UCONN Husky Nutrition On-the-Go, Sugary Drink Reduction (SDR)

Center for Population Health, UCONN Health

Overview

Husky Nutrition On-the-Go: Sugary Drink Reduction (SDR) is a direct education intervention designed to reduce sugary drink consumption among three to five-year-old children enrolled in early childhood education (ECE) programs by changing primary caregiver knowledge, motivation, and behaviors. SDR is a 10-week, brief interaction program developed for implementation during child pick-up times at ECE programs located in SNAP-Ed eligible communities. The curriculum includes 10 nutrition education modules centered around eight discrete messages about the information, motivation, or skills needed to understand why and how to decrease sugary drink consumption in a child’s diet. Each week, the parent encounters an activity to apply knowledge and skills learned at a display board, repetition of a targeted message for the week, informational handouts, and a gift to reinforce that message.  A series of short videos that reinforce SDR messages has also been developed for social media. Each week of the program, students enrolled in a university service-learning course set up the weekly display board at participating ECE centers and greet parents when they pick up their children.

Target Behavior: Healthy Eating

Intervention Type: Direct Education

Intervention Reach and Adoption

SDR targets parents of preschool-age children when they pick up their child from ECE centers in SNAP-Ed eligible communities. SDR focuses on reducing sugary drink consumption among preschool-age children by delivering education to parents because parents of young children play the primary role in determining their child’s consumption of sugary drinks. However, parents often have difficulty attending traditional nutrition classes due to lack of time, child care needs, transportation, or competing priorities. The SDR approach reduces these barriers by using a location and time that already fits into a parent’s schedule. SDR program implementation occurs regularly at five sites, four of which are in Hartford, and the SDR program has been adopted as an abbreviated series or single sessions at other sites, such as public libraries, WIC education sessions, mobile food vans, and pediatric clinics.

Setting: Child care (Learn)

Target Audience: Preschool (<5 years), Parents/Mothers/Fathers

Race/Ethnicity: Special focus on Asian, Black or African American, and White communities

Intervention Components

SDR includes a sequence of eight discrete messages on the information, motivation, or skills needed to the understand why and how to decrease sugary drinks in a child’s diet. SDR includes eight boards, designed for weekly delivery by trained undergraduates. The effectiveness of each individual board, different intervals between board presentations, or delivery by non-students has not been evaluated. Partners have used the boards for single-sessions and note high participant satisfaction. Although the board’s text is in English, the simplicity of the messages, as well as research staff capacity and student fluency in Spanish, allow for greater participation.

Intervention Materials

The intervention materials include:

  • Curriculum:
    • Lessons for each of the 10 weekly lessons with educator aides and scripts
    • Lists of all equipment and supplies
    • Photos of the display boards
  • Syllabus for the supporting three-credit service-learning class
  • Supporting videos (not part of the original intervention)
  • Overview of the intervention used to evaluate the program and publications
  • Description of the role of the SNAP-Ed manager

Material are available on the SNAP4CT Husky Nutrition Curriculum webpage.

Intervention Costs

Materials available at no cost.

Evidence Summary

During SDR development, the School Readiness Coalition of over 60 ECE centers and parents of young children in the target communities participated in focus groups, interviews, and surveys about the approach, content, and delivery of the program. Additionally, a randomized control trial funded by the USDA Childhood Obesity Prevention Initiative evaluated the effectiveness of the intervention. The primary instruments used to evaluate intervention effectiveness include a participant demographics form, child weekend food record/recall, and the Information, Motivation, Behavior Survey (Goodell et al. 2012). The Information, Motivation, Behavior Survey, additional instruments (Pierce et al 2011 & 2012; Coleman et al. 2011) used in the formative evaluation phase of the project, and other publications can be found within the SDR’s publication page. The logic model guiding the program, the intervention model articulated for sugary drink consumption, and copies of evaluation instruments can be found on the evidence/research link on the SNAP4CT Husky Nutrition Curriculum webpage.

Results of the intervention:

  • In total, 367 parent/child dyads (77.9%) completed both the 10-week program and three-month follow-up.
  • Of the 367 parent/child dyads, 260 had a child that consumed greater than two ounces of SD (sugary drinks) at baseline (70.8%).
  • Among children who were consumers and had a parent in the intervention group (n=133), 69.9% decreased intake at three-month post intervention, with 57.9% having a decrease of at least two ounces.
  • For parents of children with SDI (sugary drink intake) at baseline, information (p<0.001) and behavior scores (p<0.001) significantly increased following the intervention.
  • Increases in information (p<0.001), but not behavior scores (p=.22), were significant when compared to parents in the control group.

Lessons learned related to data collection and analyses:

  • Large range of beverages available in the home (>3500 types)
  • Beverages can be allotted to specific family members
  • Beverages can have cultural specificity
  • Beverages can have non-commercial sourcing (beverages prepared from home recipes)
  • Powdered beverages in the home complicate analyses (converting the total available to fluid ounces inflates the total inventory)
  • Almost 30% of parents who enrolled in the study served their child less than two ounces of sugary drinks daily
  • Household inventories of sugary drinks designated for the child did not decrease, even when child sugary drink intake decreased (suggesting low resource households may be reluctant to dispose of infrequently consumed food)

Evidence-based Approach: Research-tested

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
Individual ST1 MT1
Environmental Settings
Sectors of Influence

ST1: Healthy Eating

  • ST1l: Motivation scores for parents of children with SDI at baseline did not increase significantly at three-months post intervention, when compared to baseline (Mean =0.017, p=.717)
  • ST1l: Information scores for parents of children with SDI at baseline significantly increased by an average of 0.203 when measured three-months post intervention (p<0.001)

MT1: Healthy Eating

  • MT1h: 9% (494/707) of preschool-age children decreased their daily SDI at the three-month follow-up (six months from baseline)
  • MT1h: 57.9% (409/707) of preschool-age children who consumed SD at baseline decreased SDI by greater than two ounces per day at three-month follow-up
  • MT1h: Behavior scores for parents of children with sugary drink intake at baseline significantly increased by an average of 0.162 when measured three-months post intervention (p<0.001)

Evaluation Materials

The evaluation materials available by participant include:

  • Parent: IMB Survey for Sugary Drinks, Home Beverage Inventory, Weekend Food Recall, Child Feeding Practices, Food Security Questionnaire, Height and Weight recording sheet
  • Student: Cultural competence and leadership surveys
  • Partner: Teacher involvement and approval surveys
  • Program: Site involvement and approval surveys, student performance evaluation, program participation and student reflections

For access to evaluation materials, please contact Ann M. Ferris.

Additional Information

Website: The SDR website includes the program’s overview, lesson plans, video lessons, syllabus, and research evidence.

Contact Person(s):
Ann M. Ferris
Phone: 860-463-6870
Email: aferris@uchc.edu