Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial
Abstract Background Although reducing sugar-sweetened beverage (SSB) intake is an important behavioral strategy to improve health, no known SSB-focused behavioral trial has examined maintenance of SSB behaviors after an initial reduction. Guided by the RE-AIM framework, this study examines 6–18 mont...
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | International Journal of Behavioral Nutrition and Physical Activity |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12966-018-0728-7 |
| _version_ | 1818026764796952576 |
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| author | Jamie M. Zoellner Wen You Paul A. Estabrooks Yvonnes Chen Brenda M. Davy Kathleen J. Porter Valisa E. Hedrick Angela Bailey Natalie Kružliaková |
| author_facet | Jamie M. Zoellner Wen You Paul A. Estabrooks Yvonnes Chen Brenda M. Davy Kathleen J. Porter Valisa E. Hedrick Angela Bailey Natalie Kružliaková |
| author_sort | Jamie M. Zoellner |
| collection | DOAJ |
| description | Abstract Background Although reducing sugar-sweetened beverage (SSB) intake is an important behavioral strategy to improve health, no known SSB-focused behavioral trial has examined maintenance of SSB behaviors after an initial reduction. Guided by the RE-AIM framework, this study examines 6–18 month and 0–18 month individual-level maintenance outcomes from an SSB reduction trial conducted in a medically-underserved, rural Appalachia region of Virginia. Reach and implementation indicators are also reported. Methods Following completion of a 6-month, multi-component, behavioral RCT to reduce SSB intake (SIPsmartER condition vs. comparison condition), participants were further randomized to one of three 12-month maintenance conditions. Each condition included monthly telephone calls, but varied in mode and content: 1) interactive voice response (IVR) behavior support, 2) human-delivered behavior support, or 3) IVR control condition. Assessments included the Beverage Intake Questionnaire (BEVQ-15), weight, BMI, and quality of life. Call completion rates and costs were tracked. Analysis included descriptive statistics and multilevel mixed-effects linear regression models using intent-to-treat procedures. Results Of 301 subjects enrolled in the 6-month RCT, 242 (80%) were randomized into the maintenance phase and 235 (78%) included in the analyses. SIPsmartER participants maintained significant 0–18 month decreases in SSB. For SSB, weight, BMI and quality of life, there were no significant 6–18 month changes among SIPsmartER participants, indicating post-program maintenance. The IVR-behavior participants reported greater reductions in SSB kcals/day during the 6–18 month maintenance phase, compared to the IVR control participants (− 98 SSB kcals/day, 95% CI = − 196, − 0.55, p < 0.05); yet the human-delivered behavior condition was not significantly different from either the IVR-behavior condition (27 SSB kcals/day, 95% CI = − 69, 125) or IVR control condition (− 70 SSB kcals/day, 95% CI = − 209, 64). Call completion rates were similar across maintenance conditions (4.2–4.6 out of 11 calls); however, loss to follow-up was greatest in the IVR control condition. Approximated costs of IVR and human-delivered calls were remarkably similar (i.e., $3.15/participant/month or $38/participant total for the 12-month maintenance phase), yet implications for scalability and sustainability differ. Conclusion Overall, SIPsmartER participants maintained improvements in SSB behaviors. Using IVR to support SSB behaviors is effective and may offer advantages as a scalable maintenance strategy for real-world systems in rural regions to address excessive SSB consumption. Trial registry Clinicaltrials.gov; NCT02193009; Registered 11 July 2014. Retrospectively registered. |
| first_indexed | 2024-12-10T04:37:12Z |
| format | Article |
| id | doaj.art-18d2b105f45646a8b77869499d4963fa |
| institution | Directory Open Access Journal |
| issn | 1479-5868 |
| language | English |
| last_indexed | 2024-12-10T04:37:12Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Behavioral Nutrition and Physical Activity |
