Abstract
To evaluate the impact of a multi-level, multi-component (MLMC) adult obesity intervention on beverage intake in Native American adults living in five geographically and culturally diverse tribal communities. A 14-month, community-randomised, MLMC design was utilised, with three communities randomised to Intervention and two communities randomised to Comparison. FFQ were administered pre- and post-interventions, and difference-in-differences (DiD) analysis was used to assess intervention impact on beverage intake. The intervention took place within food stores, worksites, schools and selected media outlets located in the five communities. Key activities included working with store owners to stock healthy beverages, display and dispersal of educational materials, support of policies that discouraged unhealthy beverage consumption at worksites and schools and taste tests. Data were collected from 422 respondents between the ages of 18 and 75 living in the five communities pre-intervention; of those, 299 completed post-intervention surveys. Only respondents completing both pre- and post-intervention surveys were included in the current analysis. The DiD for daily servings of regular, sugar-sweetened soda from pre- to post-intervention was significant, indicating a significant decrease in Intervention communities (P < 0·05). No other changes to beverage intake were observed. Large, MLMC obesity interventions can successfully reduce the intake of regular, sugar-sweetened soda in Native American adults. This is important within modern food environments where sugar-sweetened beverages are a primary source of added sugars in Native American diets.
Highlights
This is the first study to examine changes in beverage intake resulting from an MLMC obesity intervention in Native American adults
We found that Native American adults living in Intervention communities significantly decreased daily consumption of regular soda in comparison with Native American adults living in Comparison communities but did not increase the intake of healthier beverages promoted by the intervention
An average 20 oz serving of regular soda, the standard size reported by our evaluation sample, contains 1046 kJ all from added sugars
Summary
The development and design of the OPREVENT programme have been described in detail elsewhere[31]. The result was a community-centred MLMC obesity intervention programme with food store, worksite, school and media components that discouraged these problem foods, beverages and behaviours by emphasising traditional foods and PA and utilised culturally informed and appropriate materials and evaluation methods. It was implemented in Intervention communities by local, Native American interventionists in five phases over 14 months beginning in the summer of 2012, with each phase focused on specific target foods and beverages, PA and/or associated food-related behaviours such as cooking or meal planning.
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