Effectiveness of behavioral interventions and behavior change techniques for reducing soft drink intake in disadvantaged adolescents: A systematic review and meta‐analysis

Abstract

Reducing sugar-sweetened beverage (SSB) intake is an important dietary target, especially among socioeconomically disadvantaged ethnic minority adolescents. This review and meta-analysis evaluated the effectiveness of behavioural interventions aiming to reduce SSB intake in socioeconomically disadvantaged ethnic minority adolescents and examined which behaviour change techniques (BCTs) were most effective. A systematic search was conducted using the PRISMA criteria. Quality assessments were done using the Cochrane criteria. In a narrative synthesis, studies were divided into effective and non-effective, and relative effectiveness ratios of individual BCTs were calculated. Pooled standardized mean differences (SMDs) and their 95% confidence intervals were estimated with random-effects models using cluster robust methods. Twenty-two studies were included in the qualitative synthesis. A meta-analysis (n = 19) revealed no significant between-group differences in reduction of SSB intake. Five self-regulatory BCTs had an effectiveness ratio >50%: feedback, goal-setting, action planning, self-monitoring and problem-solving/barrier identification. The risk of bias assessments were judged to be moderate to high risk for randomized controlled trials (RCTs) studies and low to moderate for pre-post studies. There was no indication of publication bias. In conclusion, self-regulatory BCTs may be effective components to change SSB behaviour. However, high-quality research is needed to evaluate the effectiveness of behavioural interventions and identify BCTs effective for reducing SSB intake among disadvantaged adolescents with ethnic minority backgrounds.

Applying the temporal self-regulation theory to understand sugar-sweetened beverage consumption among Chinese college students

“…Gregorio-Pascual & Mahler, 2020 ). On the other hand, interventions aimed at improving individuals’ self-regulatory capacity and/or developing healthy drinking habits normally use various behavior change techniques (BCTs), such as feedback, goal-setting, self-monitoring, and so on (Shagiwal et al, 2020 ). Previous studies also showed a signifiant reduction of SSB consumption for intervention focused on self-regulatory capacity and habit among adolescents (e.g.…”

Sugar-sweetened beverages, effects on appetite and public health strategies to reduce the consumption among children: a review

“…46 Several public health interventions have been conducted aiming to reduce the consumption of SSBs. 9,49,84 The most commonly discussed public health strategies aiming to decrease the consumption of SSBs are summarized in Table 1. In this review, we described implemented taxation measures and their impact in sales and in preventable cases of disease and death, marketing regulations applied to children and adolescents, and ultimately the intention of application of a single FOP labeling system in all countries, with the goal of increasing consumers' food literacy.…”

“…Several public health interventions have been conducted aiming to reduce the consumption of SSBs 9,49,84 . The most commonly discussed public health strategies aiming to decrease the consumption of SSBs are summarized in Table 1.…”

Current Knowledge Base of Beverage Health Impacts, Trends, and Intake Recommendations for Children and Adolescents: Implications for Public Health

“…Interventions that address multiple levels of the socialecological model and incorporate systems thinking are recommended to improve health outcomes, especially among vulnerable populations [81]. A systematic review and metaanalysis found studies using self-regulatory behavior change techniques, including feedback, goal-setting, action planning, self-monitoring, and problem-solving, helped to reduce SSB intake among socioeconomically disadvantaged adolescents from ethnic minorities, but overall, the behavioral interventions were not very effective [82]. The researchers noted that more high-quality studies investigating behavioral interventions in disadvantaged youth are needed and that future studies should design interventions that utilize strategies tailored to these groups [82].…”