| spelling | doaj.art-18d2b105f45646a8b77869499d4963fa2022-12-22T02:01:58ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682018-10-0115111610.1186/s12966-018-0728-7Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trialJamie M. Zoellner0Wen You1Paul A. Estabrooks2Yvonnes Chen3Brenda M. Davy4Kathleen J. Porter5Valisa E. Hedrick6Angela Bailey7Natalie Kružliaková8Department of Public Health Sciences, School of Medicine, University of VirginiaDepartment of Agricultural and Applied Economics, Virginia TechDepartment of Health Promotion, University of Nebraska Medical CenterSchool of Journalism, University of KansasDepartment of Human Nutrition, Foods and Exercise, Virginia TechCancer Center without Walls at the UVA Cancer CenterDepartment of Human Nutrition, Foods and Exercise, Virginia TechDepartment of Movement Arts, Health Promotion & Leisure Studies, Bridgewater State UniversityDepartment of Human Nutrition, Foods and Exercise, Virginia TechAbstract Background Although reducing sugar-sweetened beverage (SSB) intake is an important behavioral strategy to improve health, no known SSB-focused behavioral trial has examined maintenance of SSB behaviors after an initial reduction. Guided by the RE-AIM framework, this study examines 6–18 month and 0–18 month individual-level maintenance outcomes from an SSB reduction trial conducted in a medically-underserved, rural Appalachia region of Virginia. Reach and implementation indicators are also reported. Methods Following completion of a 6-month, multi-component, behavioral RCT to reduce SSB intake (SIPsmartER condition vs. comparison condition), participants were further randomized to one of three 12-month maintenance conditions. Each condition included monthly telephone calls, but varied in mode and content: 1) interactive voice response (IVR) behavior support, 2) human-delivered behavior support, or 3) IVR control condition. Assessments included the Beverage Intake Questionnaire (BEVQ-15), weight, BMI, and quality of life. Call completion rates and costs were tracked. Analysis included descriptive statistics and multilevel mixed-effects linear regression models using intent-to-treat procedures. Results Of 301 subjects enrolled in the 6-month RCT, 242 (80%) were randomized into the maintenance phase and 235 (78%) included in the analyses. SIPsmartER participants maintained significant 0–18 month decreases in SSB. For SSB, weight, BMI and quality of life, there were no significant 6–18 month changes among SIPsmartER participants, indicating post-program maintenance. The IVR-behavior participants reported greater reductions in SSB kcals/day during the 6–18 month maintenance phase, compared to the IVR control participants (− 98 SSB kcals/day, 95% CI = − 196, − 0.55, p < 0.05); yet the human-delivered behavior condition was not significantly different from either the IVR-behavior condition (27 SSB kcals/day, 95% CI = − 69, 125) or IVR control condition (− 70 SSB kcals/day, 95% CI = − 209, 64). Call completion rates were similar across maintenance conditions (4.2–4.6 out of 11 calls); however, loss to follow-up was greatest in the IVR control condition. Approximated costs of IVR and human-delivered calls were remarkably similar (i.e., $3.15/participant/month or $38/participant total for the 12-month maintenance phase), yet implications for scalability and sustainability differ. Conclusion Overall, SIPsmartER participants maintained improvements in SSB behaviors. Using IVR to support SSB behaviors is effective and may offer advantages as a scalable maintenance strategy for real-world systems in rural regions to address excessive SSB consumption. Trial registry Clinicaltrials.gov; NCT02193009; Registered 11 July 2014. Retrospectively registered.http://link.springer.com/article/10.1186/s12966-018-0728-7BeveragesRandomized controlled trialMaintenanceRural populationBehavioral researchTechnology |
| spellingShingle | Jamie M. Zoellner Wen You Paul A. Estabrooks Yvonnes Chen Brenda M. Davy Kathleen J. Porter Valisa E. Hedrick Angela Bailey Natalie Kružliaková Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial International Journal of Behavioral Nutrition and Physical Activity Beverages Randomized controlled trial Maintenance Rural population Behavioral research Technology |
| title | Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial |
| title_full | Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial |
| title_fullStr | Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial |
| title_full_unstemmed | Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial |
| title_short | Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial |
| title_sort | supporting maintenance of sugar sweetened beverage reduction using automated versus live telephone support findings from a randomized control trial |
| topic | Beverages Randomized controlled trial Maintenance Rural population Behavioral research Technology |
| url | http://link.springer.com/article/10.1186/s12966-018-0728-7 |
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