Action sequence learning, habits, and automaticity in obsessive-compulsive disorder.

This study investigates the goal/habit imbalance theory of compulsion in obsessive-compulsive disorder (OCD), which postulates enhanced habit formation, increased automaticity, and impaired goal/habit arbitration. It directly tests these hypotheses using newly developed behavioral tasks. First, OCD patients and healthy participants were trained daily for a month using a smartphone app to perform chunked action sequences. Despite similar procedural learning and attainment of habitual performance (measured by an objective automaticity criterion) by both groups, OCD patients self-reported higher subjective habitual tendencies via a recently developed questionnaire. Subsequently, in a re-evaluation task assessing choices between established automatic and novel goal-directed actions, both groups were sensitive to re-evaluation based on monetary feedback. However, OCD patients, especially those with higher compulsive symptoms and habitual tendencies, showed a clear preference for trained/habitual sequences when choices were based on physical effort, possibly due to their higher attributed intrinsic value. These patients also used the habit-training app more extensively and reported symptom relief post-study. The tendency to attribute higher intrinsic value to familiar actions may be a potential mechanism leading to compulsions and an important addition to the goal/habit imbalance hypothesis in OCD. We also highlight the potential of smartphone app training as a habit reversal therapeutic tool.

Synergizing habits and goals with variational Bayes.

Behaving efficiently and flexibly is crucial for biological and artificial embodied agents. Behavior is generally classified into two types: habitual (fast but inflexible), and goal-directed (flexible but slow). While these two types of behaviors are typically considered to be managed by two distinct systems in the brain, recent studies have revealed a more sophisticated interplay between them. We introduce a theoretical framework using variational Bayesian theory, incorporating a Bayesian intention variable. Habitual behavior depends on the prior distribution of intention, computed from sensory context without goal-specification. In contrast, goal-directed behavior relies on the goal-conditioned posterior distribution of intention, inferred through variational free energy minimization. Assuming that an agent behaves using a synergized intention, our simulations in vision-based sensorimotor tasks explain the key properties of their interaction as observed in experiments. Our work suggests a fresh perspective on the neural mechanisms of habits and goals, shedding light on future research in decision making.

Reward, relief, and habit drinking profiles in treatment seeking individuals with an AUD.

AIMS: This study aimed to compare reward, relief, and habit treatment-seeking individuals on recent drinking, alcohol use disorder (AUD) phenomenology, and mood. The second aim of the study was to evaluate the predictive validity of reward, relief, and habit profiles. METHOD: Treatment-seeking individuals with an AUD (n = 169) were recruited to participate in a medication trial for AUD (NCT03594435). Reward, relief, and habit drinking groups were assessed using the UCLA Reward Relief Habit Drinking Scale. Group differences at baseline were evaluated using univariate analyses of variance. A subset of participants were enrolled in a 12-week, double-blind, placebo-controlled medication trial (n = 102), and provided longitudinal drinking and phenomenology data. The predictive validity of group membership was assessed using linear regression analyses. RESULTS: At baseline, individuals who drink primarily for relief had higher craving and negative mood than those who drink for reward and habit. Prospectively, membership in the relief drinking group predicted greater alcohol use, greater heavy drinking, and fewer days abstinent compared to those in the reward drinking group. Membership in the relief drinking group also predicted greater alcohol craving, more alcohol-related consequences, and more anxiety symptoms over 12 weeks compared to those in the reward drinking group. CONCLUSIONS: This study provides support for reward and relief drinking motive profiles in treatment-seeking individuals with an AUD. Membership in the relief drinking motive group was predictive of poorer drinking outcomes and more negative symptomology over 12 weeks, indicating that individuals who drink for relief may be a particularly vulnerable sub-population of individuals with AUD.

Breaking the plastic habit: Drivers of single-use plastic reduction among Thai university students.

