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  1. Article: Diminished thymosin alpha-1 levels in persons exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

    Stehr-Green, P A / Naylor, P H / Hoffman, R E

    Journal of toxicology and environmental health

    1989  Volume 28, Issue 3, Page(s) 285–295

    Abstract: There is evidence from animal studies that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) impairs ... mean Thya-1 serum level (977.3 +/- 304.1 pg/ml vs. 1148.7 +/- 482.1 pg/ml, p less than .01 by t-test ...

    Abstract There is evidence from animal studies that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) impairs immune responses, with the thymus being a principal target organ. The purpose of this study was to evaluate thymic function, through measurement of thymic hormone levels, in persons exposed to TCDD. We examined thymosin alpha-1 (Thya-1) levels in sera from a group of 94 persons who were presumed to be exposed to TCDD from living, working, or recreating in a contaminated residential area. We compared these results, along with results from in vitro and in vivo tests of immune function, with those from a group of 105 unexposed persons who were similar with regard to age, sex, and race. The exposed group had a significantly lower mean Thya-1 serum level (977.3 +/- 304.1 pg/ml vs. 1148.7 +/- 482.1 pg/ml, p less than .01 by t-test). We also found a statistically significant trend of decreasing Thya-1 levels with increasing number of years of residence in the TCDD-contaminated area. However, Thya-1 levels were not associated with other measures of immune function in the TCDD-exposed group. Thus, while the principal findings suggest that long-term TCDD exposure may be associated with diminished secretion of Thya-1, the lack of an association with an increased prevalence of clinically diagnosed immune suppression in these TCDD-exposed persons makes the biologic significance of the findings unclear. Further studies are needed to more fully evaluate possible long-term TCDD-induced effects on the thymus and human immune function.
    MeSH term(s) Age Factors ; Animals ; Continental Population Groups ; Dioxins/adverse effects ; Environmental Exposure ; Female ; Humans ; Immunity/drug effects ; Male ; Mice ; Polychlorinated Dibenzodioxins/adverse effects ; Sex Factors ; T-Lymphocytes/drug effects ; Thymosin/blood ; Thymus Gland/drug effects
    Chemical Substances Dioxins ; Polychlorinated Dibenzodioxins ; Thymosin (61512-21-8) ; thymalfasin (W0B22ISQ1C)
    Language English
    Publishing date 1989
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 197268-6
    ISSN 1087-2620 ; 0098-4108 ; 0040-9014
    ISSN (online) 1087-2620
    ISSN 0098-4108 ; 0040-9014
    DOI 10.1080/15287398909531349
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    Zs.A 1268: Show issues Location:
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  2. Article ; Online: Patientenseitige Anliegen und palliativpsychologische Interventionen im Rahmen eines stationären Palliativdienstes.

    Oberth, Paula / Neuschulz, Markus / Ernst, Jochen / Schotte, Dörte / Bercker, Sven / Stehr, Sebastian / Lehmann-Laue, Antje / Mehnert-Theuerkauf, Anja

    Psychotherapie, Psychosomatik, medizinische Psychologie

    2024  

    Abstract: Background: Multi-professional inpatient palliative care services are increasingly complementing palliative care in hospitals alongside palliative care units. The present study aims to investigate the nature and frequency of patient concerns and ... ...

