Removal of sugar sweetened beverages from sale in a hospital setting-Consumer opinion and influence on purchasing behavior.

ISSUE ADDRESSED: This study investigated the impact of removing sugar sweetened beverages (SSBs) from sale in a regional health service. Drink purchasing patterns were measured by product ordering data. Consumer opinion regarding the intervention, self-reported packaged drink purchase and consumption were also explored. METHODS: Packaged drinks were classified into two categories, SSB or non-SSB and drink types. Drink sales were determined by the collection of product ordering data for all packaged drink types sold, six months prior to and twelve months after the removal of SSBs. A consumer survey was undertaken six months after SSB removal to assess consumer opinion regarding SSB removal, self-reported SSB consumption and purchase. Descriptive and Wilcoxon rank-sum tests analyses assessed differences in packaged drinks purchase, self-reported SSB consumption and purchase. Open-ended survey responses were thematically analysed. RESULTS: The median monthly number of juices, and diet drinks ordered increased significantly (P = .05). 59% of the survey respondents regularly consumed SSBs and 58% agreed or strongly agreed with removing SSBs from sale. However, some consumers felt it was a removal of their freedom of choice. CONCLUSIONS: Removing SSBs from sale can result in consumers making healthier purchases. There was support for the initiative as it is seen as the responsibility of the health service to role model healthy eating behaviours. SO WHAT?: This study indicates removal of SSBs from sale is a promising health promotion intervention that can contribute to positive behaviour change, and potentially influence longer-term health and wellbeing.

Development of a language-independent functional evaluation.

UNLABELLED: Haig AJ, Jayarajan S, Maslowski E, Yamakawa KS, Tinney M, Beier KP, Juang D, Chan L, Boggess T, Loar J, Owusu-Ansah B, Kalpakjian C. Development of a language-independent functional evaluation. OBJECTIVE: To design, validate, and critique a tool for self-report of physical functioning that is independent of language and literacy. DESIGN: Software design and 2 prospective trials followed by redesign. SETTING: United States and African university hospitals. PARTICIPANTS: Outpatient and inpatient competent adults with diverse physical impairments. INTERVENTIONS: (1) Software design process leading to a Preliminary Language-Independent Functional Evaluation (Pre-L.I.F.E.); (2) patient surveys using a printed Pre-L.I.F.E. and a computer-animated Pre-L.I.F.E. tested in random order, followed by a questionnaire version of the standard Barthel Index; and (3) software redesign based on objective and qualitative experiences with Pre-L.I.F.E. MAIN OUTCOME MEASURES: Validation of the general concept that written and spoken language can be eliminated in assessment of function. Development of a refined Language-Independent Functional Evaluation (L.I.F.E.). RESULTS: A viable Pre-L.I.F.E. software was built based on design parameters of the clinical team. Fifty Americans and 51 Africans demonstrated excellent (Cronbach alpha>0.8 Americans) and good (alpha>.425 Africans) reliability. In general, the relations between Pre-L.I.F.E. and Barthel scores were excellent in the United States (interclass correlation coefficient for stair climbing, .959) but somewhat less good in Africa, with elimination functions very poorly related. The computer-animated Pre-L.I.F.E. was faster and trended to be more reliable than the printed Pre-L.I.F.E. in both the United States and Africa. Redesign meetings corrected statistical and qualitative challenges, resulting in a new tool, the L.I.F.E. CONCLUSIONS: Literacy and language translation can be eliminated from some aspects of functional assessment. The new L.I.F.E., based on solid empirical evidence and design principles, may be a practical solution to assessment of function in the global culture.