This study investigated the decision-making dynamics for pro-environmental behavior among Thai university students, focusing on reducing the consumption of single-use plastics (SUP). By adopting a dynamic approach to the Theory of Planned Behavior (TPB), the research examined the influence of psychosocial factors, including attitudes, perceived behavioral control, and subjective norms, on SUP reduction intention at different phases of behavior change. Using structural equation modelling, we analyzed quantitative data (n = 317) from the selected universities. The results revealed that attitudes predicted behavioral intentions only among individuals in the contemplation phase of reducing SUP. Attitudes had a small but limited influence on the behavioral intentions of students who had not yet acted. Perceived behavioral control, on the other hand, significantly impacted behavioral intentions across all phases of behavior change, highlighting its importance in SUP reduction. The study also confirmed subjective norms' positive influence on students' behavioral intentions in the pre-contemplation phase. Practical implications suggested segmenting residents based on their behavior change phase so that public policymakers can allocate resources more efficiently and effectively by tailoring campaigns to specific behavior change phases, ultimately promoting sustainable behavior among university students.

Opioid use and disposal at 2 weeks post-surgery: Brief communication regarding excess opioids and disposal habits.

OBJECTIVE: To measure the number of unused prescription opioids and disposal habits of patients following orthopedic shoulder surgery. DESIGN: A prospective observational study. SETTING: Academic orthopedic sports medicine department. PATIENTS: Sixty-seven patients undergoing shoulder surgery. INTERVENTIONS: Nine-question opioid use questionnaire. MAIN OUTCOME MEASURES: Responses to an opioid use questionnaire were collected at 2 weeks post-surgery. Outcomes of interest included the amount of initial opioid prescription used and the disposal of excess opioids. RESULTS: Sixty-seven patients completed the opioid use questionnaire. Forty-six (68.7 percent) patients reported having excess opioids at 2 weeks. Of the 46 patients with excess opioids, 57 percent disposed of the excess, and 43 percent planned to keep their opioids. CONCLUSION: Two-thirds of the patients reported having excess opioids, highlighting the issue of an overabundance of unused prescription opioids in America. Utilization of opioid-free pain management strategies and drug disposal kits should be explored to reduce the number of unused and improperly disposed opioids.

Digital Behavior Change Intervention Designs for Habit Formation: Systematic Review.

BACKGROUND: With the development of emerging technologies, digital behavior change interventions (DBCIs) help to maintain regular physical activity in daily life. OBJECTIVE: To comprehensively understand the design implementations of habit formation techniques in current DBCIs, a systematic review was conducted to investigate the implementations of behavior change techniques, types of habit formation techniques, and design strategies in current DBCIs. METHODS: The process of this review followed the PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. A total of 4 databases were systematically searched from 2012 to 2022, which included Web of Science, Scopus, ACM Digital Library, and PubMed. The inclusion criteria encompassed studies that used digital tools for physical activity, examined behavior change intervention techniques, and were written in English. RESULTS: A total of 41 identified research articles were included in this review. The results show that the most applied behavior change techniques were the self-monitoring of behavior, goal setting, and prompts and cues. Moreover, habit formation techniques were identified and developed based on intentions, cues, and positive reinforcement. Commonly used methods included automatic monitoring, descriptive feedback, general guidelines, self-set goals, time-based cues, and virtual rewards. CONCLUSIONS: A total of 32 commonly design strategies of habit formation techniques were summarized and mapped to the proposed conceptual framework, which was categorized into target-mediated (generalization and personalization) and technology-mediated interactions (explicitness and implicitness). Most of the existing studies use the explicit interaction, aligning with the personalized habit formation techniques in the design strategies of DBCIs. However, implicit interaction design strategies are lacking in the reviewed studies. The proposed conceptual framework and potential solutions can serve as guidelines for designing strategies aimed at habit formation within DBCIs.

Adolescents' attitudes, habits, identity and social support in relation to physical activity after the COVID-19 pandemic.

