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National Institutes of Health: National Cancer Institute: Division of Cancer Control and Population Sciences
Grant Details

Grant Number: 5R01CA154364-02 Interpret this number
Primary Investigator: Zoellner, Jamie
Organization: Virginia Polytechnic Inst And St Univ
Project Title: SIPSMARTER: a Nutrition Literacy Approach to Reducing Sugar-Sweetened Beverages
Fiscal Year: 2012
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Abstract

DESCRIPTION (provided by applicant): Despite the substantial impact sugar-sweetened beverages (SSB) have on total energy intake and the fact that consumption has doubled in the US over the past 25 years; there are no known efficacy trials that have specifically targeted reducing SSB intake among adults. Furthermore, adults with lower health literacy consume higher amounts of SSB and the field lacks theory-based interventions to support behavior change in this population. This research explicitly targets changes in SSB intake through improvements in health literacy, defined within a nutrition context as nutrition numeracy (the ability to read, understand, and apply numbers to make appropriate dietary decisions) and nutrition-related media literacy (the ability to access, analyze, and evaluate nutrition-related media). Phase 1 of the project utilizes focus groups and pilot testing methodologies to guide development of the interventions. The primary objective for Phase 2 is to conduct a three group randomized controlled trial to determine the relative effectiveness of a Theory of Planned Behavior (TPB)-based SSB intervention with (SIPmatE) and without (SIPmart) an enhanced and integrated nutrition literacy component targeting nutrition numeracy and nutrition-related media literacy, as compared to a matched-contact control condition. All three 6-month interventions will be delivered using in- person, small-group communication channels and automated self-monitoring through interactive voice response (IVR) technology. The target population includes 639 low socioeconomic participants residing in 11 at-risk, rural southwest Virginia counties. All outcomes will be assessed at baseline, 6 months, and 12 months post intervention (i.e., 18 months post baseline). The primary outcome is SSB consumption, and secondary outcomes include body weight and a new non-invasive 13C biomarker technique for added sugar intake. Changes in the primary and secondary outcomes will be determined using a mixed effect model to account for individual, time, and group differences within a multitreatment framework. Components from the RE-AIM framework (i.e. reach, effectiveness, adoption, implementation, & maintenance) will also be assessed and evaluated, along with cost-effectiveness models for each arm. This study fills an important void in the health literacy literature by integrating motivation/intention processes with skill-based nutrition literacy processes to understand causal pathways and complex relationships impacting a life-style behavior under real world and naturally occurring community environments. The long-term goals of this research are to improve nutrition literacy among health disparate populations, reduce SSB consumption and the associated adverse health consequences related to excessive caloric and added sugar consumption (i.e. obesity, type II diabetes, coronary heart disease, dental caries, and cancer), bridge the conceptual gap among concepts in health behavior theory and health literacy, expand the reach of simple and cost-effective interventions among hard-to- reach populations, and reduce the reliance on self-reported measures of dietary intake.

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Publications

Mixed Methods Evaluation Of A Randomized Control Pilot Trial Targeting Sugar-sweetened Beverage Behaviors
Authors: Zoellner J. , Cook E. , Chen Y. , You W. , Davy B. , Estabrooks P. .
Source: Open Journal Of Preventive Medicine, 2013-02-01 00:00:00.0; 3(1), p. 51-57.
PMID: 23997992
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The Comparative Validity Of Interactive Multimedia Questionnaires To Paper-administered Questionnaires For Beverage Intake And Physical Activity: Pilot Study
Authors: Riebl S.K. , Paone A.C. , Hedrick V.E. , Zoellner J.M. , Estabrooks P.A. , Davy B.M. .
Source: Jmir Research Protocols, 2013; 2(2), p. e40.
PMID: 24148226
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Talking Health, A Pragmatic Randomized-controlled Health Literacy Trial Targeting Sugar-sweetened Beverage Consumption Among Adults: Rationale, Design & Methods
Authors: Zoellner J. , Chen Y. , Davy B. , You W. , Hedrick V. , Corsi T. , Estabrooks P. .
Source: Contemporary Clinical Trials, 2014 Jan; 37(1), p. 43-57.
PMID: 24246819
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A Dual-carbon-and-nitrogen Stable Isotope Ratio Model Is Not Superior To A Single-carbon Stable Isotope Ratio Model For Predicting Added Sugar Intake In Southwest Virginian Adults
Authors: Hedrick V.E. , Zoellner J.M. , Jahren A.H. , Woodford N.A. , Bostic J.N. , Davy B.M. .
Source: The Journal Of Nutrition, 2015 Jun; 145(6), p. 1362-9.
PMID: 25855120
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Using Teach-back To Understand Participant Behavioral Self-monitoring Skills Across Health Literacy Level And behavioral Condition
Authors: Porter K. , Chen Y. , Estabrooks P. , Noel L. , Bailey A. , Zoellner J. .
Source: Journal Of Nutrition Education And Behavior, 2016 Jan; 48(1), p. 20-26.e1.
PMID: 26453368
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Changes In The Healthy Beverage Index In Response To An Intervention Targeting A Reduction In Sugar-sweetened Beverage Consumption As Compared To An Intervention Targeting Improvements In Physical Activity: Results From The Talking Health Trial
Authors: Hedrick V.E. , Davy B.M. , Myers E.A. , You W. , Zoellner J.M. .
Source: Nutrients, 2015 Dec; 7(12), p. 10168-78.
PMID: 26690208
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Effects Of A Behavioral And Health Literacy Intervention To Reduce Sugar-sweetened Beverages: A Randomized-controlled Trial
Authors: Zoellner J.M. , Hedrick V.E. , You W. , Chen Y. , Davy B.M. , Porter K.J. , Bailey A. , Lane H. , Alexander R. , Estabrooks P.A. .
Source: The International Journal Of Behavioral Nutrition And Physical Activity, 2016; 13, p. 38.
PMID: 27000402
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