UBC Undergraduate Research

Healthy Beverage Initiative Huang, Renee; Laird, Marika; Leung, Tracy 2018-04-10

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UBC Social Ecological Economic Development Studies (SEEDS) Sustainability ProgramStudent Research Report Healthy Beverage Initiative Renee Huang, Marika Laird, Tracy Leung University of British Columbia LFS 450Themes: Health, Community, Wellbeing  April 10, 2018 Disclaimer: UBC SEEDS provides students with the opportunity to share the findings of their studies, as well as their opinions, conclusions and recommendations with the UBC community. The reader should bear in mind that this is a student project/report and is not an official document of UBC. Furthermore readers should bear in mind that these reports may not reflect the current status of activities at UBC. We urge you to contact the research persons mentioned in a report or the SEEDS Coordinator about the current status of the subject matter of a project/report. Laird, Leung, Huang 2   Table of Contents  Executive Summary 4 Introduction 5 Methodology and Methods 7 Research Methodology 7 Research Methods 8 Secondary Data Collection Research Methods 8 Literature Review 8 Other Secondary Data Source 8 Primary Data Collection Research Methods 9 Primary Data 9 Results 11 Literature Review 11 Interviews 12 Description of Demographic 12 Questions Regarding UCSF HBI Video 14 Questions Regarding UCSF HBI 18 Questions Regarding a HBI at UBC 19 Discussion 20 Interpretation of Demographic 20 Opinions of UCSF HBI Video 21 Likes of UCSF HBI Video 21 Dislikes of UCSF HBI Video 22 Influence on Consumption Habits 23 Effectiveness of Video Format 23 Opinions of UCSF HBI 24 Support for a HBI at UBC 25  Laird, Leung, Huang 3   Major Concerns and Misconceptions 26 Interview Limitations 27 Recommendations and Conclusion 29 Recommendations for Future Research 29 Format for HBI Awareness 29 A HBI at UBC 29 Recommendations for Action and Implementation 30 Wellbeing and Student Housing and Hospitality Services Stakeholders 30 UBC Building Operations and Sustainable + Engineering 31 Conclusion 32 Appendices 34 Appendix A: Interview Questions 34 Appendix B: Map of Interview Locations on UBC Vancouver Campus 35 Appendix C: Recorded Location, Date and Time of Interviews 36 Appendix D: Interview Script 37 Appendix E: Consent Form 38 Appendix F: Raw Interview Data 41 Appendix G: Interview Success 56 Appendix H: Additional Interview Data 58 Works Cited 61    Laird, Leung, Huang 4   Executive Summary The University of British Columbia (UBC) aimed to explore opportunity for a Healthy Beverage Initiative (HBI) to promote tap water consumption and limit the sales of sugar-sweetened beverages (SSBs) (Parr and Toor 2). SSBs are defined as any drink that has various forms of sugar added in, including, but not limited to sodas, fruit drinks, sports drinks, energy drinks, sweetened waters, and coffee and tea beverages with added sugars (Centers for Disease Control and Prevention n.p.). The hope was that implementing a HBI at UBC would create a more sustainable and supportive environment to make informed decisions around beverage consumption on campus. The University of California San Francisco (UCSF) implemented a HBI where they eliminated all sales of SSBs and created a video to promote their HBI (“UCSF Healthy Beverage Initiative”). Our research goal was to obtain student feedback from a minimum of 50 UBC students by watching the HBI promotional video conducted by the UCSF.  Our first objective was to identify student attitudes and perceptions towards the UCSF HBI video. Our second objective was to develop recommendations to inform the implementation of a HBI at UBC. To meet our project objectives, we conducted a literature review to address specific issues related to a HBI. We also used secondary data sources to better understand planned or implemented strategies to reduce consumption of unhealthy beverages and/or increase consumption of healthy beverages. Lastly, we conducted randomized interviews at the following 10 locations on campus: AMS Student Nest, Agora Café, Henry Angus Building, Forest Sciences Centre, Buchanan B, Wayne and William White Engineering Design Centre, Neville Scarfe Building, Place Vanier Residence Commonsblock, Acadia Park Residence Commons block and UBC Life Building. Our interviews were 10 minutes in length and we had an interview success rate of 52.08%. Thus, we conducted 50 interviews with undergraduate and graduate UBC students of various programs and year levels. Following their written consent, we recorded qualitative data on their perspectives, reactions and opinions on both the UCSF HBI and video in an Excel spreadsheet. Each participant was entered to win one of two $25 UBC Bookstore gift cards provided they gave their email. We did our interview data analysis manually and used the results of that and our literature review to inform our recommendations. 