Psychometric properties of the Chinese version of the sugar-sweetened beverages media literacy scale for undergraduates.
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ABSTRACT:
SUBMITTER: Long C
PROVIDER: S-EPMC9615564 | biostudies-literature | 2022
REPOSITORIES: biostudies-literature
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Psychometric properties of the Chinese version of the sugar-sweetened beverages media literacy scale for undergraduates.
Long Chen C Yoon Myeong Sook MS
Frontiers in public health 20221014
Specific domains of the Sugar-Sweetened Media Literacy Scale (SSM-ML) have been shown to significantly assess sugar-sweetened beverage (SSB) calorie intake in the US population. This study aimed to describe the psychometric properties of the revised Chinese version of the SSB-ML (C-SSB-ML) and evaluate its validity and reliability. Results from 975 undergraduates at two of the largest universities in a province in southwest China showed that Cronbach's alphas for the overall scale, the three dim ...[more]
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Project description:ImportanceReductions in sugar-sweetened beverage (SSB) intake can improve health, but are difficult for individuals to achieve on their own.ObjectivesTo evaluate whether a workplace SSB sales ban was associated with SSB intake and cardiometabolic health among employees and whether a brief motivational intervention provides added benefits to the sales ban.Design, setting, and participantsThis before-after study and additional randomized trial conducted from July 28, 2015, to October 16, 2016, at a Northern California university and hospital assessed SSB intake, anthropometrics, and cardiometabolic biomarkers among 214 full-time English-speaking employees who were frequent SSB consumers (≥360 mL [≥12 fl oz] per day) before and 10 months after implementation of an SSB sales ban in a large workplace, with half the employees randomized to receive a brief motivational intervention targeting SSB reduction.InterventionsThe employer stopped selling SSBs in all workplace venues, and half the sample was randomized to receive a brief motivational intervention and the other half was a control group that did not receive the intervention. This intervention was modeled on standard brief motivational interventions for alcohol used in the workplace that promote health knowledge and goal setting.Main outcomes and measuresOutcomes included changes in SSB intake, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and measures of abdominal adiposity. The primary associations tested were the correlation between changes in SSB intake and changes in HOMA-IR.ResultsAmong the 214 study participants, 124 (57.9%) were women, with a mean (SD) age of 41.2 (11.0) years and a baseline mean (SD) body mass index of 29.4 (6.5). They reported a mean daily intake of 1050 mL (35 fl oz) of SSBs at baseline and 540 mL (18 fl oz) at follow-up-a 510-mL (17-fl oz) (48.6%) decrease (P < .001). Reductions in SSB intake correlated with improvements in HOMA-IR (r = 0.16; P = .03). Those not randomized to receive the brief intervention reduced their SSB intake by a mean (SD) of 246.0 (84.0) mL (8.2 [2.8] fl oz), while those also receiving the brief intervention reduced SSB intake by 762.0 (84.0) mL (25.4 [2.8] fl oz). From baseline to follow-up, there were significant reductions in mean (SE) waist circumference (2.1 [2.8] cm; P < .001).Conclusions and relevanceThis study's findings suggest that the workplace sales ban was associated with a reduction in SSB intake and a significant reduction in waist circumference among employees within 10 months. The randomized clinical trial portion of this study found that targeting those at high risk with a brief motivational intervention led to additional improvements. Workplace sales bans may offer a promising new private-sector strategy for reducing the health harms of SSB intake.Trial registrationClinicalTrials.gov identifier: NCT02585336.
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Project description:BackgroundAlthough consumption of sugar-sweetened beverages (SSBs) is associated with higher caloric intakes, the amount SSBs contribute to higher intakes has not been addressed.PurposeTo estimate the amount SSBs contribute to higher caloric intakes and determine how the diets of SSB consumers and nonconsumers differ.MethodsThe What We Eat In America, NHANES 2003-2010 surveys were combined into a sample of 13,421 children; analyses were conducted in December 2012. To determine the contribution of SSBs to higher caloric intakes, total non-SSB intake (food + non-SSB beverages) of SSB consumers and nonconsumers were compared using linear regression models controlling for demographic and socioeconomic factors. Analyses also compared intakes between nonconsumers and SSB consumers with different amounts of SSB consumption.ResultsFor children aged 2-5 years and 6-11 years, total non-SSB intakes did not differ between nonconsumers and SSB consumers at any level of SSB consumption, indicating that SSBs were primarily responsible for the higher caloric intakes among SSB consumers. A similar finding was observed among children aged 12-18 years; however, both food and SSB contributed to higher caloric intakes of adolescents consuming ≥500 kcal of SSBs. Among those aged 12-18 years, higher intakes of foods (e.g., pizza, burgers, fried potatoes, and savory snacks) and lower intakes of non-SSB beverages (e.g., fluid milk and fruit juice) were associated with increased SSB intake.ConclusionsSugar-sweetened beverages are primarily responsible for the higher caloric intakes of SSB consumers, and SSB consumption is associated with intake of a select number of food and beverage groups, some of which are often unhealthy (e.g., pizza and grain-based desserts).