This study focuses on adolescents' cognitive processes, behaviors and social support (SS) as they relate to physical activity (PA) before and after the pandemic. The aims of the study were: (1) to investigate the changes in adolescents' engagement in moderate and vigorous physical activity (MVPA), and examine the changes in PA-related attitudes and behaviors before and after the COVID-19 pandemic; (2) to analyze the correlations between the significant changes that were found, PA engagement, and SS. The survey targeted third-year middle school students of Italian nationality, attending male and female mixed classes, residents in urban, periphery and sub-urban areas, living in families with different incomes, and different habits of engaging in PA. A longitudinal study was developed using a standardized questionnaire. The questionnaire was administered in April-May 2023 to a sample of 952 students aged 11/14 residing in the Marche region in Central Italy. Increasing values were found in the post-COVID-19 phase for all the cognitive processes and attitudes, in particular, those regarding habits (0.66 vs 0.50, + 32%) and identity (0.70 vs 0.55, + 27%) related to PA. Significant correlations were found between these values and VPA engagement and between the values of the same indicators and SS (p < 0.01). The strongest relationship was found with the dimension of identity (r = 0.51; r = 054).

The effect of exercise on sleep habits of children with type 1 diabetic: a randomized clinical trial.

BACKGROUND: Adequate sleep and exercise are important components of the human lifestyle. Paying attention to these two factors is very important to improve the condition of children with type 1 diabetes. Therefore, this study aimed to investigate the effect of exercise on sleep habits in children with type 1 diabetes. MATERIAL & METHODS: 62 children with type 1 diabetes participated in this clinical trial. They will be divided into the intervention group (31) and the control group (31). Sleep habits were measured using the Children's Sleep Habits Questionnaire (CSHQ). All children's parents completed the CSHQ. The intervention for the experimental group consisted of 8 weeks of regular exercise program. The exercise program was prepared as an educational video and provided to parents. Paired sample t-test and ANCOVA test were used with SPSS 23. RESULTS: 62 children with an average age of 9.32 ± 2.02 were studied. Fifty-four and eight% of the children were girls and the rest were boys. The analysis of the variance test showed a significant difference (F = 144.72, P ≤ 0.01) between the average score of the sleep habits of the control group (62.45 ± 5.12) and the experimental group (47.06 ± 4.39). CONCLUSION: Sleep habits in the experimental group improved after 8 weeks of exercise training using educational videos. Exercise as a non-pharmacological treatment is an effective way to manage diabetes and improve sleep quality in diabetic children.

Evaluation of Sleep Habits and Their Relationship With Quality of Life in Children With Epilepsy.

BACKGROUND: The aim of this study was to investigate sleep habits, quality of life (QoL), and the relationship between them in children with epilepsy. METHODS: In this cross-sectional study, children aged two to 18 years being followed up for epilepsy were assessed using the Children's Sleep Habits Questionnaire (CSHQ) and the Pediatric Quality of Life Inventory (PedsQL). Pearson or Spearman correlation analysis was performed to examine the relationship between normally distributed and non-normally distributed variables, respectively. Linear regression analysis was used to examine independent variables associated with PedsQL total scale score. Level of significance was accepted as P < 0.05. RESULTS: The study included 112 children with a mean age of 10.5 ± 4.4 years (51.8% female). The frequency of poor sleep habits was 96.4%. There was a good level of agreement between children's and parents' PedsQL total, physical health, and psychosocial health scores (P < 0.001). Correlation analysis between QoL and sleep parameters revealed negative correlations between total sleep score and self-assessed PedsQL total scale, physical health, and psychosocial health scores (P < 0.05) and parent-assessed PedsQL total scale and psychosocial health scores (P < 0.05). The results of linear regression analysis indicated that the factors most significantly associated with lower QoL were high CSHQ total sleep score and exclusively daytime seizures (P < 0.001). CONCLUSIONS: It was found that children with epilepsy had poor sleep habits and low QoL and that poor sleep habits have a negative impact on QoL.

Impact of tobacco habits on poor oral health status among bone-factory workers in a low literacy city in India: A cross-sectional study.

