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The consumption of sugary beverages is a serious problem in the United States that is associated with obesity, diabetes, and cardiovascular disease. Therefore, the success that Howard County had in decreasing the sales of sugary beverages—through a broad-based community intervention that included media, community engagement, and policy changes—is gratifying.1
The editors were as impressed with the rigor of the methods as the decrease in soda and fruit drink sales. Too often programs are declared a success (or failure) based on temporal changes (or lack thereof). However, without a control group, how can one determine whether the changes seen are attributable to the intervention? By using a difference-in-differences approach, the authors adjusted for temporal changes and differences between communities at baseline. Also, the authors compared sales based on store register data rather than relying on self-reports, which are subject to social desirability bias.
Public health campaigns can never be evaluated with the precision of laboratory experiments. However, these authors demonstrate the value of a well-performed evaluation of an important public health intervention. Other communities should implement similar programs.
Conflict of Interest Disclosures: None reported.
Katz MH. Decreasing the Sale of Sugary Beverages: How Sweet It Is. JAMA Intern Med. 2017;177(5):674. doi:10.1001/jamainternmed.2016.9678
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