Study protocol for iSIPsmarter: A randomized-controlled trial to evaluate the efficacy, reach, and engagement of a technology-based behavioral intervention to reduce sugary beverages among rural Appalachian adults

Zoellner, Jamie; Porter, Kathleen; You, Wen; Reid, Annie L.; Frederick, Christina; Hilgart, Michelle; Brock, Donna-Jean P.; Tate, Deborah F.; Ritterband, Lee M.

doi:10.1016/j.cct.2021.106566

Cited by 5 publications

(7 citation statements)

References 94 publications

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“…In terms of study implications, the efficacy of i SIPsmarter in reducing SSB consumption in rural Appalachian adults is currently being evaluated in a randomized controlled trial that includes a 2-group design ( i SIPsmarter vs static Participant Education website) with 4 assessment points (Clinical Trial Registry: NCT05030753) [ 36 ]. When efficacy and other summative data are available, they will provide additional insights to inform the potential value of applying an HCD process to build i SIPsmarter as well as identify future areas of study.…”

Section: Discussionmentioning

confidence: 99%

“…i SIPsmarter is a technology-based behavior and health literacy intervention aimed at improving SSB behaviors among Appalachia adults [ 36 ]. i SIPsmarter was adapted from the evidence-based intervention SIP smart ER [ 37 ].…”

Section: Methodsmentioning

confidence: 99%

“…In its final form, i SIPsmarter comprises 6 internet-delivered interactive cores, which are metered out sequentially over time, with a new core becoming available 1 week after completion of the previous core; an integrated SMS text message strategy to engage users in tracking and reporting SSB consumption behaviors; and an electronic cellular-enabled scale for in-home weighing [ 36 ]. At the end of cores 2 to 6, the users evaluate their SSB and weight diary data and set a personalized SSB consumption and weight action plan for the upcoming week.…”

Section: Methodsmentioning

confidence: 99%

“…Similar to SIP smart ER, i SIPsmarter is grounded in the Theory of Planned Behavior and health literacy, numeracy, and media literacy concepts. In addition, the scientifically grounded core content, key learning objectives, and behavior change techniques of the digital i SIPsmarter intervention are similar to those of the original evidence-based SIP smart ER intervention [ 36 , 37 ]. The main difference between the two is the addition of evidence-based weight self-monitoring and weight-related strategies to i SIPsmarter.…”

Section: Methodsmentioning

confidence: 99%

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Development of a Digital Behavioral Intervention to Reduce the Consumption of Sugar-Sweetened Beverages Among Rural Appalachian Adults: Multiphased, Human-Centered Design Approach

Zoellner¹,

Reid²,

Porter³

et al. 2023

JMIR Hum Factors

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Background To avoid the low engagement and limited efficacy of digital behavioral health interventions, robust human-centered design (HCD) processes are needed. Objective The primary objective of this study was to describe a flexible, step-by-step HCD process to develop digital behavioral health interventions by illustrating iSIPsmarter as an example. iSIPsmarter is a digital intervention for reducing the consumption of sugar-sweetened beverages (SSBs) that comprises 6 internet-based cores metered out over time to deliver the program content, an integrated SMS text message strategy to engage users in reporting SSB behaviors, and an electronic cellular-enabled scale for in-home weighing. The secondary objective is to illustrate the key components and characteristics of iSIPsmarter that resulted from the HCD process. Methods The methods were guided by the Model for Internet Interventions and by best practices in HCD and instructional design processes (eg, rapid prototype development and think-aloud protocol). The 3-phased (ie, contextual, prototype testing, end user testing phases) process followed in this study included a series of 13 semistructured one-on-one interviews with 7 advisory team participants from the targeted Appalachian user group. The interviews were content coded by 2 researchers and then deductively coded to the suggested areas of digital behavioral health interventions. Results The participants provided rich perspectives pertaining to iSIPsmarter’s appearance, behavioral prescriptions, burdens, content, delivery, message, participation, and assessment. These inputs included requests for built-in flexibility to account for varying internet and SMS text message accessibility among users; ideas to resolve the issues and problems encountered when using the prototypes, including those related to navigation and comprehension of content; ideas to enhance personalized feedback to support motivation and goal setting for SSB consumption and weight; and feedback to refine the development of realistic and relatable vignettes. The participants were able to interact with multiple prototype drafts, allowing researchers to capture and incorporate feedback related to the iSIPsmarter dashboard, daily SSB and weight diaries, action planning, core content, interactions, and vignettes. Conclusions Using scientific models and established processes is critical for building robust and efficacious interventions. By applying an existing model and HCD and instructional design processes, we were able to identify assumptions and address the key areas of the iSIPsmarter intervention that were hypothesized to support users’ engagement and promote behavior change. As evidenced by the rich feedback received from the advisory team members and the resulting iSIPsmarter product, the HCD methodology was instrumental in the development process. Although the final iSIPsmarter content is specific to improving SSB consumption behaviors among adults in rural areas, the intent is that this HCD process will have wide applications in the development of digital behavioral health interventions across multiple geographic and behavioral contexts.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Development of a Digital Behavioral Intervention to Reduce the Consumption of Sugar-Sweetened Beverages Among Rural Appalachian Adults: Multiphased, Human-Centered Design Approach

