Kids SIPsmartER: A multi-level behavioral and health literacy intervention to reduce sugar-sweetened beverages among Appalachian middle-school students

Kids SIPsmartER：多层次的行为和健康素养干预措施，旨在减少阿巴拉契亚中学生的含糖饮料

• 批准号: 10312773
• 负责人: Jamie Zoellner
• 金额: $ 83万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-03 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10312773
• 关键词: Adolescent; Adoption; Adult; Appalachian Region; Behavior; Behavioral; Body mass index; Cardiovascular Diseases; Caregivers; Child; Chronic; Collaborations; Consumption; County; Data; Dental; Dental caries; Diabetes Mellitus; Disparity; Educational Curriculum; Effectiveness; Enrollment; Environment; Evaluation; Feasibility Studies; Frequencies; Fruit; Gatekeeping; Geography; Goals; Health; Health Promotion; Health education; Heart Diseases; High School Student; Home; Home environment; Individual; Influentials; Institutionalization; Intake; Intervention; Interview; Maintenance; Malignant Neoplasms; Medical; Methods; Middle School Student; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity associated cancer; Odds Ratio; Outcome; Phase; Planning Theory; Population; Prevention; Prevention Research; Prevention program; Prospective Studies; Public Health; Qualitative Research; Quality of life; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Research Personnel; Resources; Review Literature; Rural; Rural Appalachia; Sampling; School-Age Population; Schools; Seminal; Services; Sports; Students; Surveys; System; Tea; Text Messaging; Time; Training; Transportation; Virginia; Voice; Work; Youth; comparison control; digital; effectiveness evaluation; evidence base; health goals; health inequalities; health literacy; hybrid type 1 design; implementation determinants; improved; junior high school; literacy; mathematical ability; medically underserved; process evaluation; programs; public health relevance; response; role model; scale up; school district; seventh grade; soft drink; sugar; sweetened beverage; systematic review; teacher; theories; Adolescent; Adoption; Adult; Appalachian Region; Behavior; Behavioral; Body mass index; Cardiovascular Diseases; Caregivers; Child; Chronic; Collaborations; Consumption; County; Data; Dental; Dental caries; Diabetes Mellitus; Disparity; Educational Curriculum; Effectiveness; Enrollment; Environment; Evaluation; Feasibility Studies; Frequencies; Fruit; Gatekeeping; Geography; Goals; Health; Health Promotion; Health education; Heart Diseases; High School Student; Home; Home environment; Individual; Influentials; Institutionalization; Intake; Intervention; Interview; Maintenance; Malignant Neoplasms; Medical; Methods; Middle School Student; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity associated cancer; Odds Ratio; Outcome; Phase; Planning Theory; Population; Prevention; Prevention Research; Prevention program; Prospective Studies; Public Health; Qualitative Research; Quality of life; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Research Personnel; Resources; Review Literature; Rural; Rural Appalachia; Sampling; School-Age Population; Schools; Seminal; Services; Sports; Students; Surveys; System; Tea; Text Messaging; Time; Training; Transportation; Virginia; Voice; Work; Youth; comparison control; digital; effectiveness evaluation; evidence base; health goals; health inequalities; health literacy; hybrid type 1 design; implementation determinants; improved; junior high school; literacy; mathematical ability; medically underserved; process evaluation; programs; public health relevance; response; role model; scale up; school district; seventh grade; soft drink; sugar; sweetened beverage; systematic review; teacher; theories

