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Kids SipSmartER, an Intervention to Reduce Sugar-sweetened Beverages

Kids SipSmartER: A Multi-level Behavioral and Health Literacy Intervention to Reduce Sugar-sweetened Beverages Among Appalachian Middle-school Students

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03740113
Enrollment
1013
Registered
2018-11-14
Start date
2018-08-15
Completion date
2024-06-07
Last updated
2025-04-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Sugary Beverages

Keywords

Sugar sweetened beverages, health disparities, Appalachia

Brief summary

Overall Goal: To determine the effectiveness of Kids SIPsmartER in improving sugar-sweetened beverages behaviors among 7th grade students. Secondary aims are to determine (1) changes in secondary student outcomes (e.g. quality of life, BMI z-score, theory-related variables, health and media literacy), (2) changes in caregiver SSB behaviors and home environment, (3) maintenance of outcomes at 19-months post-baseline, (4) assess the reach and representativeness of Kids SIPsmartER, among students and caregivers, and (5) implementation, adoption, and maintenance among teachers and schools.

Detailed description

The intake of sugar-sweetened beverages (SSB, e.g., soda/pop, sweet tea, sports and energy drinks, fruit drinks) is disproportionately high in Appalachia, including among adolescents whose intake is more than double the national average and more than four times the recommended daily amount. There are strong and consistent scientific data and systematic reviews documenting relationships among high SSB consumption and numerous chronic health conditions such obesity, some types of obesity-related cancers, diabetes, cardiovascular disease, and dental erosion and decay. Reaching adolescents with behaviorally-focused health programs where they spend the majority of their time, at school, shows promise. However, engaging caregivers who serve as their child's most influential role model as well as the gatekeeper for the home environment may be equally as important in changing adolescents' SSB behaviors. Finally, there is a great need to understand how to support schools and teachers to deliver and maintain evidence-based health education programs, especially among rural schools. Thus, the overarching goal of this proposal is to work in partnership with Appalachian middle schools to implement and evaluate Kids SIPsmartER. Kids SIPsmartER is a 6-month, school-based, behavior and health literacy curriculum aimed at improving SSB behaviors among middle school students. The program also integrates a two-way short service message (SMS) strategy to engage caregivers in SSB role modeling and supporting home SSB environment changes. Kids SIPsmartER is grounded by the Theory of Planned Behavior as well as health literacy, media literacy, numeracy, and public health literacy concepts. In the proposed cluster-randomized controlled trial, the investigators target 12 middle schools in medically underserved Appalachian counties in southwest Virginia. This study is guided by the RE-AIM (reach, adoption, effectiveness, implementation, and maintenance) framework and is a type 1 hybrid design. The primary aim is to assess changes in SSB behaviors at 7-months among 7th grade students at schools receiving Kids SIPsmartER, as compared to control schools. The investigators will also evaluate changes in secondary student outcomes (e.g., BMI, quality of life, theory-related variables), changes in caregiver outcomes (e.g., SSB behaviors, home SSB environment), and 19-month maintenance of outcomes. The reach and representativeness of Kids SIPsmartER will be assessed. Furthermore, the investigators will use a mixed-methods approach with interviews, surveys, observation, and process evaluation strategies to determine the degree to which teachers implement Kids SIPsmartER as intended and the potential for institutionalization within the schools. The long-term goal of this health promotion and prevention line of research is to establish an effective, scalable, and sustainable multi-level strategy to improve SSB behaviors and reduce SSB-related health inequities and chronic conditions (e.g. obesity, cancer, type II diabetes, heart disease, dental caries) in rural Appalachia.

Interventions

BEHAVIORALKids SipSmartER

Kids SIPsmartER is grounded by the Theory of Planned Behavior as well as health literacy, media literacy, numeracy, and public health literacy concepts

Sponsors

University of Virginia
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE

Intervention model description

Cluster randomized design of schools

Eligibility

Sex/Gender
ALL
Age
10 Years to 85 Years
Healthy volunteers
Yes

Inclusion criteria

* 7th grade students in the 12 enrolled schools during the years their school is randomized to one of these cohorts are eligible to participate * Parents/caregivers of enrolled middle school students

Exclusion criteria

* Data from students with major cognitive disabilities that could compromise self-report behavioral data quality will be excluded

Design outcomes

Primary

MeasureTime frameDescription
Student: SSB Change From Baseline to 7-months (All Participants)Baseline and 7-monthsChange in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Secondary