Oral health is a vital indicator of well-being that is influenced by various habits and lifestyles of individuals. Oral diseases are the bottleneck in the effective control of non-communicable diseases (NCDs) due to chronic in nature and reciprocal relationship as sharing the common risk factors and habits such as sugar, tobacco, and alcohol consumption that increase the risk of developing various inevitable diseases. However, there is a lack of literature highlighting the relationship between risk factors for oral diseases and general health among individuals. This cross-sectional study was carried out among 500 study participants aged 20 to 64 years who gave written informed consent and were recruited by Multistage Stratified Cluster Sampling technique among workers in five bone factories, working for at least one year since January 2001 to March 2022 in Sambhal city, Uttar Pradesh. WHO-Basic Oral Health Survey-1997 was used to record the data regarding sociodemographic and oral health status variables. We used the modified WHO-STEPWISE pre-structured questionnaire to record tobacco consumption habits and oral health-seeking behavior. We scheduled a clinical intra-oral examination to record the Decayed Missing Filled Teeth (DMFT) index and the interview on the premises of five bone factories. Among the 500 bone-factory workers, the total number of males was 342 (68.40%) and 158 (31.60%) were females. The mean age (Standard Deviation) was 33.18 (10), and the mean DMFT score of factory workers was 2.84 (3.12). Production workers had the highest mean DMFT score of 4.60 (3.25). More than half of the factory workers (53.2%) were tobacco users. Tobacco users were 3.52 times more likely to have a severe DMFT index. Most common pre-cancerous lesions were oral submucous fibrosis and leukoplakia. Compared to non-tobacco users, mild tobacco users have 6.80 folds higher odds of oral lesions. Tobacco consumption is not only harmful for oral health but also leads to several non-communicable and systemic diseases. NCDs and dental caries are chronic and preventable conditions with a bidirectional relationship implicated by modifiable major risk factors such as tobacco consumption. Decreasing the consumption of tobacco use may improve oral health and reduce the risk of the development of NCDs. Also, regular dental visits should be scheduled to monitor the oral health status of factory workers. Additionally, tailored intervention for tobacco cessation should be implicated to maintain the general and oral health of industrial workers.

Development of a Questionnaire on Knowledge, Habits, and Attitudes on Sexually Transmitted Infections in Teenagers and Young Adults / Generación de un cuestionario sobre conocimientos, hábitos y actitudes sobre infecciones de transmisión sexual en adolescentes y adultos jóvenes

Communication with teenagers who are significantly affected by sexually transmitted infections (STIs) is essential for the sake of prevention. The aim of this study is to develop a specific questionnaire for surveying the degree of knowledge, behavior, and attitudes of current teenagers and young adults on STIs to come up with the proper training tools. We conducted the study following the Delphi method, a 2-round critical assessment score (from 1 to 9) of all domains and items. Only domains and items with median scores ≥8 were selected. A total of 8 panelists were involved in this survey. After establishing a median score ≥8, a total of 14 domains and 40 items were eventually selected. This is the first questionnaire ever conducted to study the knowledge, habits, and attitudes of contemporary teenagers and young adults on STIs, and stands as a valuable tool for future training on STI prevention in teenagers and young adults. (AU)

La comunicación con los adolescentes, quienes están marcadamente afectados por las infecciones de transmisión sexual (ITS) es imprescindible para diseñar programas de prevención. El objetivo de este estudio es desarrollar un cuestionario específico para estudiar el grado de conocimiento, los hábitos y las actitudes de los adolescentes y los adultos jóvenes frente a las ITS. El estudio se desarrolló siguiendo el método Delphi con un panel de expertos. Posteriormente se realizó una evaluación crítica (puntuación de 1 a 9) de todos los dominios e ítems a través de 2 vueltas, seleccionándose dominios y elementos con una puntuación mediana ≥8. Participaron un total de 8 panelistas. Al establecerse la mediana de puntuación en ≥8, quedaron finalmente aceptados 14 dominios y 40 ítems. Este es el primer cuestionario que analiza los conocimientos, los hábitos y las actitudes de los adolescentes y los adultos jóvenes actuales sobre las ITS, y una valiosa herramienta para la formación futura sobre la prevención de las ITS en adolescentes y adultos jóvenes. (AU)

