external validity of health literacy interventions: A systematic literature review using the RE-AIM framework. The Journal of Health Communication, 16, 55-72. doi:10.1080/10810730.2011.604381
[7] Tate, D.F., Turner-McGrievy, G., Lyons, E., et al. (2012) Replacing caloric beverages with water or diet beverages for weight loss in adults: Main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. American Journal of Clinical Nutrition, 95, 555-563. doi:10.3945/ajcn.111.026278
[8] Stookey, J.D., Constant, F., Popkin, B.M., et al. (2008) Drinking water is associated with weight loss in overweight dieting women independent of diet and activity. Obesity, 16, 2481-2488. doi:10.1038/oby.2008.409
[9] Chen, L.W., Appel, L.J., Loria, C., et al. (2009) Reduction in consumption of sugar-sweetened beverages is associated with weight loss: The PREMIER trial. American Journal of Clinical Nutrition, 89, 1299-1306. doi:10.3945/ajcn.2008.27240
[10] Wen, K.-Y., Miller, S.M., Stanton, A.L., et al. (2012) The development and preliminary testing of a multimedia patient-provider survivorship communication module for breast cancer survivors. Patient Education and Counseling, 88, 344-349. doi:10.1016/j.pec.2012.02.003
[11] Helfand, M., Berg. A., Flum, D., et al. (2012) Draft Methodology report: Our questions, our decisions: Standards for patient-centered outcomes research. http://pcori.org/assets/MethodologyReport-Comment.pdf
[12] Venetis, M.K., Robinson, J.D. Turkiewicz, K.L., et al. (2009) An evidence base for patient-centered cancer care: A meta-analysis of studies of observed communication between cancer specialists and their patients. Patient Education and Counseling, 77, 379-383. doi:10.1016/j.pec.2009.09.015
[13] Ajzen, I. (1985) From intentions to actions: A theory of planned behavior. In: Kuhl, J. and Beckmann, J., Eds., Action-Control: From Cognition to Behavior, Springer, Heidelberg, 11-39.
[14] Zarcadoolas, C., Pleasant, A. and Greer, D. (2006) Advancing health literacy: A framework for understanding and action. Jossey-Bass, San Francisco.
[15] Aufderheide, P. (1993) Part II: Conference Proceedings and Next Steps. Communications and Society Program of the Aspen Institute, Washington DC.
[16] Glasgow, R.E., Vogt, T.M. and Boles, S.M. (1999) Evaluating the public health impact of health promotion interventions: The RE-AIM framework. American Journal of Public Health, 89, 1322-1327. doi:10.2105/AJPH.89.9.1322
[17] Zoellner, J., Krzeski, E., Harden, S., et al. (2012) Qualitative application of the theory of planned behavior to understand beverage consumption behaviors among adults. Journal of the Academy of Nutrition and Dietetics, 112, 1774-1784. doi:10.1016/j.jand.2012.06.368
[18] Hedrick, V.E., Savla, J., Comber, D.L., et al. (2012) Development of a brief questionnaire to assess habitual beverage intake (BEVQ-15): Sugar-sweetened beverages and total beverage energy intake. Journal of the Academy of Nutrition and Dietetics, 112, 840-849. doi:10.1016/j.jand.2012.01.023
[19] Zoellner, J., Estabrooks, P., Davy, B., et al. (2012) Exploring the theory of planned behavior to explain sugar-sweetened beverage consumption. Journal of Nutrition Education and Behavior, 44, 172-177. doi:10.1016/j.jneb.2011.06.010
[20] Primack, B.A., Gold, M.A., Switzer, G.E., et al. (2006) Development and validation of a smoking media literacy scale for adolescents. Archives of Pediatric and Adolescent Medicine, 160, 369-374. doi:10.1001/archpedi.160.4.369
[21] Klesges, R., Eck, L., Mellon, M., et al. (1990) The accuracy of self-reports of physical activity. Medical Science Sports and Exercise, 22, 690-697. doi:10.1249/00005768-199010000-00022
[22] Weiss, B., Mays, M., Martz, W., et al. (2005) Quick assessment of literacy in primary care: The newest vital sign. Annuals of Family Medicine, 3, 514-522. doi:10.1370/afm.405
[23] Levav, J. and Fitzsimons, G. (2006) When questions change behavior: The role of ease representation. Physcological Science, 17, 207-213.

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.