MeasureTime frameDescription
Student: BMI Z-score Change From Baseline to 7-monthsBaseline and 7-monthsStudent BMI z-score: BMI z-score was calculated using the World Health Organization (WHO) growth reference standards. The z-score represents the number of standard deviations a child's BMI is from the population mean for age and sex. A z-score of 0 corresponds to the median BMI of the reference population. Positive values indicate a BMI higher than the reference median, while negative values indicate a BMI lower than the reference median. Higher z-scores generally indicate increased adiposity, with standard clinical thresholds defining overweight as a BMI z-score ≥ 1 and obesity as a BMI z-score ≥ 2.
Caregiver: BMI Change From Baseline to 7-MonthsBaseline and 7-monthsCaregiver BMI was calculated from height and weight data using the following equation: kg/m\^2
Caregiver: SSB Change From Baseline to 7-months (All Participants)Baseline and 7-monthsChange in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.
Caregiver: Quality of Life Change From Baseline to 7-months--Unhealthy DaysBaseline and 7-monthsUsing validated scoring procedures, an unhealthy days score was computed by adding the number of physically and mentally unhealthy days within the past 30 days, with a minimum score of 0 and maximum score of 30 days. Higher scores indicate worse quality of life.
Student: Quality of Life Change From Baseline to 7-months--school Related FunctionBaseline and 7-monthsSchool-related quality of life (QOL) was assessed with the 5-item school functioning subscale of the Pediatric QOL Inventory which used a 5-point Likert scale (i.e., 1 = never a problem, 5 = almost always a problem). Applying validated scoring procedures, items were reverse-scored and linearly transformed to a 0 to 100 scale with higher scores indicating higher school-related QOL.
Student and Caregiver: Quality of Life Change From Baseline to 7-months--Overall Health RatingBaseline and 7-monthsOverall health rating is a Single item question asking to rate general overall health and scored on a 5-point Likert scale from 1=poor to 5=excellent.

Countries

United States

Participant flow

Participants by arm

ArmCount
Kids SipSmartER
Kids SIPsmartER is a 12 session, 6-month program with an integrated two-way short service message (SMS) strategy to engage caregivers in SSB role modeling and supporting home SSB environment changes Kids SipSmartER: Kids SIPsmartER is grounded by the Theory of Planned Behavior as well as health literacy, media literacy, numeracy, and public health literacy concepts
424
Kids SipSmartER
Kids SIPsmartER is a 12 session, 6-month program with an integrated two-way short service message (SMS) strategy to engage caregivers in SSB role modeling and supporting home SSB environment changes Kids SipSmartER: Kids SIPsmartER is grounded by the Theory of Planned Behavior as well as health literacy, media literacy, numeracy, and public health literacy concepts
6
Control
Control arm receives no intervention
322
Control
Control arm receives no intervention
6
Total758