[Artículo traducido] Generación de un cuestionario sobre conocimientos, hábitos y actitudes sobre infecciones de transmisión sexual en adolescentes y adultos jóvenes / Development of a Questionnaire on Knowledge, Habits, and Attitudes on Sexually Transmitted Infections in Teenagers and Young Adults

La comunicación con los adolescentes, quienes están marcadamente afectados por las infecciones de transmisión sexual (ITS) es imprescindible para diseñar programas de prevención. El objetivo de este estudio es desarrollar un cuestionario específico para estudiar el grado de conocimiento, los hábitos y las actitudes de los adolescentes y los adultos jóvenes frente a las ITS. El estudio se desarrolló siguiendo el método Delphi con un panel de expertos. Posteriormente se realizó una evaluación crítica (puntuación de 1 a 9) de todos los dominios e ítems a través de 2 vueltas, seleccionándose dominios y elementos con una puntuación mediana ≥8. Participaron un total de 8 panelistas. Al establecerse la mediana de puntuación en ≥8, quedaron finalmente aceptados 14 dominios y 40 ítems. Este es el primer cuestionario que analiza los conocimientos, los hábitos y las actitudes de los adolescentes y los adultos jóvenes actuales sobre las ITS, y una valiosa herramienta para la formación futura sobre la prevención de las ITS en adolescentes y adultos jóvenes. (AU)

Communication with teenagers who are significantly affected by sexually transmitted infections (STIs) is essential for the sake of prevention. The aim of this study is to develop a specific questionnaire for surveying the degree of knowledge, behavior, and attitudes of current teenagers and young adults on STIs to come up with the proper training tools. We conducted the study following the Delphi method, a 2-round critical assessment score (from 1 to 9) of all domains and items. Only domains and items with median scores ≥8 were selected. A total of 8 panelists were involved in this survey. After establishing a median score ≥8, a total of 14 domains and 40 items were eventually selected. This is the first questionnaire ever conducted to study the knowledge, habits, and attitudes of contemporary teenagers and young adults on STIs, and stands as a valuable tool for future training on STI prevention in teenagers and young adults. (AU)

[A survey of parents of preschool children on their perception of bad oral habits].

PURPOSE: Through questionnaire survey, parents' cognition of children's bad oral habits and their related influencing factors were explored, in order to provide a reference for science popularization and education in future work. METHODS: With a self-designed questionnaire, 247 parents of children at first visit were surveyed on basic information and problems related to bad oral habits. Descriptive statistics were used for the counting data. Logistic regression analysis was used for the relevant factors affecting the parents' cognition of children's bad oral habits with SPSS 26.0 software package. RESULTS: Among 247 parents of preschool children, 17.4% of the parents took their children to the hospital for treatment because of bad oral habits. The prevalence of oral unhealthy habits was 44%. Parents' knowledge of bad oral habits was not high, less than half of the parents (46.6%) knew about bad oral habits, of which 82.6% of the parents thought that bad oral habits would affect the development of children's teeth, jaws, face and mental health, including facial contour (62.1%), dentition (34.7%), masticatory function (48.4%), and mental health (21.1%). 78.3% of the parents thought that bad oral habits needed to be corrected; 69.6% of the parents thought that they needed to go to the hospital for treatment, and 30.4% of the parents thought that it was ok as long as their children giving up bad oral habits. 61.7% of the parents would seek medical treatment in time when their children had bad oral habits. The ways for parents to obtain knowledge about bad oral habits were hospital education (61.5%). Parents with different characteristics had different cognition of bad oral habits. Logistic regression analysis showed that parents' education background was a risk factor affecting parents' cognition of bad oral habits(P=0.009). CONCLUSIONS: Parents' awareness of bad oral habits is not high, and parents' educational background is a risk factor for parents' awareness of bad oral habits. It is necessary to improve parents' awareness of oral habits, strengthen health education of bad oral habits, especially for parents with special signs, and improve the attention to oral health care, to achieve early detection, early prevention, early treatment and timely treatment, so as to prevent the occurrence and development of malocclusion.

