Role of social ecological model level on young Pacific children's sugar-sweetened beverage and water intakes: Children's Healthy Living intervention

Ariella R Korn, Jean Butel, James Davis, Ashley B Yamanaka, Patricia Coleman, Lynne R Wilkens, Christina D Economos, Rachel Novotny, Ariella R Korn, Jean Butel, James Davis, Ashley B Yamanaka, Patricia Coleman, Lynne R Wilkens, Christina D Economos, Rachel Novotny

Abstract

Objective: To examine children's sugar-sweetened beverage (SSB) and water intakes in relation to implemented intervention activities across the social ecological model (SEM) during a multilevel community trial.

Design: Children's Healthy Living was a multilevel, multicomponent community trial that reduced young child obesity (2013-2015). Baseline and 24-month cross-sectional data were analysed from nine intervention arm communities. Implemented intervention activities targeting reduced SSB and increased water consumption were coded by SEM level (child, caregiver, organisation, community and policy). Child SSB and water intakes were assessed by caregiver-completed 2-day dietary records. Multilevel linear regression models examined associations of changes in beverage intakes with activity frequencies at each SEM level.

Setting: US-Affiliated Pacific region.

Participants: Children aged 2-8 years (baseline: n 1343; 24 months: n 1158).

Results: On average (± sd), communities implemented 74 ± 39 SSB and 72 ± 40 water activities. More than 90 % of activities targeted both beverages together. Community-level activities (e.g. social marketing campaign) were most common (61 % of total activities), and child-level activities (e.g. sugar counting game) were least common (4 %). SSB activities across SEM levels were not associated with SSB intake changes. Additional community-level water activities were associated with increased water intake (0·62 ml/d/activity; 95 % CI: 0·09, 1·15) and water-for-SSB substitution (operationalised as SSB minus water: -0·88 ml/d/activity; 95 % CI: -1·72, -0·03). Activities implemented at the organization level (e.g. strengthening preschool wellness guidelines) and policy level (e.g. SSB tax advocacy) also suggested greater water-for-SSB substitution (P < 0·10).

Conclusions: Community-level intervention activities were associated with increased water intake, alone and relative to SSB intake, among young children in the Pacific region.

Keywords: Multilevel trial; Pacific region; Social ecological model; Sugar-sweetened beverages; Water; Young children.

References

    1. Hawley NL & McGarvey ST (2015) Obesity and diabetes in Pacific Islanders: the current burden and the need for urgent action. Curr Diab Rep 15, 29.
    1. Lott M, Callahan E, Welker Duffy E et al. (2019) Healthy Beverage Consumption in Early Childhood: Recommendations from Key National Health and Nutrition Organizations. Technical Scientific Report. Durham, NC: Healthy Eating Research.
    1. The National Academies of Sciences Engineering Medicine, Food and Nutrition Board Health & Medicine Division (2017) Strategies to Limit Sugar-Sweetened Beverage Consumption in Young Children: Proceedings of a Workshop. Washington, DC: National Academies Press.
    1. Malik VS, Pan A, Willett WC et al. (2013) Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr 98, 1084–1102.
    1. Scharf RJ & DeBoer MD (2016) Sugar-sweetened beverages and children’s health. Annu Rev Public Health 37, 273–293.
    1. Glass TA & McAtee MJ (2006) Behavioral science at the crossroads in public health: extending horizons, envisioning the future. Soc Sci Med 62, 1650–1671.
    1. Golden SD & Earp JAL (2012) Social ecological approaches to individuals and their contexts:twenty years of health education & behavior health promotion interventions. Health Educ Behav 39, 364–372.
    1. Novotny R, Davis J, Butel J et al. (2018) Effect of the children’s healthy living program on young child overweight, obesity, and Acanthosis Nigricans in the US-Affiliated Pacific Region: a randomized clinical trial. JAMA Netw Open 1, e183896.
    1. Braun KL, Nigg CR, Fialkowski MK et al. (2014) Using the ANGELO model to develop the children’s healthy living program multilevel intervention to promote obesity preventing behaviors for young children in the US-affiliated Pacific Region. Child Obes 10, 474–481.
    1. Wilken LR, Novotny R, Fialkowski MK et al. (2013) Children’s Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity. BMC Public Health 13, 944.
    1. Fialkowski MK, DeBaryshe B, Bersamin A et al. (2014) A community engagement process identifies environmental priorities to prevent early childhood obesity: the Children’s Healthy Living (CHL) program for remote underserved populations in the US Affiliated Pacific Islands, Hawaii and Alaska. Matern Child Health J 18, 2261–2274.
    1. Novotny R, Fialkowski MK, Areta AA et al. (2013) University of Hawai’i cancer center connection: the pacific way to child wellness: the Children’s Healthy Living Program for remote underserved minority populations of the pacific region (CHL). Hawaii J Med Public Health 72, 406–408.
    1. Novotny R, Nigg C, McGlone K et al. (2013) Pacific Tracker 2 - expert system (PacTrac2-ES) behavioural assessment and intervention tool for the Pacific Kids DASH for Health (PacDASH) study. Food Chem 140, 471–477.
    1. LaComb RP, Sebastian RS, Wilkinson Enns C et al. (2011) Beverage Choices of US Adults: What We Eat in America, NHANES 2007–2008. Food Surveys Research Group Dietary Data Brief No. 6. Washington, DC: ARS.
    1. Dekkers AL, Verkaik-Kloosterman J, van Rossum CT et al. (2014) SPADE, a new statistical program to estimate habitual dietary intake from multiple food sources and dietary supplements. J Nutr 144, 2083–2091.
    1. Tate DF, Lytle LA, Sherwood NE et al. (2016) Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions. Transl Behav Med 6, 236–243.
    1. Ritchie LD, Woodward-Lopez G, Au LE et al. (2018) Associations of community programs and policies with children’s dietary intakes: the Healthy Communities Study. Pediatr Obes 13, 14–26.
    1. McNeill LH, Wyrwich KW, Brownson RC et al. (2006) Individual, social environmental, and physical environmental influences on physical activity among black and white adults: a structural equation analysis. Ann Behav Med 31, 36–44.
    1. Butel J, Braun KL, Nigg CR et al. (2019) Estimating intervention dose of the multilevel multisite children’s healthy living program intervention. Transl Behav Med. Published online: 22 May 2019. doi: 10.1093/tbm/ibz073.

Source: PubMed

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