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      Controlled cohort evaluation of the LiveLighter mass media campaign’s impact on adults’ reported consumption of sugar-sweetened beverages

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          Abstract

          Objective

          To evaluate the LiveLighter ‘Sugary Drinks’ campaign impact on awareness, knowledge and sugar-sweetened beverage (SSB) consumption.

          Design

          Cohort study with population surveys undertaken in intervention and comparison states at baseline (n=900 each), with 78% retention at follow-up (intervention: n=673; comparison: n=730). Analyses tested interactions by state (intervention, comparison) and time (baseline, follow-up).

          Setting and participants

          Adults aged 25–49 years residing in the Australian states of Victoria and South Australia.

          Intervention

          The 6-week mass media campaign ran in Victoria in October/November 2015. It focused on the contribution of SSBs to the development of visceral ‘toxic fat’, graphically depicted around vital organs, and ultimately serious disease. Paid television advertising was complemented by radio, cinema, online and social media advertising, and stakeholder and community engagement.

          Primary outcome measure

          Self-reported consumption of SSBs, artificially sweetened drinks and water.

          Secondary outcome measures

          Campaign recall and recognition; knowledge of the health effects of overweight and SSB consumption; perceived impact of SSB consumption on body weight and of reduced consumption on health.

          Results

          A significant reduction in frequent SSB consumption was observed in the intervention state (intervention: 31% compared with 22%, comparison: 30% compared with 29%; interaction p<0.01). This was accompanied by evidence of increased water consumption (intervention: 66% compared with 73%; comparison: 68% compared with 67%; interaction p=0.09) among overweight/obese SSB consumers. This group also showed increased knowledge of the health effects of SSB consumption (intervention: 60% compared with 71%, comparison: 63% compared with 59%; interaction p<0.05) and some evidence of increased prevalence of self-referent thoughts about SSB’s relationship to weight gain (intervention: 39% compared with 45%, comparison: 43% compared with 38%; interaction p=0.06).

          Conclusions

          The findings provide evidence of reduced SSB consumption among adults in the target age range following the LiveLighter campaign. This is notable in a context where public health campaigns occur against a backdrop of heavy commercial product advertising promoting increased SSB consumption.

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          Most cited references28

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          A 10-year retrospective of research in health mass media campaigns: where do we go from here?

          Seth Noar (2005)
          Mass media campaigns have long been a tool for promoting public health. How effective are such campaigns in changing health-related attitudes and behaviors, however, and how has the literature in this area progressed over the past decade? The purpose of the current article is threefold. First, I discuss the importance of health mass media campaigns and raise the question of whether they are capable of effectively impacting public health. Second, I review the literature and discuss what we have learned about the effectiveness of campaigns over the past 10 years. Finally, I conclude with a discussion of possible avenues for the health campaign literature over the next 10 years. The overriding conclusion is the following: The literature is beginning to amass evidence that targeted, well-executed health mass media campaigns can have small-to-moderate effects not only on health knowledge, beliefs, and attitudes, but on behaviors as well, which can translate into major public health impact given the wide reach of mass media. Such impact can only be achieved, however, if principles of effective campaign design are carefully followed.
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            Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies.

            To summarise evidence on the association between intake of dietary sugars and body weight in adults and children. Systematic review and meta-analysis of randomised controlled trials and prospective cohort studies. OVID Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science (up to December 2011). Eligible studies reported the intake of total sugars, intake of a component of total sugars, or intake of sugar containing foods or beverages; and at least one measure of body fatness. Minimum duration was two weeks for trials and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. For trials, we pooled data for weight change using inverse variance models with random effects. We pooled cohort study data where possible to estimate effect sizes, expressed as odds ratios for risk of obesity or β coefficients for change in adiposity per unit of intake. 30 of 7895 trials and 38 of 9445 cohort studies were eligible. In trials of adults with ad libitum diets (that is, with no strict control of food intake), reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval 0.39 to 1.21; P<0.001); increased sugars intake was associated with a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). Isoenergetic exchange of dietary sugars with other carbohydrates showed no change in body weight (0.04 kg, -0.04 to 0.13). Trials in children, which involved recommendations to reduce intake of sugar sweetened foods and beverages, had low participant compliance to dietary advice; these trials showed no overall change in body weight. However, in relation to intakes of sugar sweetened beverages after one year follow-up in prospective studies, the odds ratio for being overweight or obese increased was 1.55 (1.32 to 1.82) among groups with the highest intake compared with those with the lowest intake. Despite significant heterogeneity in one meta-analysis and potential bias in some trials, sensitivity analyses showed that the trends were consistent and associations remained after these studies were excluded. Among free living people involving ad libitum diets, intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.
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              A systematic review of social marketing effectiveness

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                25 April 2018
                : 8
                : 4
                : e019574
                Affiliations
                [1 ] departmentCentre for Behavioural Research in Cancer , Cancer Council Victoria , Melbourne, Victoria, Australia
                [2 ] departmentChief Executive , Heart Foundation (Western Australia) , Subiaco, Western Australia, Australia
                [3 ] departmentCancer Prevention Centre , Cancer Council Victoria , Melbourne, Victoria, Australia
                Author notes
                [Correspondence to ] Dr Belinda C Morley; Belinda.Morley@ 123456cancervic.org.au
                Article
                bmjopen-2017-019574
                10.1136/bmjopen-2017-019574
                5922472
                29695387
                a2fe836a-3001-42bb-b45d-1df1d09c8be1
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 12 September 2017
                : 13 March 2018
                : 21 March 2018
                Funding
                Funded by: State Government Victoria, Australia;
                Categories
                Public Health
                Research
                1506
                1724
                Custom metadata
                unlocked

                Medicine
                sugary drinks,sugar-sweetened beverages,mass media,obesity,health behaviours,australia
                Medicine
                sugary drinks, sugar-sweetened beverages, mass media, obesity, health behaviours, australia

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