Implementation, home mediators and children’s sugary drink consumption - results from DAGIS study

Abstract Background and objectives The effectiveness of a health behavior intervention can depend on the extent to which the intervention is implemented; higher degree of implementation (DOI) might associate with larger intervention effects. This study examined whether the parental DOI of an health behavior intervention had an effect on children's consumption of sugar-sweetened beverages (SSB) and was the effect mediated by home factors. Methods the DAGIS preschool intervention was conducted in 2017-2018 in Finland among 3-6-year-olds with valid data from 476 children. At baseline and follow-up parents reported 1) children's SSB consumption in a semi-quantified food frequency questionnaire, 2) availability of SSB at home, parental role modelling of drinking SSB, and norm (parental view on the suitable amount of SSB for children), and 3) DOI: a dichotomized sum variable on several aspects of parental program implementation. In the analyses, high and low DOI were compared to control group. Mediation analysis of the effect of DOI on the change in children's SSB consumption via change in availability, role modelling and norm was conducted with R statistical software. Results High DOI was associated with reduced consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No mediated effects were found. All studied mediators impacted the change in SSB consumption, but the DOI had no effect on the change in mediators. Conclusions Intervention effect on the consumption of SSB was only found in the high DOI group, which supports the importance of assessing intervention implementation. Since the found effect was not mediated by the studied mediators, other possible mediators should be examined, as understanding intervention mediators is crucial in developing successful interventions. Key messages The consumption of SSB reduced only among children whose parents implemented the intervention to a large degree. The effect was not mediated by availability of SSB, parental role modelling, or norm.


Background and objectives:
The effectiveness of a health behavior intervention can depend on the extent to which the intervention is implemented; higher degree of implementation (DOI) might associate with larger intervention effects. This study examined whether the parental DOI of an health behavior intervention had an effect on children's consumption of sugar-sweetened beverages (SSB) and was the effect mediated by home factors. Methods: the DAGIS preschool intervention was conducted in 2017-2018 in Finland among 3-6-year-olds with valid data from 476 children. At baseline and follow-up parents reported 1) children's SSB consumption in a semi-quantified food frequency questionnaire, 2) availability of SSB at home, parental role modelling of drinking SSB, and norm (parental view on the suitable amount of SSB for children), and 3) DOI: a dichotomized sum variable on several aspects of parental program implementation. In the analyses, high and low DOI were compared to control group. Mediation analysis of the effect of DOI on the change in children's SSB consumption via change in availability, role modelling and norm was conducted with R statistical software.

Results:
High DOI was associated with reduced consumption of SSB . No mediated effects were found. All studied mediators impacted the change in SSB consumption, but the DOI had no effect on the change in mediators.

Conclusions:
Intervention effect on the consumption of SSB was only found in the high DOI group, which supports the importance of assessing intervention implementation. Since the found effect was not mediated by the studied mediators, other possible mediators should be examined, as understanding intervention mediators is crucial in developing successful interventions. Key messages: The consumption of SSB reduced only among children whose parents implemented the intervention to a large degree.
The effect was not mediated by availability of SSB, parental role modelling, or norm.

Background:
In the Shanghai Declaration on promoting health in the 2030 Agenda of the UNs for Sustainable Development highlighted the importance of health literacy (HL) to empower individual citizens and enable their engagement in collective health promotion action. The aim of this study was to demonstrate the COVID-19 digital HL and the information-seeking behavior among students in Medical University -Sofia.

Methods:
For the purpose of the study a web-based questionnaire was distributed among medical students from the Faculty of Medicine, and health sciences students from the Faculty of Public Health and the Medical College-Sofia, all from Medical University -Sofia in Bulgaria. The study was conducted between February and April 2022. In total 239 respondents participated, all anonymously and voluntarily. In data analysis established statistical methods were used.

Results:
Data collected show that when students searched the Internet for information on the coronavirus or related topics, nearly two thirds (66%) of the respondents could either easy or very easy decide whether the information is reliable or not, and (81%) could easy or very easy decide whether the information is written with commercial interests. In addition among the respondents 82% find easy or very easy to check different websites to see whether they provide the same information.

Conclusions:
From the presented analysis the following conclusion can be made: when navigate the social media platforms and forums, it is significant for health sciences students to obtain the appropriate searching skills, in order to be confident to identify the validity of the information and make informed