    Title translation Patient concerns and palliative psychology interventions within an inpatient palliative care service.
    Abstract Background: Multi-professional inpatient palliative care services are increasingly complementing palliative care in hospitals alongside palliative care units. The present study aims to investigate the nature and frequency of patient concerns and palliative psychological interventions in the context of palliative psychological work, as well as the perceived quality of outcomes in an inpatient palliative service.
    Methods: Palliative psychological interventions for terminally ill patients at the inpatient palliative care service at Leipzig University Hospital were investigated in a prospective follow-up evaluation study. Psychological distress (distress thermometer) as well as the perceived quality of the results of the palliative psychological support (from the therapist`s perspective) were recorded. Patient concerns and psychological conversation topics and interventions were recorded. Descriptive and regression analytic procedures were used.
    Results: Over a year, 355 patients in the inpatient palliative care service received psychological support, 304 participated in the study (mean age 63.8 years, 55% male, 89% oncological disease). An average of 3 palliative psychological interviews were conducted; 64% of patients reported high psychological distress (M=6.5). The most common patient concerns and topics within the interviews were dealing with emotions (87%), resources (83%), conflicting care and autonomy issues (77%) and hope (76%); significantly less common were spiritual concerns (2%) or the patient's legacy (9%). The most frequently used palliative psychological interventions included: support in illness processing and acceptance (74%) or in emotional-relieving interventions (98%) as in normalisation (75%), active listening (97%) or emotional containment (95%). Regression analysis showed that an oncological (vs. non-oncological) disease, a high number of palliative psychological interviews and interventions, comprehensive information regarding the palliative dimension of the diagnosis as well as undisturbed contact in the initial interview had a positive effect on the perceived outcome quality.
    Conclusion: The study results show that palliative psychologists play an important role in inpatient palliative care teams and should be involved as early as possible in the course of the disease. There is a need for improvement, especially in the palliative psychological care of non-oncological patients.
    Language German
    Publishing date 2024-04-22
    Publishing country Germany
    Document type English Abstract ; Journal Article
    ZDB-ID 800571-0
    ISSN 1439-1058 ; 0173-7937 ; 0937-2032
    ISSN (online) 1439-1058
    ISSN 0173-7937 ; 0937-2032
    DOI 10.1055/a-2279-1024
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  3. Article ; Online: A Mobile Health Information Behavior Model: Theoretical Development and Mixed-Method Testing in the Context of Mobile Apps on Child Poisoning Prevention.

    Stehr, Paula / Ermel, Lyn / Rossmann, Constanze / Reifegerste, Doreen / Lindemann, Ann-Kathrin / Schulze, Annett

    Journal of health communication

    2023  Volume 28, Issue 10, Page(s) 648–657

    Abstract: While several studies have explored the use of mobile health applications, few have observed determinants of mobile ... ...

    Abstract While several studies have explored the use of mobile health applications, few have observed determinants of mobile health
    Language English
    Publishing date 2023-08-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1427988-5
    ISSN 1087-0415 ; 1081-0730
    ISSN (online) 1087-0415
    ISSN 1081-0730
    DOI 10.1080/10810730.2023.2250313
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    Zs.A 5899: Show issues Location:
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  4. Conference proceedings ; Online: Frequency analysis of peak flows in Chile

    Stehr, A. / Rojas, O. / Link, O.

    XXVIII General Assembly of the International Union of Geodesy and Geophysics (IUGG)

    Are there significant differences in the estimation when considering trends?

    2023  

    Abstract: ... of statistical methods that consider a stationary versus non-stationary state, expressed in p-values less than 0.025. ...

    Abstract Climate change is increasing the magnitude and frequency of extreme hydrological phenomena, such as droughts and floods, throughout the planet. Given its geographic characteristics, Chile is one of the most vulnerable countries in the world to climate change. Observed rainfall and river flow series show statistically significant trends of change and a notable non-stationarity. Given the above, the assumption of stationarity of the series widely used in the estimation of peak flows with different return periods, would no longer be fulfilled. The objective of this work is to evaluate if there are significant differences in peak flow values obtained for different return periods when using the classical statistical method (steady state) and methods that consider the non-stationarity of these. For this purpose, 14 representative stations located between the Maule Region and the Araucanía Region will be analyzed. Stations were selected considering a record of more than 30 years of data, in addition to presenting a positive and significant trend in the series of maximum flows.The study area includes characteristics of Mediterranean and temperate climates of the south, which is determined by a variation in the pluviometry regimes with an increase in precipitation from north to south. The results, when estimating peak flows with different return periods, show that for 50% of the stations analyzed there is a statistically significant difference between the application of statistical methods that consider a stationary versus non-stationary state, expressed in p-values less than 0.025.
    Subject code 333
    Language English
    Publishing date 2023-07-11
    Publishing country de
    Document type Conference proceedings ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Health effects of long-term exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