74% of the participants found the UCSF video format an effective way to spread the awareness of the health effects of SSBs and were influenced to reflect on their own consumption habits. They liked the clarity, length, statistics/facts, animations/visual appeal of the video and 32% reported wanting to change their consumption habits after watching it. Also, 56% of UBC students said they liked UCSF replacing SSBs with healthier beverage options and 62% of all participants said they would support a HBI at UBC. Therefore, we suggest using a video for UBC’s HBI, but making the following changes: adding subtitles, changing the information context for Canada and UBC, and involving media experts in its creation. In addition to the video, we suggest adding other formats to more efficiently and effectively educate students on the HBI. Finally, involving community members in the implementation process and partnering with UBC Building Operations and Sustainable Engineering to install filtered water fountains would best support a HBI at UBC.  Laird, Leung, Huang 5   Introduction  The healthy beverage initiative (HBI) video produced by the University of California San Francisco (UCSF) mentioned high intakes of sugar in sugar-sweetened beverages (SSBs) is a worldwide concern (UCSF Healthy Beverage Initiative n.p.). According to Centers for Disease Control and Prevention, SSBs include any liquids sweetened “with added sugars of various forms such as brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, lactose, malt syrup, maltose, molasses, raw sugar, and sucrose” (n.p.). Examples of SSBs include regular sodas, fruit drinks, sports drinks, energy drinks, sweetened waters, and coffee and tea beverages with added sugars (Centers for Disease Control n.p.). Excess SSBs consumption increases the risk of obesity and diseases (National Academies of Sciences, Engineering, and Medicine 1) and is negatively associated with the intake of important micronutrients (Euna and Powell 43). Also, since excess consumption of SSBs can lead to dental caries, type 2 diabetes, and cardiovascular disease, the National Academies of Sciences, Engineering, and Medicine suggested that one method to decrease SSBs consumption is to promote water consumption (2). The University of British Columbia (UBC) can encourage healthier beverage decisions among students by providing an environment that can help guide them towards healthier habits for life. Young adults are impressionable and UBC is a community in which many students are learning to live on their own for the first time (Parr and Toor 2). Therefore, UBC aims to carry out a HBI that limits the sales of SSBs and promotes both tap water consumption and sociocultural, environmental and economic sustainability. Firstly, the sociocultural sustainability benefits of a HBI at UBC align with the goals of the 2017 UBC Action Framework for a Nutritionally Sound Campus in working towards becoming a health promoting university (UBC Wellbeing 4). A HBI at UBC follows the action plan by  Laird, Leung, Huang 6   making healthier choices available in food outlets, at events, and in vending machines across campus, thereby improving the short and long-term health and well-being of the community (UBC Wellbeing 4). Secondly, by promoting tap water over the use of plastic bottles, UBC can lower their plastic bottle usage, reducing environmental waste and greenhouse gas emissions for an environmentally sustainable campus (UBC Wellbeing 7). Thirdly, UBC is in a high-cost community, which has contributed to food insecurity for some members (UBC Wellbeing 8). In just the Faculty of Land and Food Systems at UBC alone, just over half (55%) of students are food secure, with the rest experiencing varying levels of food insecurity, ranging from mildly insecure to severely insecure (James and Rideout 4). Thus, it is important to have healthy and affordable options available to promote a diet able to fuel UBC’s academic and professional demands. The economic sustainability of UBC campus is also important. After removing SSBs, campus food and beverage establishment sales at UCSF fully recovered just two years after implementing their HBI (Parr and Toor 7). Lastly, a HBI at UBC could create opportunities for grants related to health promotion from the government, health authorities, or foundations, as well as research/campus living lab opportunities (Parr and Toor 2). This positive exposure of UBC as a sustainable and health-promoting campus and could have massive impacts regionally, provincially, nationally and internationally. UBC can lead as an example of a successful health-promoting and sustainable campus for other campuses and institutions at the regional, provincial, national and international levels (Parr and Toor 2). Regionally, the HBI directly affects UBC community members as the UBC campus will no longer sell SSBs and instead promote the consumption of healthier beverage options. In Canada, high intakes of SSBs is a large dietary contributor to an increased rate of obesity and chronic disease (Vanderlee et al. 168). The Ministry of Education has found SSBs to play a role  Laird, Leung, Huang 7   in this major public health concern (5). The HBI video produced by UCSF emphasized reducing SSBs as a way to mitigate the impact of excess sugar consumption (UCSF Healthy Beverage Initiative n.p.). Our research goal was to obtain student feedback from a minimum of 50 UBC students by watching the HBI promotional video conducted by UCSF. Our first project objective was to identify student attitudes and perceptions towards a HBI video produced by UCSF (“UCSF Healthy Beverage Initiative”) and SSBs in general. Our second project objective was to develop recommendations to inform a HBI for UBC.  Methodology and Methods Research Methodology We implemented a Community-Based Action Research Methodology by conducting interviews for feedback from community members on UBC Vancouver Campus. Community-Based Action Research seeks to change issues that are critical to a community by focusing on engaging community members and having the participants, researchers, and all other representative equally involved and voiced (Burns et al. 5). To implement Community-Based Action Research, we aimed to include all UBC student participants interviewed and equally considered each of their opinions. We were responsible for addressing the concerns of any participants, researchers, and representatives and worked to come up with the best possible solutions that would benefit as many people involved as possible. Also, we consulted our community partners Student Housing and Hospitality Services (SHHS), UBC Wellbeing Office and SEEDS Sustainability Program throughout our research.  Laird, Leung, Huang 8   Research Methods Secondary Data Collection Research Methods Literature Review  We each conducted a literature review to address a specific issue related to healthy beverage initiatives. We did this by searching keywords in the online UBC library database. One member researched tap water safety and used keywords such as “tap water”, “safety” and “tap water consumption” to search for peer-reviewed articles. Another did research on the prevalence of excess sugar consumption and obesity rates by searching keywords such as “health”, “obesity” and “sugar consumption”. Lastly, our third group member looked into habit development and behavior of students by searching keywords “children”, “students”, “sugar consumption”, “school” and “habit forming”. Literature was selected on its relevance to our community context and healthy beverage initiatives in general.  Other Secondary Data Source  In addition, our literature review, we used the HBI video that UCSF produced, as well as the UCSF HBI website and UBC HBI proposal provided to us, to review and gain a better understanding of the HBI. Accessing and watching the UCSF HBI video allowed us to develop relevant interview questions and notes on any missing or important information that was crucial for the participant to understand. Knowing the video well also provided us with enough context to understand the specific parts of the video the participants referred to and provide more specific answers when we received questions regarding the video. Also, the Healthy Beverage Initiative page on the UCSF website provided information that the video did not mention. This supplemented our understanding of the UCSF HBI and was helpful when we answered questions from participants that were beyond the scope of the video (UCSF Campus Life Services n.p.).  