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Project description:BackgroundDespite excessive consumption of sugar-sweetened beverages (SSB), little is known about behavioral interventions to reduce SSB intake among adults, particularly in medically-underserved rural communities. This type 1 effectiveness-implementation hybrid RCT, conducted in 2012-2014, applied the RE-AIM framework and was designed to assess the effectiveness of a behavioral intervention targeting SSB consumption (SIPsmartER) when compared to an intervention targeting physical activity (MoveMore) and to determine if health literacy influenced retention, engagement or outcomes.MethodsGuided by the Theory of Planned Behavior and health literacy strategies, the 6 month multi-component intervention for both conditions included three small-group classes, one live teach-back call, and 11 interactive voice response calls. Validated measures were used to assess SSB consumption (primary outcome) and all secondary outcomes including physical activity behaviors, theory-based constructs, quality of life, media literacy, anthropometric, and biological outcomes.ResultsTargeting a medically-underserved rural region in southwest Virginia, 1056 adult participants were screened, 620 (59%) eligible, 301 (49%) enrolled and randomized, and 296 included in these 2015 analyses. Participants were 93% Caucasian, 81% female, 31 % ≤ high-school educated, 43% < $14,999 household income, and 33% low health literate. Retention rates (74%) and program engagement was not statistically different between conditions. Compared to MoveMore, SIPsmartER participants significantly decreased SSB kcals and BMI at 6 months. SIPsmartER participants significantly decreased SSB intake by 227 (95% CI = -326,-127, p < 0.001) kcals/day from baseline to 6 months when compared to the decrease of 53 (95% CI = -88,-17, p < 0.01) kcals/day among MoveMore participants (p < 0.001). SIPsmartER participants decreased BMI by 0.21 (95% CI = -0.35,-0.06; p < 0.01) kg/m(2) from baseline to 6 months when compared to the non-significant 0.10 (95 % CI = -0.23, 0.43; NS) kg/m(2) gain among MoveMore participants (p < 0.05). Significant 0-6 month effects were observed for about half of the theory-based constructs, but for no biological outcomes. Health literacy status did not influence retention rates, engagement or outcomes.ConclusionsSIPsmartER is an effective intervention to decrease SSB consumption among adults and is promising for translation into practice settings. SIPsmartER also yielded small, yet significant, improvements in BMI. By using health literacy-focused strategies, the intervention was robust in achieving reductions for participants of varying health literacy status.Trial registrationClinicaltrials.gov; ID: NCT02193009 .
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Project description:BackgroundThe eHealth Literacy Scale (eHEALS) was introduced in China in 2013 as one of the most important electronic health literacy measurement instruments. After a decade of development in China, it has received widespread attention, although its theoretical underpinnings have been challenged, thus demanding more robust research evidence of factorial validity and multigroup measurement properties.ObjectiveThis study aimed to evaluate the Chinese version of the eHEALS in terms of its measurement properties.MethodsA cross-sectional survey was conducted in a university setting in China. Item statistics were checked for response distributions and floor and ceiling effects. Internal consistency reliability was confirmed with Cronbach α, split-half reliability, Cronbach α if an item was deleted, and item-total correlation. A total of 5 representative eHEALS factor structures were examined and contrasted using confirmatory factor analysis. The study used the item-level content validity index (I-CVI) and the average of the I-CVI scores of all items on the scale to assess the content validity of the dominance model. Furthermore, the validated dominance model was subsequently used to evaluate the relevance and representation of elements in the instrument and to assess measurement invariance across genders.ResultsA total of 972 respondents were identified, with a Cronbach α of .92, split-half reliability of 0.88, and item-total score correlation coefficients ranging from 0.715 to 0.781. Cronbach α if an item was deleted showed that all items should be retained. Acceptable content validity was supported by I-CVIs ≥0.80. The confirmatory factor analysis confirmed that the 3-factor model was acceptable. The measurement model met all relevant fit indices: average variance extracted from 0.663 to 0.680, composite reliability from 0.810 to 0.857, chi-square divided by the df of 4.768, root mean square error of approximation of 0.062, standardized root mean squared residual of 0.020, comparative fit index (CFI) of 0.987, and Tucker-Lewis index of 0.979. In addition, the scale demonstrated error variance invariance (Δnormed fit index=-0.016, Δincremental fit index=-0.012, ΔTucker-Lewis index=0.005, Δcomparative fit index=-0.012, Δrelative fit index=0.005, and Δroot mean square error of approximation=0.005).ConclusionsA 3-factor model of the Chinese version of the eHEALS fits best, and our findings provide evidence for the strict measurement invariance of the instrument regarding gender.
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Project description:BackgroundWhether consumption of sugar-sweetened beverages (SSBs) or artificially sweetened beverages (ASBs) is associated with the risk of breast cancer is of public health interest.ObjectivesWe sought to evaluate associations between consumption of SSBs and ASBs and risks of total and subtype-specific breast cancer.MethodsWe followed 82,713 women from the Nurses' Health Study (1980 to 2016) and 93,085 women from the Nurses' Health Study II (1991 to 2017). Cumulatively averaged intakes of SSBs and ASBs from FFQs were tested for associations with incident breast cancer cases and subtypes using Cox regression models. We also evaluated the associations stratified by menopausal status, physical activity, BMI, and alcohol intake.ResultsWe documented 11,379 breast cancer cases during 4,655,153 person-years of follow-up. Consumption of SSBs or ASBs was not associated with total breast cancer risk: pooled HRs comparing extreme categories (≥1/day compared with <1/month) were 1.03 (95% CI, 0.95-1.12) and 0.96 (95% CI, 0.91-1.02), respectively. We observed a suggestive interaction by BMI using pooled data (P-interaction = 0.08), where a modestly higher risk of breast cancer with each serving per day increment of SSBs was found in lean women (HR, 1.06; 95% CI, 1.01-1.11) but not among overweight or obese women (HR, 1.00; 95% CI, 0.95-1.06). Moreover, in the pooled, fully adjusted analysis, compared to infrequent consumers (<1/month), those who consumed ≥1 serving of ASBs per day had a lower risk of luminal A breast tumors (HR, 0.90; 95% CI, 0.80-1.01; P-trend = 0.02).ConclusionsAlthough no significant associations were observed overall, consumption of SSBs was associated with a slightly higher risk of breast cancer among lean women. This finding could have occurred by chance and needs confirmation. Our findings also suggest no substantial increase in the risk of breast cancer with consumption of ASBs.
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