    Hoffman, R E / Stehr-Green, P A / Webb, K B / Evans, R G / Knutsen, A P / Schramm, W F / Staake, J L / Gibson, B B / Steinberg, K K

    JAMA

    1986  Volume 255, Issue 15, Page(s) 2031–2038

    Abstract: In 1971, sludge wastes contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin were mixed with waste ... tetrachlorodibenzo-p-dioxin is associated with depressed cell-mediated immunity, although the effects have not ...

    Abstract In 1971, sludge wastes contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin were mixed with waste oil and sprayed on a dirt road at the Quail Run Mobile Home Park in Gray Summit, Mo. We performed a comprehensive examination of 154 exposed and 155 unexposed persons in the area. There were no consistent differences between the two groups on medical history, physical examination, serum and urinary chemistry studies, and neurologic tests. Results of liver function tests suggested possible subclinical effects. The exposed group had an increased frequency of anergy (11.8% vs 1.1%) and relative anergy (35.3% vs 11.8%). The exposed group also had non-statistically significant increased frequencies of abnormal T-cell subset test results (10.4% vs 6.8%), a T4/T8 ratio of less than 1.0 (8.1% vs 6.4%), and an abnormality in the functional T-cell test results (12.6% vs 8.5%). These findings suggest that long-term exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin is associated with depressed cell-mediated immunity, although the effects have not resulted in an excess of clinical illness in the exposed group. Further studies are indicated to elucidate the pathophysiology and clinical significance of these immunologic findings.
    MeSH term(s) Adolescent ; Adult ; Blood/drug effects ; Child ; Dioxins/adverse effects ; Environmental Pollutants/adverse effects ; Epidemiologic Methods ; Female ; Humans ; Immunity, Cellular/drug effects ; Male ; Medical Records ; Missouri ; Neurologic Examination ; Physical Examination ; Polychlorinated Dibenzodioxins/adverse effects ; Psychological Tests ; Sensation/drug effects ; Skin Diseases/chemically induced ; Soil Pollutants/adverse effects ; Time Factors ; Urine/analysis
    Chemical Substances Dioxins ; Environmental Pollutants ; Polychlorinated Dibenzodioxins ; Soil Pollutants
    Language English
    Publishing date 1986-04-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0098-7484 ; 0254-9077 ; 0002-9955
    ISSN (online) 1538-3598
    ISSN 0098-7484 ; 0254-9077 ; 0002-9955
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    Ua VI Zs.88: Show issues Location:
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  6. Article: Assessment of 2,3,7,8-tetrachlorodibenzo-p-dioxin exposure using a modified D-glucaric acid assay.

    Steinberg, K K / MacNeil, M L / Karon, J M / Stehr, P A / Neese, J W / Needham, L L

    Journal of toxicology and environmental health

    1985  Volume 16, Issue 6, Page(s) 743–752

    Abstract: ... exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD). The modified assay combined improvements ...

