Should messages discourage sugary drinks, encourage water, or both? A randomized experiment with U.S. parents. 2023

Anna H Grummon, and Allison J Lazard, and Lindsey Smith Taillie, and Marissa G Hall
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States of America; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States of America; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States of America. Electronic address: agrummon@stanford.edu.

Campaigns to improve beverage consumption typically focus on discouraging unhealthy beverages (e.g., soda), encouraging healthy beverages (e.g., water), or both. It remains unclear which of these strategies is most effective. We recruited a national convenience sample of U.S. parents of children ages 2-12 (n = 1078, 48% Latino[a]) to complete an online survey in 2019. We randomly assigned participants to view: 1) a control message, 2) a soda discouragement message, 3) a water encouragement message, or 4) both soda discouragement and water encouragement messages shown side-by-side in random arrangement. Intervention messages mimicked New York City's "Pouring on the Pounds" campaign. Participants rated messages on perceived effectiveness for discouraging soda consumption and encouraging water consumption (1-5 response scales) and reported feelings and intentions about drinking soda and water (1-7 scales). Compared to those with no exposure, participants who viewed the soda discouragement message reported higher perceived discouragement from drinking soda (Average Differential Effect [ADE] = 1.18), more negative feelings toward drinking soda (ADE = 0.83) and stronger intentions to avoid drinking soda (ADE = 0.45) (ps < 0.001). The soda discouragement message also exerted beneficial effects on perceived effectiveness, feelings, and intentions related to water consumption (ADEs = 0.33-0.68; ps < 0.001). Exposure to the water encouragement message had beneficial effects on outcomes related to water consumption (ADEs = 0.28-0.81, ps < 0.001), but limited impact on outcomes related to soda consumption. Across outcomes, results indicated diminishing returns from exposure to both message types. Messaging campaigns discouraging unhealthy beverages may be more promising for improving beverage consumption than messages only promoting healthier beverages.

UI MeSH Term Description Entries
D010290 Parents Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent. Step-Parents,Parental Age,Parenthood Status,Stepparent,Age, Parental,Ages, Parental,Parent,Parental Ages,Status, Parenthood,Step Parents,Step-Parent,Stepparents
D002253 Carbonated Beverages Drinkable liquids combined with or impregnated with CARBON DIOXIDE. Carbonated Drinks,Soda Pop,Soft Drinks,Beverage, Carbonated,Beverages, Carbonated,Carbonated Beverage,Carbonated Drink,Drink, Carbonated,Drink, Soft,Drinks, Carbonated,Drinks, Soft,Pop, Soda,Pops, Soda,Soda Pops,Soft Drink
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000080845 Sugar-Sweetened Beverages Liquids or drinks sweetened with added sugars of various forms. Sugar Sweetened Beverage,Sugar-Added Beverage,Sugar-Added Beverages,Sugar-Sweetened Soda,Sugar-Sweetened Sodas,Sugar-Sweetened Soft Drink,Sugar-Sweetened Soft Drinks,Sweetened Beverage,Sweetened Beverages,Sweetened Drink,Sweetened Drinks,Beverage, Sugar Sweetened,Beverage, Sugar-Added,Beverage, Sugar-Sweetened,Beverage, Sweetened,Beverages, Sugar Sweetened,Beverages, Sugar-Added,Beverages, Sugar-Sweetened,Beverages, Sweetened,Drink, Sugar-Sweetened Soft,Drink, Sweetened,Drinks, Sugar-Sweetened Soft,Drinks, Sweetened,Soda, Sugar-Sweetened,Sodas, Sugar-Sweetened,Soft Drink, Sugar-Sweetened,Soft Drinks, Sugar-Sweetened,Sugar Added Beverage,Sugar Added Beverages,Sugar Sweetened Beverages,Sugar Sweetened Soda,Sugar Sweetened Sodas,Sugar Sweetened Soft Drink,Sugar Sweetened Soft Drinks,Sugar-Sweetened Beverage,Sweetened Beverage, Sugar,Sweetened Beverages, Sugar
D001628 Beverages Liquids that are suitable for drinking. (From Merriam Webster Collegiate Dictionary, 10th ed) Beverage
D014867 Water A clear, odorless, tasteless liquid that is essential for most animal and plant life and is an excellent solvent for many substances. The chemical formula is hydrogen oxide (H2O). (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Hydrogen Oxide

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