Baseline characteristics

CharacteristicKids SipSmartERTotalControl
Age, Continuous
Caregiver Age (years)
40.8 years
STANDARD_DEVIATION 7
40.6 years
STANDARD_DEVIATION 6.7
40.4 years
STANDARD_DEVIATION 6.2
Age, Continuous
Student Age (years)
12.6 years
STANDARD_DEVIATION 0.5
12.7 years
STANDARD_DEVIATION 0.5
12.7 years
STANDARD_DEVIATION 0.4
BMI status
Caregiver BMI Status
Healthy Weight (student BMI 5th- <85th%; caregiver BMI 18.5-24.9 kg/m2)
16 Participants44 Participants28 Participants
BMI status
Caregiver BMI Status
Obese (student BMI 95th -<99th%; caregiver BMI 30-34.9 kg/m2)
26 Participants42 Participants16 Participants
BMI status
Caregiver BMI Status
Other or unknown
10 Participants17 Participants7 Participants
BMI status
Caregiver BMI Status
Overweight (student BMI 85th-<95th%; caregiver BMI 25-29.9 kg/m2)
31 Participants58 Participants27 Participants
BMI status
Caregiver BMI Status
Severe Obesity (student BMI >/= 99th%; caregiver BMI >/= 30 kg/m2)
34 Participants55 Participants21 Participants
BMI status
Caregiver BMI Status
Underweight (student BMI < 5th%; caregiver BMI < 18.5 kg/m2)
1 Participants4 Participants3 Participants
BMI status
Student BMI Status
Healthy Weight (student BMI 5th- <85th%; caregiver BMI 18.5-24.9 kg/m2)
142 Participants245 Participants103 Participants
BMI status
Student BMI Status
Obese (student BMI 95th -<99th%; caregiver BMI 30-34.9 kg/m2)
58 Participants98 Participants40 Participants
BMI status
Student BMI Status
Other or unknown
11 Participants30 Participants19 Participants
BMI status
Student BMI Status
Overweight (student BMI 85th-<95th%; caregiver BMI 25-29.9 kg/m2)
57 Participants96 Participants39 Participants
BMI status
Student BMI Status
Severe Obesity (student BMI >/= 99th%; caregiver BMI >/= 30 kg/m2)
33 Participants48 Participants15 Participants
BMI status
Student BMI Status
Underweight (student BMI < 5th%; caregiver BMI < 18.5 kg/m2)
5 Participants9 Participants4 Participants
Caregiver BMI32.1 kg/m2
STANDARD_DEVIATION 7.7
30.8 kg/m2
STANDARD_DEVIATION 7.9
29.5 kg/m2
STANDARD_DEVIATION 8
Caregiver Educational Attainment
4-year college degree or higher
36 Participants71 Participants35 Participants
Caregiver Educational Attainment
High School, GED, or less
28 Participants56 Participants28 Participants
Caregiver Educational Attainment
Other or unknown
5 Participants8 Participants3 Participants
Caregiver Educational Attainment
Some college, Associates degree
49 Participants85 Participants36 Participants
Caregiver Household Income
<$25,000
20 Participants38 Participants18 Participants
Caregiver Household Income
$25,000-$49,000
16 Participants36 Participants20 Participants
Caregiver Household Income
$50,000-$74,999
25 Participants43 Participants18 Participants
Caregiver Household Income
>/= $75,000
37 Participants68 Participants31 Participants
Caregiver Household Income
Other or unknown
20 Participants35 Participants15 Participants
Ethnicity (NIH/OMB)
Caregiver Ethnicity
Hispanic or Latino
1 Participants1 Participants0 Participants
Ethnicity (NIH/OMB)
Caregiver Ethnicity
Not Hispanic or Latino
117 Participants219 Participants102 Participants
Ethnicity (NIH/OMB)
Caregiver Ethnicity
Unknown or Not Reported
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Student Ethnicity
Hispanic or Latino
15 Participants24 Participants9 Participants
Ethnicity (NIH/OMB)
Student Ethnicity
Not Hispanic or Latino
291 Participants502 Participants211 Participants
Ethnicity (NIH/OMB)
Student Ethnicity
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Caregiver Race
American Indian or Alaska Native
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Caregiver Race
Asian
2 Participants3 Participants1 Participants
Race (NIH/OMB)
Caregiver Race
Black or African American
3 Participants7 Participants4 Participants
Race (NIH/OMB)
Caregiver Race
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Caregiver Race
Native Hawaiian or Other Pacific Islander
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Caregiver Race
Unknown or Not Reported
7 Participants15 Participants8 Participants
Race (NIH/OMB)
Caregiver Race
White
105 Participants193 Participants88 Participants
Race (NIH/OMB)
Student Race
American Indian or Alaska Native
42 Participants74 Participants32 Participants
Race (NIH/OMB)
Student Race
Asian
6 Participants12 Participants6 Participants
Race (NIH/OMB)
Student Race
Black or African American
9 Participants19 Participants10 Participants
Race (NIH/OMB)
Student Race
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Student Race
Native Hawaiian or Other Pacific Islander
3 Participants7 Participants4 Participants
Race (NIH/OMB)
Student Race
Unknown or Not Reported
11 Participants24 Participants13 Participants
Race (NIH/OMB)
Student Race
White
235 Participants390 Participants155 Participants
Region of Enrollment
United States
424 participants746 participants322 participants
Sex/Gender, Customized
Caregiver Gender
Female
112 Participants208 Participants96 Participants
Sex/Gender, Customized
Caregiver Gender
Male
6 Participants12 Participants6 Participants
Sex/Gender, Customized
Caregiver Gender
Other or unknown
0 Participants0 Participants0 Participants
Sex/Gender, Customized
Student Gender
Female
182 Participants289 Participants107 Participants
Sex/Gender, Customized
Student Gender
Male
122 Participants231 Participants109 Participants
Sex/Gender, Customized
Student Gender
Other or unknown
2 Participants6 Participants4 Participants
Student BMI percentile73.2 percentile
STANDARD_DEVIATION 27.1
74.1 percentile
STANDARD_DEVIATION 26.2
75.8 percentile
STANDARD_DEVIATION 24.6
Student BMI z-score0.9 z-score
STANDARD_DEVIATION 1.1
0.9 z-score
STANDARD_DEVIATION 1.1
1.0 z-score
STANDARD_DEVIATION 1

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 4240 / 322
other
Total, other adverse events
0 / 4240 / 322
serious
Total, serious adverse events
0 / 4240 / 322

Outcome results

Primary

Student: SSB Change From Baseline to 7-months (All Participants)

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes student participants. While caregivers were analyzed for change in SSB, caregiver SSB change was a secondary outcome and therefore they are not reported here. Overall participants analyzed includes students who completed both the baseline and 7 month follow up items for the BEVQ-15.

