A cluster randomised controlled trial of a sugar-sweetened beverage intervention in secondary schools: Pilot study protocol

Ooi, Jia Ying; Sutherland, Rachel; Nathan, Nicole; Yoong, Sze Lin; Janssen, Lisa; Wrigley, Jessica; Wolfenden, Luke

doi:10.1177/0260106018791856

Cited by 9 publications

(25 citation statements)

References 62 publications

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“…We conducted trial register searches to identify ongoing studies, and found 10 studies which we judged likely to meet our eligibility criteria upon completion. These include four studies on improved availability of drinking water in schools (Kajons 2018; NCT02996422; NCT03069274; NCT03181971), two studies on improved availability of low‐calorie beverages in the home environment (NCT02877823; NCT0306927), and one study each on reduced availability of SSB and improved availability of drinking water in schools (Oi 2018), reduced availability of SSB in workplaces (NCT03431051), price increases on SSB (NCT02914821) and the removal of SSB from supermarket checkout coolers (NCT03518151). We provide details of these studies in the section Characteristics of ongoing studies.…”

Section: Resultsmentioning

confidence: 99%

Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health

Philipsborn

Stratil

Burns

et al. 2019

Cochrane Database of Systematic Reviews

171

136

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BackgroundFrequent consumption of excess amounts of sugar‐sweetened beverages (SSB) is a risk factor for obesity, type 2 diabetes, cardiovascular disease and dental caries. Environmental interventions, i.e. interventions that alter the physical or social environment in which individuals make beverage choices, have been advocated as a means to reduce the consumption of SSB.ObjectivesTo assess the effects of environmental interventions (excluding taxation) on the consumption of sugar‐sweetened beverages and sugar‐sweetened milk, diet‐related anthropometric measures and health outcomes, and on any reported unintended consequences or adverse outcomes.Search methodsWe searched 11 general, specialist and regional databases from inception to 24 January 2018. We also searched trial registers, reference lists and citations, scanned websites of relevant organisations, and contacted study authors.Selection criteriaWe included studies on interventions implemented at an environmental level, reporting effects on direct or indirect measures of SSB intake, diet‐related anthropometric measures and health outcomes, or any reported adverse outcome. We included randomised controlled trials (RCTs), non‐randomised controlled trials (NRCTs), controlled before‐after (CBA) and interrupted‐time‐series (ITS) studies, implemented in real‐world settings with a combined length of intervention and follow‐up of at least 12 weeks and at least 20 individuals in each of the intervention and control groups. We excluded studies in which participants were administered SSB as part of clinical trials, and multicomponent interventions which did not report SSB‐specific outcome data. We excluded studies on the taxation of SSB, as these are the subject of a separate Cochrane Review.Data collection and analysisTwo review authors independently screened studies for inclusion, extracted data and assessed the risks of bias of included studies. We classified interventions according to the NOURISHING framework, and synthesised results narratively and conducted meta‐analyses for two outcomes relating to two intervention types. We assessed our confidence in the certainty of effect estimates with the GRADE framework as very low, low, moderate or high, and presented ‘Summary of findings’ tables.Main resultsWe identified 14,488 unique records, and assessed 1030 in full text for eligibility. We found 58 studies meeting our inclusion criteria, including 22 RCTs, 3 NRCTs, 14 CBA studies, and 19 ITS studies, with a total of 1,180,096 participants. The median length of follow‐up was 10 months. The studies included children, teenagers and adults, and were implemented in a variety of settings, including schools, retailing and food service establishments. We judged most studies to be at high or unclear risk of bias in at least one domain, and most studies used non‐randomised designs. The studies examine a broad range of interventions, and we present results for these separately.Labelling interventions (8 studies): We found moderate‐certainty evidence that traffic‐light labelli...