Project Summary: The intake of sugar-sweetened beverages (SSB, e.g., soda/pop, sweet tea, sports and energy drinks, fruit drinks) is disproportionately high in Appalachia, including among adolescents whose intake is more than double the national average and more than four times the recommended daily amount. There are strong and consistent scientific data and systematic reviews documenting relationships among high SSB consumption and numerous chronic health conditions such obesity, some types of obesity-related cancers, diabetes, cardiovascular disease, and dental erosion and decay. Reaching adolescents with behaviorally- focused health programs where they spend the majority of their time, at school, shows promise. However, engaging caregivers who serve as their child’s most influential role model as well as the gatekeeper for the home environment may be equally as important in changing adolescents’ SSB behaviors. Finally, there is a great need to understand how to support schools and teachers to deliver and maintain evidence-based health education programs, especially among rural schools. Thus, the overarching goal of this proposal is to work in partnership with Appalachian middle schools to implement and evaluate Kids SIPsmartER. Kids SIPsmartER is a 6-month, school-based, behavior and health literacy curriculum aimed at improving SSB behaviors among middle school students. The program also integrates a two-way short service message (SMS) strategy to engage caregivers in SSB role modeling and supporting home SSB environment changes. Kids SIPsmartER is grounded by the Theory of Planned Behavior as well as health literacy, media literacy, numeracy, and public health literacy concepts. In our proposed cluster-randomized controlled trial, we target 12 middle schools in medically underserved Appalachian counties in southwest Virginia. Our study is guided by the RE-AIM (reach, adoption, effectiveness, implementation, and maintenance) framework and is a type 1 hybrid design. The primary aim is to assess changes in SSB behaviors at 7-months among 7th grade students at schools receiving Kids SIPsmartER, as compared to control schools. We will also evaluate changes in secondary student outcomes (e.g., BMI, quality of life, theory-related variables), changes in caregiver outcomes (e.g., SSB behaviors, home SSB environment), and 19-month maintenance of outcomes. The reach and representativeness of Kids SIPsmartER will be assessed. Furthermore, we will use a mixed-methods approach with interviews, surveys, observation, and process evaluation strategies to determine the degree to which teachers implement Kids SIPsmartER as intended and the potential for institutionalization within the schools. The long-term goal of this health promotion and prevention line of research is to establish an effective, scalable, and sustainable multi-level strategy to improve SSB behaviors and reduce SSB-related health inequities and chronic conditions (e.g. obesity, cancer, type II diabetes, heart disease, dental caries) in rural Appalachia.

项目摘要：摄入糖甜卧室（SSB，例如苏打/流行音乐，甜茶，体育和体育和 在阿巴拉契亚州的能量饮料，果实饮料），包括摄入量的青少年 是全国平均水平的两倍多，是建议每日金额的四倍以上。有 强大而一致的科学数据和系统评价记录了高SSB之间的关系 消费和许多慢性健康状况，例如肥胖症，某些类型的肥胖相关癌症， 糖尿病，心血管疾病以及牙齿侵蚀和衰减。在行为上接触青少年 集中精力的健康计划在学校里花费大部分时间在学校都表现出了希望。然而， 吸引他们作为孩子最有影响力的榜样的看护人以及 家庭环境在改变青少年的SSB行为方面同样重要。最后，有一个 非常需要了解如何支持学校和教师提供和维持基于证据的健康 教育计划，尤其是在农村学校中。那就是该提议的总体目标是在 与阿巴拉契亚中学合作实施和评估儿童sipsmarter。儿童sipsmarter是 一个6个月的基于学校，行为和健康素养课程，旨在改善SSB的行为 中学生。该计划还将双向短路服务消息（SMS）策略集成到 让看护人参与SSB角色建模和支持家庭SSB环境的变化。儿童sipsmarter是 以计划行为理论以及健康素养，媒体素养，数字和公众为基础 健康素养概念。在我们拟议的集群随机对照试验中，我们针对12个中学 西南弗吉尼亚州的医学服务不足的阿巴拉契亚县。我们的研究在Re-aim的指导下（触及， 采用，有效性，实施和维护）框架，是1型混合设计。这 主要目的是评估7年级学生在7年级学生中的SSB行为的变化 与对照学校相比，孩子们sipsmarter。我们还将评估二级学生的变化 结果（例如BMI，生活质量，与理论相关的变量），护理人员结果的变化（例如SSB 行为，家庭SSB环境）和成果的19个月维护。覆盖范围和 将评估儿童sipsmarter的代表性。此外，我们将使用混合方法 采访，调查，观察和过程评估策略，以确定 教师按预期实施儿童sipsmarter，并在学校内实施制度化的潜力。 这种健康促进和预防研究的长期目标是建立有效的， 可扩展且可持续的多层次策略，以改善SSB行为并降低与SSB相关的健康 农村的不平等和慢性病（例如肥胖，癌症，II型糖尿病，心脏病，龋齿） 阿巴拉契亚。