{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:51:00Z","timestamp":1792003860251,"version":"4.4.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Behav Nutr Phys Act"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Sugar-sweetened beverages (SSBs) are a significant source of added sugars in the Indian diet, contributing to adverse health outcomes such as obesity, type 2 diabetes, and dental caries. Multi-component interventions (MCIs) have shown promise in reducing the consumption of harmful products like tobacco. This study assessed the effectiveness of a multi-component intervention\u2014comprising Pictorial Health Warnings (PHWs), educational pamphlets, and targeted counseling\u2014in reducing parental purchases of SSBs for children.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A randomized stepped-wedge controlled trial was conducted across three urban slum sectors in Hyderabad. A total of 60 parents were recruited, with data collected over ten weeks. MCIs were implemented on SSBs at general stores, and outcomes were measured by comparing SSB purchase frequency, risk perception, and parental attitudes before and after the intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The implementation of MCIs led to a significant reduction in SSB purchases, with 25% of parents buying SSBs post-intervention compared to 55% pre-intervention (<jats:italic>p<\/jats:italic>\u2009=\u20090.002). Parents also purchased SSBs with fewer calories post-intervention (45\u00a0kcal vs. 92\u00a0kcal, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Additionally, MCIs increased awareness of SSB-related harms (d\u2009=\u20092.19, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and strengthened negative emotional responses (d\u2009=\u20092.08, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). No significant differences were observed in the appeal or perceived tastiness of SSBs (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>MCIs on SSBs effectively reduced purchase frequency and calorie intake among parents in urban slum settings. The findings support the potential for MCIs to be a feasible public health intervention to reduce SSB consumption in similar socio-economic contexts.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>CTRI\/2024\/08\/072220 dated 09\/08\/2024.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12966-025-01800-0","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T10:19:37Z","timestamp":1756549177000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of a multi-component intervention including pictorial warnings to reduce sugar-sweetened beverage consumption - a randomized controlled trial"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1873-4363","authenticated-orcid":false,"given":"Kumar Guru","family":"Mishra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Afreen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7589-9124","authenticated-orcid":false,"given":"Nabnita","family":"Patnaik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"issue":"6","key":"1800_CR1","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1097\/MPG.0000000000001733","volume":"65","author":"NF Mis","year":"2017","unstructured":"Mis NF, Braegger C, Bronsky J, Campoy C, Domell\u00f6f M, Embleton ND, Hojsak I, Hulst J, Indrio F, Lapillonne A, Mihatsch W. 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Additionally, the trial was registered with the Clinical Trials Registry, India (CTRI\/2024\/08\/072220 date 09\/08\/2024). Informed consent was obtained from all participants prior to their inclusion in the study. For participants under the age of 16, informed consent was obtained from their parents or legal guardians. Additionally, for illiterate participants, consent was obtained through their legally authorized representatives (LARs) or guardians in accordance with ethical guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants provided consent for the publication of the data and results derived from this study, ensuring that their personal information will remain confidential and anonymized.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"115"}}