    Abstract An enzyme-inhibition assay was evaluated and modified to quantify D-glucaric acid in a population exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD). The modified assay combined improvements described separately in previous reports, including pH adjustment by standard addition of buffers rather than by titration, an optimum pH of 2.3 for converting D-glucaric acid to 1,4-glucarolactone, and the use of the relation reciprocal of absorbance versus concentration for calculating unknowns. Reference limits for adult males were 0.06-5.90 mmol D-glucaric acid/mol creatinine and for adult females 0.87-6.23 mmol D-glucaric acid/mol creatinine. Children under the age of 15 yr had a reference range of 0-8.34 mmol D-glucaric acid/mol creatinine. Persons on anticonvulsant therapy excreted from 3 to 10 times the upper reference limits of D-glucaric acid. Urinary concentrations of D-glucaric acid in persons identified as being at high risk for exposure to 2,3,7,8-TCDD in Times Beach, Mo., were not significantly different from concentrations in those identified as being at low risk for such exposure.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Chromatography, Gas ; Dioxins/toxicity ; Environmental Exposure ; Female ; Glucaric Acid/urine ; Humans ; Hydrogen-Ion Concentration ; Male ; Polychlorinated Dibenzodioxins/toxicity ; Pregnancy ; Sex Factors ; Sugar Acids/urine
    Chemical Substances Dioxins ; Polychlorinated Dibenzodioxins ; Sugar Acids ; Glucaric Acid (QLZ991V4A2)
    Language English
    Publishing date 1985
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197268-6
    ISSN 1087-2620 ; 0098-4108 ; 0040-9014
    ISSN (online) 1087-2620
    ISSN 0098-4108 ; 0040-9014
    DOI 10.1080/15287398509530785
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  7. Article: A pilot epidemiologic study of possible health effects associated with 2,3,7,8-tetrachlorodibenzo-p-dioxin contaminations in Missouri.

    Stehr, P A / Stein, G / Webb, K / Schramm, W / Gedney, W B / Donnell, H D / Ayres, S / Falk, H / Sampson, E / Smith, S J

    Archives of environmental health

    1986  Volume 41, Issue 1, Page(s) 16–22

    Abstract: In 1971, 2,3,7,8-tetrachlorodibenzodioxin (TCDD)-containing waste oils were sprayed for dust control on residential, recreational, and work areas in Missouri. In several of these areas, the magnitude and the extent of this environmental contamination ... ...

    Abstract In 1971, 2,3,7,8-tetrachlorodibenzodioxin (TCDD)-containing waste oils were sprayed for dust control on residential, recreational, and work areas in Missouri. In several of these areas, the magnitude and the extent of this environmental contamination were not known until late 1982 or 1983. In the first phase of the investigation, a group of persons considered to be at highest risk of exposure and an appropriate comparison group were selected from reviews of Health Effects Survey screening questionnaires. These persons received complete medical examinations and a series of laboratory tests focused on detecting presymptomatic effects in key target organ systems (i.e., hepatic, dermatologic, immunologic, and neurologic effects). Comparisons of these two groups did not produce any firm indications of increased disease prevalence directly related to the putative exposures; of significance is the fact that no cases of chloracne or porphyria cutanea tarda were seen. Nevertheless, no overall definitive conclusion should be based just on this initial pilot study. Insights were provided that are being examined in more refined epidemiologic studies using different designs and strategies--especially of larger, more homogeneous population groups in which exposure status can be better characterized--focused primarily on discerning any potential effects on the urinary tract, liver, neurological, and immune systems. Concurrently, research into the development of replicable laboratory analytical methods and reference ranges for measuring TCDD body burden are being pursued.
    MeSH term(s) Adolescent ; Adult ; Antibody Formation/drug effects ; Chemical and Drug Induced Liver Injury ; Dioxins/poisoning ; Environmental Pollutants/toxicity ; Epidemiologic Methods ; Female ; Health ; Health Status ; Humans ; Liver Diseases/epidemiology ; Male ; Missouri ; Neurologic Examination ; Pilot Projects ; Polychlorinated Dibenzodioxins/poisoning ; Risk ; Skin Diseases/chemically induced ; Skin Diseases/epidemiology
    Chemical Substances Dioxins ; Environmental Pollutants ; Polychlorinated Dibenzodioxins
    Language English
    Publishing date 1986-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 211701-0
    ISSN 0003-9896
    ISSN 0003-9896
    DOI 10.1080/00039896.1986.9935760
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    Un I Zs.559: Show issues Location:
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  8. Article ; Online: Effective communication with caregivers to prevent unintentional injuries in children under seven years. A systematic review.