Does compulsion explain addiction?

One of the leading drug addiction theories states that habits and the underlying neural process of a ventral to dorsal striatal shift are the building blocks of compulsive drug-seeking behaviour and that compulsion is the maladaptive persistence of responding despite adverse consequences. Here we discuss that compulsive behaviour as defined primarily from the perspective of animal experimentation falls short of the clinical phenomena and their neurobiological correlates. Thus for the human condition, the concept of compulsive habbits should be critically addressed and potentially revised.

Effect of education on sun-safe behaviour in kidney transplant recipients.

BACKGROUND: Organ transplant recipients (OTR) are more likely to develop skin cancer than the general population. One of the main components of the exposome that triggers the development of skin tumours is solar ultraviolet (UV) radiation. To reduce the incidence of harmful consequences of sun exposure, sun protection education is needed for patients taking long-term immunosuppressive drugs. METHODS: In a previous study, we assessed the sun-safe behaviour of 221 OTR using a questionnaire before and after transplantation and personally educated the patients about proper sun protection. After the education, there were no further reminder presentations. Presently, the sun protection and sun seeking habits of the available 176 of these patients were questioned to assess the long-term effect of the previous sun protection education. RESULTS: Two-four years after the education, more patients wore hats and protected their skin with long-sleeved clothing than before the education. In terms of sun seeking habits, both occupational and recreational sun exposure decreased significantly. Significantly fewer people went on holiday after transplantation, but those who went on holiday spent significantly less time in the sun. CONCLUSION: The long-term positive effects of education can be seen both in the patients' sun protection and in their sun seeking habits. However, the long-term goal is to maintain these results and thereby reduce the likelihood of skin tumours and consequently the associated tumour death.

Associations between nonnutritive sucking habits, developing malocclusion, and various feeding practices in 3-6-year-old Indian urban children: A case-control study.

BACKGROUND: Nutritive sucking and nonnutritive sucking (NNS) may affect the craniofacial development, differently. AIM AND OBJECTIVES: We investigated associations between NNS habits (NNSHs), developing malocclusion, and various feeding practices in 3-6-year-old children. METHODOLOGY: A sample of 350 children 3-6-year-old from various preschools were selected for this case-control study (94 with NNSH and 256 without NNSH). NNSH (outcome) and feeding practices and developing malocclusions (exposures) were assessed using a structured study tool. RESULTS: The prevalence of NNSH in 3-6-year-old children was 26.8%. The odds (95% [confidence interval (CI)]) of boys compared to girls having NNSH were 0.66 (0.4121-1.706) (P = 0.0290). The overall prevalence of developing malocclusion in 3-6-year-old children was 34.01% out of which open bite was most commonly reported with 12.57% followed by spacing 8.5%, increased overjet 6.8%, crowding 2.2%, posterior crossbite and rotation 1.4%, and overbite 1.14%. Breastfeeding was found to be the most commonly used mode of feeding reported by 53.42% of mothers. It was found that the odds (95% [CI]) of subjects having NNSH were 0.66 (0.4694-0.9460) (P < 0.0001) who were not breastfed as compared to those who were breastfed. Among developing malocclusions, increased overjet with P = 0.0019, open bite with P = 0.0416, and spacing with P = 0.0243 were found to be associated with feeding practices. CONCLUSION: The prevalence of NNSH and developing malocclusions (increased overjet, open bite, and spacing) was 26.8% and 34.01%, respectively. Breastfeeding played a protective role against developing NNSH.

New trends on personalized sunscreens.