ArmMeasureValue (MEAN)
Kids SipSmartERStudent: SSB Change From Baseline to 7-months (All Participants)-9.9 fluid ounces
ControlStudent: SSB Change From Baseline to 7-months (All Participants)-2.7 fluid ounces
Secondary

Caregiver: BMI Change From Baseline to 7-Months

Caregiver BMI was calculated from height and weight data using the following equation: kg/m\^2

Time frame: Baseline and 7-months

Population: Because BMI is calculated differently for children, this analysis only includes caregiver participants. Student BMI changes are reported separately. Overall participants analyzed includes caregivers who reported their baseline and 7 month height and weight measures.

ArmMeasureValue (MEAN)
Kids SipSmartERCaregiver: BMI Change From Baseline to 7-Months-0.3 kg/m^2
ControlCaregiver: BMI Change From Baseline to 7-Months-0.65 kg/m^2
Secondary

Caregiver: Quality of Life Change From Baseline to 7-months--Unhealthy Days

Using validated scoring procedures, an unhealthy days score was computed by adding the number of physically and mentally unhealthy days within the past 30 days, with a minimum score of 0 and maximum score of 30 days. Higher scores indicate worse quality of life.

Time frame: Baseline and 7-months

Population: Questions were only asked of caregiver and students are not included in the analysis. Overall participants analyzed includes caregivers who completed both the baseline and 7-month follow up items for the quality of life scale.

ArmMeasureValue (MEAN)
Kids SipSmartERCaregiver: Quality of Life Change From Baseline to 7-months--Unhealthy Days-0.3 units on a scale
ControlCaregiver: Quality of Life Change From Baseline to 7-months--Unhealthy Days-1.7 units on a scale
Secondary

Caregiver: SSB Change From Baseline to 7-months (All Participants)

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes caregiver participants. While students were analyzed for change in SSB, student SSB change was a primary outcome and therefore they are not reported here. Overall participants analyzed includes caregivers who completed both the baseline and 7 month follow up items for the BEVQ-15.

ArmMeasureValue (MEAN)
Kids SipSmartERCaregiver: SSB Change From Baseline to 7-months (All Participants)-8.2 fluid ounces
ControlCaregiver: SSB Change From Baseline to 7-months (All Participants)-6.3 fluid ounces
Secondary

Student and Caregiver: Quality of Life Change From Baseline to 7-months--Overall Health Rating

Overall health rating is a Single item question asking to rate general overall health and scored on a 5-point Likert scale from 1=poor to 5=excellent.

Time frame: Baseline and 7-months

Population: Overall participants analyzed includes students and caregivers who completed both the baseline and 7 month overall health rating item.

ArmMeasureGroupValue (MEAN)
Kids SipSmartERStudent and Caregiver: Quality of Life Change From Baseline to 7-months--Overall Health RatingStudents: Overall Health Rating Change0.06 units on a scale
Kids SipSmartERStudent and Caregiver: Quality of Life Change From Baseline to 7-months--Overall Health RatingCaregivers: Overall Health Rating Change0.04 units on a scale
ControlStudent and Caregiver: Quality of Life Change From Baseline to 7-months--Overall Health RatingStudents: Overall Health Rating Change0.03 units on a scale
ControlStudent and Caregiver: Quality of Life Change From Baseline to 7-months--Overall Health RatingCaregivers: Overall Health Rating Change-0.06 units on a scale
Secondary

Student: BMI Z-score Change From Baseline to 7-months

Student BMI z-score: BMI z-score was calculated using the World Health Organization (WHO) growth reference standards. The z-score represents the number of standard deviations a child's BMI is from the population mean for age and sex. A z-score of 0 corresponds to the median BMI of the reference population. Positive values indicate a BMI higher than the reference median, while negative values indicate a BMI lower than the reference median. Higher z-scores generally indicate increased adiposity, with standard clinical thresholds defining overweight as a BMI z-score ≥ 1 and obesity as a BMI z-score ≥ 2.

Time frame: Baseline and 7-months

Population: Because BMI is calculated differently for adults, this analysis only includes student participants. Caregiver BMI changes are reported separately. Overall participants analyzed includes students who completed both the baseline and 7 month height and weight measures.