Laird, Leung, Huang 9   Finally, reading and understanding the proposal for the UBC HBI helped us compare it to the UCSF HBI. Primary Data Collection Research Methods Primary Data  We collected our primary data by conducting 50 face-to-face interviews of 10 minutes in length. We reduced our interview goal to 50 from 100 due to our time constraints. Additionally, we had response rate of 52.08% and conducted approximately 3 interviews per hour. Eligible participants were any undergraduate or graduate students currently enrolled at UBC Vancouver Campus since our research objectives required us to garner the opinion of UBC students specifically. We developed a list of 16 interview questions (Appendix A) and each question was designed to give insight on the participants’ views of either the UCSF HBI video or UCSF HBI and to make finding themes easier. Prior to administering our interviews, we tested the interview on our family and friends and made wording adjustments based on their feedback. Methods of Administration  We administered our interviews through random sampling. Individually, we approached every 5th person who walked through the entrance doors closest to each of the following locations: Honour Roll in AMS Student Nest, Agora Café in MacMillan Building, gift shop in Henry Angus Building, Tim Hortons in Forest Sciences Centre, cafeteria lounge in Buchanan B, Starbucks in Wayne and William White Engineering Building, library in Neville Scarfe Building, cafeteria in Place Vanier Residence Commonsblock, gym in Acadia Park Residence Commonsblock, and Starbucks in UBC Life Building (Appendix B). We picked these locations based on how busy they were and their likelihood to provide a varied student sample. We also  Laird, Leung, Huang 10   interviewed during the mornings, afternoons and evenings of at least one Monday, Tuesday, Wednesday, Thursday, Saturday and Sunday between March 7th and March 21st to provide a random sample (Appendix C). We approached every person following an interview script (Appendix D) and asked them to sign a consent form if they agreed to participate in our interview (Appendix E). We also asked the participants to put their email on the consent form if they wanted to be entered in a raffle draw for one of two $25 UBC Bookstore gift cards provided by SEEDS at the end of our research. The point of including the raffle in the interview process was to provide an incentive for them participating in our research.  After they signed the consent form, we asked a series of demographic questions to better understand them as a student at UBC. Then we asked them to watch the UCSF HBI video and asked questions about their thoughts and opinions of both the UCSF HBI video and UCSF HBI the video talked about. We also asked about their opinions on a HBI at UBC based on the information from the UCSF HBI video. There was an opportunity at the end of the interview for participants to make additional comments not embodied by our previous questions. Throughout the interview, we projected ourselves as friendly and non judgemental. Notes on the body language and/or other observations of the participant were sometimes made throughout the interview to provide additional context. Lastly, all raw data was recorded on an Excel spreadsheet on our personal computers (Appendix F). We did not record any distinguishing information that would affect the confidentiality of our participants and avoided using Google Drive or any other online methods to record data due to privacy and storage issues.  Following the interview, we manually analyzed our data by combining our Excel data on one computer and coded/themed them based on participant demographic, UCSF HBI video opinions, UCSF HBI opinions, and UBC HBI opinions. We used the preliminary questions  Laird, Leung, Huang 11   regarding participants' backgrounds to determine our participant demographic and used our literature review to inform important areas to analyze.  We chose face-to-face interviews as our method of gathering feedback so we as interviewers could record any other observations or notes beyond the questions themselves, or that would be difficult to get electronically. Doing so guaranteed that the participants were able to ask any immediate questions or areas they needed clarification on and allowed us to ask them to elaborate on their responses. The ability to ask follow-up questions enhanced our responses. Furthermore, the ability to visually see reactions to the video provided us with an opportunity to record body language for a better context of student opinions.  Results Literature Review We found literary support to show that excess sugar consumption has negative health effects such as dental caries (Marshall 57) and type 2 diabetes (Hidayat, Khairunnis and Madanijah 441). In addition, there is evidence that overweight and obesity rates are rising worldwide - especially among youth (Raine 3). These rising rates relate to excess calorie consumption from sugars, wherein SSBs are a common source (Dietitians of Canada 3). The National Academies of Sciences, Engineering, and Medicine suggests that reducing or eliminating SSBs consumption by replacing them with water can result in a reduced risk of diseases later in life (2). Also, community members will be more motivated to adopt water consumption if there are safe water sources located on campus (Centers for Disease Control and Prevention n.p.).  