Zoellner¹,

Reid²,

Porter³

et al. 2023

JMIR Hum Factors

Self Cite

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“…Location-based behavior nudges via smartphone delivery methods are also being considered, potentially appealing to younger adult audiences. A similar technology-based approach has been successful in reducing SSB consumption among other populations in the Appalachian region ( Zoellner et al, 2021 ). The impact of these PSE initiatives will be explored at future time points of our multi-year prospective cohort study.…”

Section: Discussionmentioning

confidence: 99%

Sugar-sweetened beverage consumption among adults in rural Appalachia

Norman-Burgdolf

DeWitt

Cardarelli

et al. 2021

Preventive Medicine Reports

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Highlights Sugar-sweetened beverage consumption differs among Appalachian adult age groups. Appalachian Millennials consume more sugar-sweetened beverages than older adults. Millennials consume 6 times more calories from non-soda SSB than older adults. Identifying SSB choices and consumption patterns inform PSE interventions.

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Components in downstream health promotions to reduce sugar intake among adults: a systematic review

Azhar Hilmy,

Nordin,

Yusof

et al. 2024

Nutr J

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Excessive sugar consumption is well documented as a common risk factor for many Non-Communicable Diseases (NCDs). Thus, an adequate intervention description is important to minimise research waste and improve research usability and reproducibility. A systematic review was conducted to identify components in published evidence interventions pertaining to the health promotions on reducing sugar intake among adults. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and used the Mixed Methods Appraisal Tool (MMAT) for quality appraisal. The period for the selected study was from 2000 to 2022, and articles were retrieved from Web of Science (WOS), Medline, Scopus, and PubMed. The target population was adults aged 18 years old and above who underwent intervention to assess the changes in their sugar intake. Data sources and all human epidemiologic studies were included. Out of the 9,333 papers identified, 25 were included. The overall quality of evidence of the studies was considered moderate. Apart from the characteristics of the reviewed studies, components of interventions are including the basis of theoretical or model for the intervention, which majority use Social Cognitive Theory, followed by PRECEDE-PROCEED model, socio-ecological and process-improvement theories and Transtheoretical Model; providers, who are commercial provider, qualified nutritionist, professor of nutrigenomics and nutrigenetics, doctor, dietitian nutritionist, lifestyle coaches, and junior public health nurses; duration of the intervention and follow-up time, varies from as short as one month to as long as 24 months; material provided either softcopy or hardcopy; tailoring approach, based on the individual goals, the process of change, genotype analysis, beliefs, barriers, and sociocultural norms; delivery mechanism either face-to-face or technology-mediated; and tools to measure the sugar consumption outcome mostly used Food Frequency Questionnaire (FFQ), besides 24-h dietary recalls, and food diaries. There are various components in downstream health promotion to reduce sugar intake among adults that can be adapted according to the local health promotion and intervention context. More well-designed interventions using integration components are encouraged in further studies.

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Study protocol for iSIPsmarter: A randomized-controlled trial to evaluate the efficacy, reach, and engagement of a technology-based behavioral intervention to reduce sugary beverages among rural Appalachian adults

Cited by 5 publications

References 94 publications

Development of a Digital Behavioral Intervention to Reduce the Consumption of Sugar-Sweetened Beverages Among Rural Appalachian Adults: Multiphased, Human-Centered Design Approach

Development of a Digital Behavioral Intervention to Reduce the Consumption of Sugar-Sweetened Beverages Among Rural Appalachian Adults: Multiphased, Human-Centered Design Approach

Sugar-sweetened beverage consumption among adults in rural Appalachia

Components in downstream health promotions to reduce sugar intake among adults: a systematic review

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