    Stehr, Paula / Reifegerste, Doreen / Rossmann, Constanze / Caspar, Katja / Schulze, Annett / Lindemann, Ann-Kathrin

    Patient education and counseling

    2022  Volume 105, Issue 8, Page(s) 2721–2730

    Abstract: Objective: This review systematically examines the theory base and effectiveness of communication strategies (i.e., message content, message attributes, communication channels, and communicators) of interventions for caregivers to prevent unintentional ... ...

    Abstract Objective: This review systematically examines the theory base and effectiveness of communication strategies (i.e., message content, message attributes, communication channels, and communicators) of interventions for caregivers to prevent unintentional child injuries.
    Methods: Relevant articles were searched in the databases Communication and Mass Media Complete, PsycInfo, Pubmed, and Google Scholar, the journal Injury Prevention, and the literature of included studies. A total of 71 articles reporting 67 different studies were included and fully coded. Quality was assessed using the Mixed Methods Appraisal Tool. Coded categories and their frequencies are described, and the effectiveness of different communication strategies is explored with crosstabs.
    Results: Only 17 studies stated the use of a specific theory base; Precaution Adoption Process-Model, Theory of Planned Behavior, and Health Belief Model were most often used. The message content of most studies aimed at knowledge dissemination; however, addressing behavioral determinants, such as risk perception and self-efficacy, was more effective. About half of the studies did not elaborate on message attributes; calls to action, exemplars, and tailoring were most often used, the latter being most effective. Communication channels ranged from printed products to face-to-face communication and digital media. In addition, studies specifying interpersonal communicators were highly effective.
    Conclusion: The results of the review suggest that the following aspects can contribute to effective communication in child injury prevention: theory-based communication, addressing broad knowledge and further behavioral determinants, digital tailoring, and health professionals as communicators. However, a conclusive statement on the effectiveness of different communication strategies is hampered by the fact that they are not specified and/or confounded in many studies.
    Practice implications: Communication strategies should be theory based and address, in addition to knowledge, behavioral determinants such as risk perception and self-efficacy. Moreover, digital tailoring is an advanced way of enhancing effectiveness and health professionals, such as pediatricians and clinic staff, are important multipliers.
    MeSH term(s) Caregivers ; Child ; Communication ; Family ; Health Personnel ; Humans ; Internet
    Language English
    Publishing date 2022-04-28
    Publishing country Ireland
    Document type Journal Article ; Review ; Systematic Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 605590-4
    ISSN 1873-5134 ; 0738-3991
    ISSN (online) 1873-5134
    ISSN 0738-3991
    DOI 10.1016/j.pec.2022.04.015
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  9. Article: Mobile Apps Aimed at Preventing and Handling Unintentional Injuries in Children Aged <7 Years: Systematic Review.

    Schulze, Annett / Lindemann, Ann-Kathrin / Brand, Fabian / Geppert, Johanna / Menning, Axel / Stehr, Paula / Reifegerste, Doreen / Rossmann, Constanze

    Interactive journal of medical research

    2023  Volume 12, Page(s) e45258

    Abstract: Background: Despite various global health crises, the prevention and handling of unintentional childhood injuries remains an important public health objective. Although several systematic reviews have examined the effectiveness of different child injury ...