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Section: Resultsmentioning

confidence: 99%

Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health

Philipsborn

Stratil

Burns

et al. 2019

Cochrane Database of Systematic Reviews

171

136

View full text Add to dashboard Cite

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“…A modelling study shows that the reduction in free sugars added to SSBs, without the use of artificial sweeteners, is predicted to reduce the prevalence of overweight, obesity and type 2 diabetes [19]. The high intake of SSBs in adolescents has been consistently linked to overweight and obesity; hence, interventions in this area should be prioritised [20]. To confirm this data, there is an increasing body of evidence that suggests that decreasing consumption of SSBs can impact positively on childhood overweight and obesity [21].…”

Section: Overweightmentioning

confidence: 99%

Consumption of Sugar-Sweetened Beverages in Paediatric Age: A Position Paper of the European Academy of Paediatrics and the European Childhood Obesity Group

Dereń

Weghuber

Caroli³

et al. 2019

Ann Nutr Metab

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Background: Health risks associated with the high consumption of sugar-sweetened beverages (SSBs) include overweight or obesity and their complications such as diabetes, as well as oral and dental decay, among others. Aim: The aim of the present statement is to inform health care professionals, parents, care-givers, teachers and school head teachers, stakeholders and governing bodies about the risks associated with drinking SSBs in infants, children and adolescents. Methods: We searched PubMed and the Cochrane databases for English language studies published from 2010 through October 1, 2018, for randomized clinical trials, meta-analyses, systematic reviews and observational studies (search terms are reported in eAppendix in the Supplement). We also manually searched the references of selected articles, reviews, meta-analyses and practice guidelines. Recommendations: Consumption of SSB by children and adolescents should be limited, and the consumption of water and other non-sweetened beverages should be promoted. Educational institutions such as nurseries, pre-schools and schools should offer unlimited access to drinking water, whereas the sale of SSBs should be banned.

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“…Secondary schools in Australia cater for students aged between 12 and 18 years. A full description of the trial methods is reported in the published protocol 27 …”

Section: Methodsmentioning

confidence: 99%

“…Following recruitment and baseline data collection, participating schools were randomised. Further recruitment and randomisation details can be found in the protocol for this study 27 …”

Section: Methodsmentioning

confidence: 99%

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A trial of a six‐month sugar‐sweetened beverage intervention in secondary schools from a socio‐economically disadvantaged region in Australia

Ooi

Wolfenden

Yoong

et al. 2021

Australian and New Zealand Journal of Public Health

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Objective: This study assessed the effectiveness of a school‐based intervention in reducing adolescents’ sugar‐sweetened beverage (SSB) consumption and percentage of energy from SSBs. Secondary outcomes were SSB consumption within school, average daily energy intake, and body mass index z‐scores. Methods: Six secondary schools located in New South Wales, Australia were recruited to participate in a six‐month pilot randomised controlled trial (1:1). The intervention included components targeting the school nutrition environment, curricula and community. Outcomes were collected via online surveys, observations, anthropometric measurements and project records. Between‐group differences were assessed via linear mixed models. Results: At the six‐month intervention endpoint (n=862) there were no statistically significant differences between students in intervention or control schools for mean daily intake of SSBs (8.55mL; CI −26.77, 43.87; p=0.63), percentage daily energy from SSBs (0.12% kJ; CI −0.55, 0.80; p=0.72), or for secondary outcomes. Acceptability of the school‐based strategies were high, however intervention fidelity varied across schools. Conclusion: While acceptable, improving fidelity of implementation and increasing the duration or intensity of the intervention may be required to reduce SSB intake. Implications for public health: Engaging parents and education stakeholders in the development phase to co‐design interventions may prove beneficial in improving intervention fidelity and enhance behavioural outcomes.

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A cluster randomised controlled trial of a sugar-sweetened beverage intervention in secondary schools: Pilot study protocol

Cited by 9 publications

References 62 publications

Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health

Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health

Consumption of Sugar-Sweetened Beverages in Paediatric Age: A Position Paper of the European Academy of Paediatrics and the European Childhood Obesity Group

A trial of a six‐month sugar‐sweetened beverage intervention in secondary schools from a socio‐economically disadvantaged region in Australia

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