ArmMeasureValue (MEAN)
Kids SipSmartERStudent: BMI Z-score Change From Baseline to 7-months0.02 z-score
ControlStudent: BMI Z-score Change From Baseline to 7-months-0.018 z-score
Secondary

Student: Quality of Life Change From Baseline to 7-months--school Related Function

School-related quality of life (QOL) was assessed with the 5-item school functioning subscale of the Pediatric QOL Inventory which used a 5-point Likert scale (i.e., 1 = never a problem, 5 = almost always a problem). Applying validated scoring procedures, items were reverse-scored and linearly transformed to a 0 to 100 scale with higher scores indicating higher school-related QOL.

Time frame: Baseline and 7-months

Population: This analysis only includes student participants. Caregiver quality of life measures are reported separately. Overall participants analyzed includes students who completed both the baseline and 7 month school related function items.

ArmMeasureValue (MEAN)
Kids SipSmartERStudent: Quality of Life Change From Baseline to 7-months--school Related Function-1.7 units on a scale
ControlStudent: Quality of Life Change From Baseline to 7-months--school Related Function-3.9 units on a scale
Post Hoc

Caregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 12 fl oz SSB at Baseline

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes caregiver participants who consumed \> 12 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While students were analyzed similarly, student SSB change across Baseline SSB intake was a primary outcome and therefore they are not reported here.

ArmMeasureValue (MEAN)
Kids SipSmartERCaregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 12 fl oz SSB at Baseline-17.5 fluid ounces
ControlCaregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 12 fl oz SSB at Baseline-7.1 fluid ounces
Post Hoc

Caregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 24 fl oz SSB at Baseline

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes caregiver participants who consumed \> 24 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While students were analyzed similarly, student SSB change across Baseline SSB intake was a primary outcome and therefore they are not reported here.

ArmMeasureValue (MEAN)
Kids SipSmartERCaregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 24 fl oz SSB at Baseline-23.7 fluid ounces
ControlCaregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 24 fl oz SSB at Baseline-9.8 fluid ounces
Post Hoc

Caregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 8 fl oz SSB at Baseline

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes caregiver participants who consumed \> 8 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While students were analyzed similarly, student SSB change across Baseline SSB intake was a primary outcome and therefore they are not reported here.

ArmMeasureValue (MEAN)
Kids SipSmartERCaregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 8 fl oz SSB at Baseline-15.0 fluid ounces
ControlCaregiver: SSB Change From Baseline to 7-months for Caregivers Consuming > 8 fl oz SSB at Baseline-5.8 fluid ounces
Post Hoc

Student: SSB Change From Baseline to 7-months for Students Consuming > 12 fl oz SSB at Baseline

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes student participants who consumed \> 12 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While caregivers were analyzed similarly, caregiver SSB change across Baseline SSB intake was a secondary outcome and therefore they are not reported here.

ArmMeasureValue (MEAN)
Kids SipSmartERStudent: SSB Change From Baseline to 7-months for Students Consuming > 12 fl oz SSB at Baseline-15.5 fluid ounces
ControlStudent: SSB Change From Baseline to 7-months for Students Consuming > 12 fl oz SSB at Baseline-7.4 fluid ounces
Post Hoc

Student: SSB Change From Baseline to 7-months for Students Consuming > 24 fl oz SSB at Baseline

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes student participants who consumed \> 24 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While caregivers were analyzed similarly, caregiver SSB change across Baseline SSB intake was a secondary outcome and therefore they are not reported here.

ArmMeasureValue (MEAN)
Kids SipSmartERStudent: SSB Change From Baseline to 7-months for Students Consuming > 24 fl oz SSB at Baseline-23.0 fluid ounces
ControlStudent: SSB Change From Baseline to 7-months for Students Consuming > 24 fl oz SSB at Baseline-10.3 fluid ounces
Post Hoc

Student: SSB Change From Baseline to 7-months for Students Consuming > 8 fl oz SSB at Baseline

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

Time frame: Baseline and 7-months

Population: This analysis only includes student participants who consumed \> 8 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While caregivers were analyzed similarly, caregiver SSB change across Baseline SSB intake was a secondary outcome and therefore they are not reported here.

ArmMeasureValue (MEAN)
Kids SipSmartERStudent: SSB Change From Baseline to 7-months for Students Consuming > 8 fl oz SSB at Baseline-13.5 fluid ounces
ControlStudent: SSB Change From Baseline to 7-months for Students Consuming > 8 fl oz SSB at Baseline-5.7 fluid ounces

Source: ClinicalTrials.gov · Data processed: Mar 2, 2026