    Abstract Background: Despite various global health crises, the prevention and handling of unintentional childhood injuries remains an important public health objective. Although several systematic reviews have examined the effectiveness of different child injury prevention measures, these reviews did not address the evaluation of mobile communication intervention tools. Whether and how mobile apps were evaluated provides information on the extent to which communication theories, models, and evidence-based knowledge were considered. Previous studies have shown that the effectiveness of mobile apps increases when theories and evidence are considered during their development.
    Objective: This systematic review aimed to identify research on mobile apps dealing with the prevention and handling of unintentional injuries in children and examine the theoretical and methodological approaches thereof. In addition, this review analyzed the different needs of various target groups of the mobile apps described in the articles.
    Methods: In total, 8 electronic databases, ranging from interdisciplinary to medical and technical as well as social sciences databases, were searched for original research articles or brief reports in peer-reviewed journals or conference proceedings. Moreover, this review encompassed a systematic scan of articles published in the BMJ journal Injury Prevention. These steps were followed by a snowball search based on the literature references in the articles identified through the initial screening. The articles had to be written in English or German, published between 2008 and 2021, and evaluate mobile apps dealing with the prevention and handling of unintentional child injuries. The identified 5 studies were analyzed by 5 independent researchers using an inductive approach. Furthermore, the quality of the studies was assessed using the Mixed Methods Appraisal Tool.
    Results: A total of 5 articles were included and assessed with regard to overall quality of theoretical and methodological foundations, assessed variables, the focal app's architecture, and the needs of the study participants. The overall study quality was moderate, although part of this classification was due to a lack of details reported in the studies. Each study examined 1 mobile app aimed at parents and other caregivers. Each study assessed at least 1 usability- or user experience-related variable, whereas the needs of the included study participants were detailed in only 20% (1/5) of the cases. However, none of the studies referred to theories such as the Technology Acceptance Model during the development of the apps.
    Conclusions: The future development and evaluation of apps dealing with the prevention and handling of child injuries should combine insights into existing models on user experience and usability with established theories on mobile information behavior. This theory-based approach will increase the validity of such evaluation studies.
    Language English
    Publishing date 2023-09-06
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 2697014-4
    ISSN 1929-073X
    ISSN 1929-073X
    DOI 10.2196/45258
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  10. Article ; Online: Are price discounts on sugar-sweetened beverages (SSB) linked to household SSB purchases? - a cross-sectional study in a large US household and retail scanner database.

    Zhong, Yichen / Auchincloss, Amy H / Stehr, Mark F / Langellier, Brent A

    Nutrition journal

    2021  Volume 20, Issue 1, Page(s) 29

    Abstract: ... in annual SSB promotion frequency was associated with 13.7% increase in annual per capita purchasing (P < 0 ... increase in annual per capita purchasing (P < 0.0001). These associations did no vary significantly across ... socioeconomic status and race subgroups (Interaction P > 0.2).: Conclusions: More frequent and deeper price ...

    Abstract Background: Price promotions on sugar-sweetened beverages (SSBs) are commonly used by retailers to provide economic incentives for purchasing. Surprisingly, there is a lack of high-quality articles that examine the frequency and magnitude of sugary beverage discounting and consumer responses to discounts. The objective of this study is to quantify the association between exposure to price discounts and SSB purchases.
    Methods: This cross-sectional study linked 2016 SSB consumption data from a U.S. household consumer panel (analytic sample N = 11,299 households) and weekly prices at stores where they shopped. We derived percent of the time SSBs were discounted (annual promotion frequency) and the amount of the discount (annual promotion magnitude) and assessed their association with household annual per capita SSB purchase ounces. Linear regression models adjusted for household size, income per capita, age, education, presence of children, race, occupation, region, and urbanicity. We also evaluated whether the association between promotion and purchase varied by socioeconomic status and race subgroups. Data were analyzed in 2019-2020.
    Results: On average, households were exposed to SSBs price promotions 44% of the time. A 10-percentage point increase in annual SSB promotion frequency was associated with 13.7% increase in annual per capita purchasing (P < 0.0001), and a 1-percentage point increase in annual SSB promotion magnitude was associated with 15.3% increase in annual per capita purchasing (P < 0.0001). These associations did no vary significantly across socioeconomic status and race subgroups (Interaction P > 0.2).
    Conclusions: More frequent and deeper price promotion was associated with higher annual per capita SSB purchases. Restricting SSB price promotions may be effective at reducing SSB consumption.
    MeSH term(s) Beverages ; Child ; Commerce ; Consumer Behavior ; Cross-Sectional Studies ; Family Characteristics ; Humans ; Sugar-Sweetened Beverages
    Language English
    Publishing date 2021-03-14
    Publishing country England
    Document type Journal Article
    ISSN 1475-2891
    ISSN (online) 1475-2891
    DOI 10.1186/s12937-021-00673-w
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