Laird, Leung, Huang 12   Interviews Description of Demographic  Based on interview results, a diverse demographic of respondents was obtained. Success rates of number people interviewed compared to number people approached at different locations ranged from 26.67% at Acadia to 75% at UBC Life Building, with an overall interview success rate of 52.08% (Appendix G).  The first years represented 24% of our sample (see fig. 1), with 42% of them being international and 58% being domestic (Appendix H). Only one participant was a graduate student, with the remaining 49 students being undergraduate students.   Fig. 1. Distribution of students’ year standing at UBC.  Most participants represented the Faculties of Arts or Science at 28% and 24% respectively, while a smaller number of students came from Sauder School of Business, Land and Food Systems, and Applied Science (see fig. 2). Forestry and Kinesiology were most underrepresented at only 2% compared to the other faculties.  Laird, Leung, Huang 13    Fig. 2. The proportion of students from various faculties at UBC.  A wide range of programs were mentioned by participants within the Faculty of Arts, Applied Science, Forestry, Kinesiology, Land and Food Systems, Sauder School of Business, and Science (Appendix H). Our UBC student sample was 34% international and 66% domestic (see figure 3). Furthermore, 24% of all participants had a preferred language other than English (see fig. 4). The other languages mentioned as preferred were Mandarin, Cantonese, and Japanese.  Laird, Leung, Huang 14    Fig. 3. Proportion of domestic students interviewed compared to international students.   Fig. 4. The proportion of reported preferred languages.  Questions Regarding UCSF HBI Video  “Good” was the word most often used in response to interview question 8 (Appendix A) with the smallest fonts representing the least often mentioned words (see fig. 5).   Laird, Leung, Huang 15    Fig. 5. A word cloud of the initial thoughts of participants after watching the UCSF HBI video. The size of the word is representative of the number of times it was mentioned in the answer, where the larger words were mentioned more.   We found that 11 participants thought the UCSF HBI video had a clear message, 7 participants said the video was a good length, 19 participants said they enjoyed the statistics and facts provided, and 19 participants enjoyed the animations and visual appeal of the video (see fig. 6).  Laird, Leung, Huang 16    Fig. 6. The parts of the video participants liked and the amount of times each element they liked was mentioned overall. Only 17 of the 50 participants found areas of the HBI video they disliked (see fig. 7). The areas of dislike included the information provided, length and pacing, video “feel”, context, or other.  Fig. 7. The parts of the video participants disliked and the amount of times each element they disliked was mentioned overall.   Laird, Leung, Huang 17   We looked at the effectiveness of the video format as a way to influence thought on consumption habits, a change in consumption habits, and also the ability to spread awareness of the health effects of SSBs. 74% of participants said the video made them reflect on their own consumption habits (Appendix H). Of the 26% who said the video didn’t make them reflect on their own consumption habits, 92% said it was because they already knew the health effects of SSBs consumption and 8% said they liked SSBs too much to care. 60% of participants would not change their consumption habits after watching the video (Appendix H). Of these people, 40% said it’s because they already don’t consume SSBs, 13.3% said the video wasn’t enough to change their consumption habits, and the remaining participants didn’t expand on why. 74% of the participants found the video format an effective format to spread the awareness of the health effects of SSBs. 18% found that a video format is only partially effective, and 8% of the participants said a video format is not an effective format to spread awareness of health effects of SSBs (see fig. 8).  Fig. 8. The effectiveness of the UCSF HBI video as a format to spread awareness of the health effects of SSBs.  