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

S. S. Shagiwal*, E. Groenestein, A. Schop-Etman, J. Jongerling, J. van der Waal, G. Noordzij, S. Denktas

*Corresponding author for this work

Research output: Contribution to journalReview articleScientificpeer-review

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.

Original languageEnglish
Pages (from-to)708-734
Number of pages27
JournalObesity science & practice
Volume6
Issue number6
DOIs
Publication statusPublished - Dec 2020
Externally publishedYes

Keywords

  • behavior change interventions
  • health inequalities
  • obesity
  • sugar-sweetened beverages
  • SWEETENED BEVERAGE CONSUMPTION
  • PROMOTE ENERGY-BALANCE
  • LOW-INCOME COMMUNITIES
  • OBESITY PREVENTION
  • BLACK-ADOLESCENTS
  • CHILDHOOD OBESITY
  • PERSONAL AGENCY
  • META-REGRESSION
  • RISK BEHAVIORS
  • ENVIRONMENT

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