Abstract：
OBJECTIVE: Childhood obesity is a serious public health challenge. Consumption of sugar-sweetened beverages (SSBs) is one contributing factor, with adolescents being the highest consumers.
METHODS: This study used a randomised controlled trial and two-by-two factorial design to determine the effectiveness of a school-based behavioural intervention (including education/promotional messages) and/or environmental intervention (chilled water station), on encouraging adolescents to choose water instead of SSBs. Sixty-one secondary schools (n = 8992 eligible students year 7 student) were recruited and randomly allocated to one of four study groups, the behavioural intervention, the environmental intervention, both interventions or neither.
RESULTS: The primary outcome was increased water consumption; secondary outcomes included changes in students\' knowledge and attitudes about water and SSBs and changes in SSB consumption. For students who received at least one intervention there was an increased odds (though not statistically significant) of higher water consumption compared to those that received no intervention. There was a decrease in SSB consumption for students who received both interventions combined (OR: 0.67; 95% confidence interval: 0.55-0.082; P < .01).
CONCLUSIONS: The combined intervention had a greater effect on decreasing SSBs consumption. This is noteworthy given SSBs are a key contributor to overweight and obesity. SO WHAT?: To our knowledge this is the first Australian study examining combined school-based interventions to specifically promote the consumption of water and decrease the consumption of SSBs in adolescents. The study findings add to the evidence regarding the benefits of delivering multicomponent school-based interventions which add value to existing interventions that address the complex public health issue of overweight and obesity.
METHODS: This study used a randomised controlled trial and two-by-two factorial design to determine the effectiveness of a school-based behavioural intervention (including education/promotional messages) and/or environmental intervention (chilled water station), on encouraging adolescents to choose water instead of SSBs. Sixty-one secondary schools (n = 8992 eligible students year 7 student) were recruited and randomly allocated to one of four study groups, the behavioural intervention, the environmental intervention, both interventions or neither.
RESULTS: The primary outcome was increased water consumption; secondary outcomes included changes in students\' knowledge and attitudes about water and SSBs and changes in SSB consumption. For students who received at least one intervention there was an increased odds (though not statistically significant) of higher water consumption compared to those that received no intervention. There was a decrease in SSB consumption for students who received both interventions combined (OR: 0.67; 95% confidence interval: 0.55-0.082; P < .01).
CONCLUSIONS: The combined intervention had a greater effect on decreasing SSBs consumption. This is noteworthy given SSBs are a key contributor to overweight and obesity. SO WHAT?: To our knowledge this is the first Australian study examining combined school-based interventions to specifically promote the consumption of water and decrease the consumption of SSBs in adolescents. The study findings add to the evidence regarding the benefits of delivering multicomponent school-based interventions which add value to existing interventions that address the complex public health issue of overweight and obesity.
摘要：
目的：儿童肥胖是一个严重的公共卫生挑战。含糖饮料(SSB)的消费是一个促成因素，青少年是最高的消费者。
方法：本研究使用随机对照试验和二乘二因子设计来确定基于学校的行为干预（包括教育/宣传信息）和/或环境干预（冷冻水站）的有效性。鼓励青少年选择水代替SSB。招募了61所中学（n=8992名合格学生7年级学生），并随机分配到四个研究组之一，行为干预，环境干预,两种干预或都不干预。
结果：主要结果是用水量增加；次要结果包括学生对水和SSB的知识和态度的变化以及SSB消耗的变化。对于接受至少一种干预的学生，与未接受干预的学生相比，耗水量增加的几率（尽管没有统计学意义）。同时接受两种干预措施的学生的SSB消费量下降（OR：0.67；95％置信区间：0.55-0.082；P<0.01）。
结论：联合干预对减少SSB消耗具有更大的作用。这是值得注意的，因为SSB是超重和肥胖的关键因素。所以呢？：据我们所知，这是澳大利亚的第一项研究，研究了基于学校的综合干预措施，以专门促进青少年的水消费和减少SSB的消费。研究结果增加了关于提供基于学校的多成分干预措施的益处的证据，这些干预措施为解决超重和肥胖的复杂公共卫生问题的现有干预措施增加了价值。
方法：本研究使用随机对照试验和二乘二因子设计来确定基于学校的行为干预（包括教育/宣传信息）和/或环境干预（冷冻水站）的有效性。鼓励青少年选择水代替SSB。招募了61所中学（n=8992名合格学生7年级学生），并随机分配到四个研究组之一，行为干预，环境干预,两种干预或都不干预。
结果：主要结果是用水量增加；次要结果包括学生对水和SSB的知识和态度的变化以及SSB消耗的变化。对于接受至少一种干预的学生，与未接受干预的学生相比，耗水量增加的几率（尽管没有统计学意义）。同时接受两种干预措施的学生的SSB消费量下降（OR：0.67；95％置信区间：0.55-0.082；P<0.01）。
结论：联合干预对减少SSB消耗具有更大的作用。这是值得注意的，因为SSB是超重和肥胖的关键因素。所以呢？：据我们所知，这是澳大利亚的第一项研究，研究了基于学校的综合干预措施，以专门促进青少年的水消费和减少SSB的消费。研究结果增加了关于提供基于学校的多成分干预措施的益处的证据，这些干预措施为解决超重和肥胖的复杂公共卫生问题的现有干预措施增加了价值。
