Preventing Non-communicable Diseases in Guatemala Through Sugary Drink Reduction

Study Overview
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Brief Summary
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Sugar-sweetened beverages are a significant contributor to adult and childhood obesity in Guatemala. Policies to place health warning labels on sugar-sweetened beverages are being pursued, but there is little empirical data on how such labels influence people. The primary aim of this study is to test the association between sugar-sweetened beverage (SSB) warning posters compared to control posters and change in SSBs purchased compared to baseline by adolescents shopping at school cafeterias in Guatemala City, Guatemala. The hypothesis is that posters with information warning people of the health harms associated with overconsuming SSBs and promoting low sugar beverages will be associated with greater reductions in SSB purchases compared to a control poster.

Official Title
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Preventing Non-communicable Diseases in Guatemala Through Sugary Drink Reduction

Conditions
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Food Preferences

Intervention / Treatment
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* Behavioral: Exposure to beverage health information
* Behavioral: Exposure to beverage calorie information


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between 12 and 18 years old Made a food or beverage purchase Has permission from parent or caregiver to participate Has not yet completed the purchase assessment Exclusion Criteria: Under 12 or over 18 years old Did not make a food or beverage purchase Parent or caregiver refused to give child permission to participate Already participated in the purchase assessment

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Three private schools will be enrolled in the study (two larger, one smaller) that have students between the ages of 12 and 18. There will be no posters displayed at any of the schools during the baseline period. The two larger schools will be randomized to either an SSB warning/non-SSB promoting poster or a calorie/control poster that will be implemented in the school cafeterias during a four-week intervention period. To increase the sample size for the intervention condition, the intervention will also be implemented at a smaller school. For the primary analysis, data only from schools that were randomized to condition will be used. Data was collected from both a sample of participants & from the cash registers directly.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Calorie/Control Poster<br>This poster will display images of both SSBs and low or no sugar beverages with calories listed below the beverages. It will simply state that those beverages are sold in the school store. | Behavioral: Exposure to beverage calorie information<br>* Calories for sugar-sweetened and non-sugar-sweetened beverages<br>|
| Experimental: SSB Warning and Non-SSB Promotion Poster<br>This poster will display images of both SSBs and low or no sugar beverages with calories listed below the beverages. In addition, the message will state that SSBs are high in sugar and should be avoided, while low or no sugar beverages are healthier options and should be chosen. | Behavioral: Exposure to beverage health information<br>* Red stop sign and avoidance message for sugar-sweetened beverages and green check mark and promotion message for non-sugar-sweetened beverage nutrition information<br>Behavioral: Exposure to beverage calorie information<br>* Calories for sugar-sweetened and non-sugar-sweetened beverages<br>|
| No Intervention: Baseline for Calorie/Control Poster<br>We will collect baseline data from a group of students before posting the Calorie/Control Poster in the control school. | |
| No Intervention: Baseline for SSB Warning and Non-SSB Promotion Poster<br>We will collect baseline data from a group of students before posting the SSB Warning and Non-SSB Promotion Poster in the intervention school. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Volume of SSBs Per Transaction | Total milliliters of SSBs per transaction from sales data | Through study period (either 4 weeks baseline, or 4 weeks intervention) | 
| Beverage Calories Per Transaction | Total number of calories for all beverages (SSBs and non-SSBs) per transaction from sales data | Through study period (either 4 weeks baseline or 4 weeks intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total Calories Per Transaction | Total number of calories for all food and beverages (SSBs and non-SSBs) per transaction from purchase assessments (e.g., calories from Coke + bag of chips) | Through time frame (either 4 weeks baseline, or 4 weeks intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Food Labeling, Adolescents