BACKGROUND/PURPOSE: Nowadays, there are emerging trends in customized and personalized photoprotection, focusing on the innovative approaches to enhance sun protection efficacy tailored to individual needs. METHODS: We conducted an electronic search of the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Skin Group Specialised Skin Register, and TESEO. Specific search terms related to personalized photoprotection and the variables of age, genetic predisposition, skin phototype, photodermatosis, and physiological conditions such as pregnancy, as well as lifestyle habits were used. RESULTS/CONCLUSION: The article highlights the challenges and opportunities in adopting personalized photoprotection strategies, aiming to promote skin health and prevent the harmful effects of UV radiation in the era of precision medicine.

Exercise Promotion System for Single Households Based on Agent-Oriented IoT Architecture.

People living alone encounter well-being challenges due to unnoticed personal situations. Thus, it is essential to monitor their activities and encourage them to adopt healthy lifestyle habits without imposing a mental burden, aiming to enhance their overall well-being. To realize such a support system, its components should be simple and loosely coupled to handle various internet of things (IoT)-based smart home applications. In this study, we propose an exercise promotion system for individuals living alone to encourage them to adopt good lifestyle habits. The system comprises autonomous IoT devices as agents and is realized using an agent-oriented IoT architecture. It estimates user activity via sensors and offers exercise advice based on recognized conditions, surroundings, and preferences. The proposed system accepts user feedback to improve status estimation accuracy and offers better advice. The proposed system was evaluated from three perspectives through experiments with subjects. Initially, we demonstrated the system's operation through agent cooperation. Then, we showed it adapts to user preferences within two weeks. Third, the users expressed satisfaction with the detection accuracy regarding their stay-at-home status and the relevance of the advice provided. They were also motivated to engage in exercise based on a subjective evaluation, as indicated by preliminary results.

Sustaining Healthy Habits: The Enduring Impact of Combined School-Family Interventions on Consuming Sugar-Sweetened Beverages among Pilot Chinese Schoolchildren.

This study assesses the enduring impact of combined school- and family-based interventions on reducing the consumption of sugar-sweetened beverages (SSBs) among schoolchildren in China. Two primary schools were assigned at random to either the Intervention Group or the Control Group, in Nanjing, eastern China. All students were in grade three and received an invitation to participate. In the first year, students in the Intervention Group received one-year intervention measures, including monthly monitoring, aiming to decrease the consumption of SSBs. Students in the Control Group only received regular monitoring without interventions. In the second year, both groups received only regular monitoring, without active interventions. A generalized estimating equations model (GEE) was used to assess the intervention effects. After two years, relative to the Control Group, the Intervention Group had a significantly improved knowledge of SSBs and an improved family environment with parents. In the Intervention Group, 477 students (97.3%) had adequate knowledge about SSBs, compared to 302 students (83.2%) in the Control Group (X2 = 52.708, p < 0.001). Two years later, the number of students who stated 'my home always has SSBs' in the Intervention Group (7.8%) was fewer than that in the Control Group (12.4%), which was a statistically significant finding (p < 0.05). One year later, both the frequency and the quantity of SSB consumption in the Intervention Group were less than those in the Control Group; such differences between the groups remained statistically significant for the quantity but not for the frequency of SSB consumption two years later. In the Intervention Group, the frequency of SSB consumption was significantly reduced by 1.0 times per week, compared to a reduction of 0.1 times per week in the Control Group in the first year (p < 0.05). In the second year, the frequency of SSB consumption was reduced by 0.8 times per week in the Intervention Group, compared to 0.5 times per week in the Control Group (p > 0.05). In the first year, the volume of SSB consumption was significantly reduced by 233 mL per week in the Intervention Group, compared to an increase of 107 mL per week in the Control Group (p < 0.05). In the second year, the volume of SSB consumption was reduced by 122 mL per week in the Intervention Group compared to an increase of 31 mL per week in the Control Group (p > 0.05). The combined school-based and family-based interventions had a positive effect on the students' knowledge of SSBs and their family dynamics during the first and second year. Relative to the Control Group, the Intervention Group had a statistically significant reduction in SSB consumption after 1 year, but not after 2 years.