Effect of a story-based, animated video to reduce added sugar consumption: A web-based randomized controlled trial

Abstract

Background Short and animated story-based (SAS) videos, which can be rapidly distributed through social media channels, are a novel and promising strategy for promoting health behaviors. In this study, we evaluate the effectiveness of a SAS video intervention to reduce the consumption of added sugars. Methods In December 2020, we randomized 4159 English-speaking participants from the United Kingdom (1:1:1) to a sugar intervention video, a content placebo video about sunscreen use (no sugar message), or a placebo video about earthquakes (no health or sugar message). We nested six list experiments in each arm and randomized participants (1:1) to a control list or a control list plus an item about consuming added sugars. The primary end-points were mean differences (on a scale of 0-100) in behavioral intent and direct restoration of freedom to consume added sugars. Results Participants (N=4013) who watched the sugar video had significantly higher behavioral intent to cut their daily intake of added sugar (mean difference (md)=16.7, 95% confidence interval (CI)=1.5-31.8, P=0.031), eat fresh fruit daily (md=16.7, 95% CI=0.5-32.9, P=0.043), and check food labels for sugar content (md=20.5, 95% CI=2.6-38.5, P=0.025) when compared with the sunscreen (content placebo) video. The sugar video did not arouse intent to restore freedom and consume added sugars when compared with the two placebo videos. Conclusions Our SAS intervention video did not arouse reactance and increased short-term behavioral intent among participants to reduce their consumption of added sugars. SAS videos, which draw on best practices from the entertainment-education media, communication theory, and the animation industry, can be an effective strategy for delivering emotionally compelling narratives to promote health behavior change.