Efficacy of school-based interventions aimed at decreasing sugar-sweetened beverage consumption among adolescents: a systematic review.
OBJECTIVE
To verify the efficacy of school-based interventions aimed at reducing sugar-sweetened beverage (SSB) consumption among adolescents in order to develop or improve public health interventions.


METHODS
Systematic review of interventions targeting adolescents and/or the school environment.


METHODS
The following databases were investigated: MEDLINE/PubMed, PsycINFO, CINAHL and EMBASE. Proquest Dissertations and Theses was also investigated for unpublished trials.


METHODS
Adolescents were defined as individuals between the ages of 12 and 17 years.


RESULTS
A total of thirty-six studies detailing thirty-six different interventions tested among independent samples (n 152 001) were included in the review. Twenty interventions were classified as educational/behavioural and ten were classified as legislative/environmental interventions. Only six interventions targeted both individuals and their environment. Over 70 % of all interventions, regardless of whether they targeted individuals, their environment or both, were effective in decreasing SSB consumption. Legislative/environmental studies had the highest success rate (90·0 %). Educational/behavioural interventions only and interventions that combined educational/behavioural and legislative/environmental approaches were almost equally effective in reducing SSB consumption with success rates of 65·0 and 66·7 %, respectively. Among the interventions that had an educational/behavioural component, 61·5 % were theory-based. The behaviour change techniques most frequently used in interventions were providing information about the health consequences of performing the behaviour (72·2 %), restructuring the physical environment (47·2 %), behavioural goal setting (36·1 %), self-monitoring of behaviour (33·3 %), threat to health (30·6 %) and providing general social support (30·6 %).


CONCLUSIONS
School-based interventions show promising results to reduce SSB consumption among adolescents. A number of recommendations are made to improve future studies.
1School of Nutrition,Laval University,Quebec City,Quebec,Canada,G1V 0A6.
Lydi-Anne
LA
Vézina-Im
3Department of Nursing Sciences,Université du Québec à Rimouski (UQAR),Levis,Quebec,Canada.
Dominique
D
Beaulieu
5Department of Information and Communication,Laval University,Quebec City,Quebec,Canada.
Ariane
A
Bélanger-Gravel
3Department of Nursing Sciences,Université du Québec à Rimouski (UQAR),Levis,Quebec,Canada.
Danielle
D
Boucher
3Department of Nursing Sciences,Université du Québec à Rimouski (UQAR),Levis,Quebec,Canada.
Caroline
C
Sirois
7CHU de Quebec Research Centre,Quebec City,Quebec,Canada.
Marylène
M
Dugas
1School of Nutrition,Laval University,Quebec City,Quebec,Canada,G1V 0A6.
Véronique
V
Provencher
D000293:Adolescent; D000294:Adolescent Behavior; D017195:Adolescent Nutritional Physiological Phenomena; D001628:Beverages / Q000009:adverse effects*; D002648:Child; D002652:Child Behavior; D002664:Child Nutritional Physiological Phenomena; D002755:Choice Behavior; D000072001:Diet, Healthy; D000073417:Dietary Sugars / Q000008:administration & dosage / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D000070497:Healthy Lifestyle; D006801:Humans; D010349:Patient Compliance; D012574:Schools
D000073417:Dietary Sugars
Adolescents; School-based interventions; Sugar-sweetened beverages; Systematic review