Laird, Leung, Huang 18    Several suggestions were made by participants to improve on the video format exemplified by UCSF HBI video. Other formats were also suggested to be used complementary to a video format (see table 1). Table 1 Suggestions for video and other formats to promote a HBI at UBC. Format Suggestions Video - More text to accompany visuals - Add subtitles - More clarity and conciseness of main points - More graphs - More facts contextualized to students in Canada (better yet, UBC students) - Include data from other countries - Real-life examples on a more individualized level in addition to federal level statistics (such as case studies) - More sound effects - List different kinds of sugars - More positive outlook (promoting healthy beverages instead of villainizing sugar and SSBs) - Use celebrities - Make it more entertaining so people don’t zone out Face-To-Face Interactions - In-class presentations - Give leaflets/handouts to students - Events/workshops  Posters/Infographics - Supplementing video with all the information in visual format (so people can refer to it and process the information at their own pace) Social Media Advertisements - PSAs - Advertisements on campus (such as frat parties) and social media (such as Facebook) - Memes as a humorous way to share health effects of SSBs - Compare with other schools in BC Questions Regarding UCSF HBI 28/50 (56%) of UBC students said they liked UCSF replacing SSBs with healthier beverage options, whereas 3/50 (6%) disliked this idea, 17/50 (34%) had speculations, and 2/50 (4%) didn’t know how they felt about it (see fig. 9). Of the people who had speculations, 10/17 (59%) still mentioned they liked the idea.  Laird, Leung, Huang 19    Fig. 9. The categorized responses of UBC students regarding their feelings on UCSF replacing SSBs with healthier beverage options. Questions Regarding a HBI at UBC  62% of all participants said they would support a HBI at UBC, 18% of all participants would partially support a HBI at UBC, and 20% of all participants would not support a HBI at UBC (see fig. 10). Of the people that said they would support a HBI at UBC, 77.4% were not LFS students and 22.6% were LFS students.  Fig. 10. Proportion of students who would either support, partially support, or not support a HBI at UBC.   Laird, Leung, Huang 20   Of the 30% of people that do consume SSBs, 54.29% of students would support a HBI at UBC, 21.71% would partially support it and 24% would not support it (see fig. 11). Also, of the 70% of people who did not mention they don’t consume SSBs, 80% would support a HBI at UBC where 20% would not. 92% of the first years consume SSBs and of these first years, 64% would support a HBI at UBC (Appendix H).  Fig. 11. The relationship between level of support of HBI at UBC and consumption of SSBs. Discussion  Interpretation of Demographic  We attribute the variety of demographic to our random sampling at multiple locations on campus. Firstly, there was a fairly balanced proportion of students representing each year standing from 1st and 4th year standing (see fig. 3). The one anomaly was an undergraduate student claiming 5th year standing at UBC. The interview question of “What year standing are you at UBC?” likely caused confusion among the participant since a student could spend more years at UBC than their year standing. Regardless, our balanced proportions of 22%-28% in 2nd and 4th year standing respectively were helpful in providing balanced feedback from students with varying time remaining at UBC. We looked more deeply into the opinions of students with  Laird, Leung, Huang 21   1st year standing as they were most eager to be interviewed, have the most time remaining at UBC, and have likely the least amount of campus familiarity. Of our 1st year standing sample, we had a nearly halved proportion of international and domestic students (Appendix H). This was favorable in our hope to have as much of an international and domestic student representation as possible. We looked into the proportion of all domestic to international students we interviewed and compared it to the overall proportion of domestic to international students at UBC Vancouver. The proportion of international students that we interviewed was 34% (see fig. 3) compared to the approximately 19% at UBC’s Vancouver campus in 2016/17 (Mathieson and Redish 7). The high international student representation likely related to the preferred languages of our participants (see fig. 4). Lastly, we looked into the faculties and programs of our participants. We found the percentage of participants in each faculty was closely representative of the actual size of the faculty on campus. For example, science and arts are two of the largest faculties on campus, and made up 24% and 28% of our sample respectively (Appendix H). We also had students from 23 different programs (Appendix H) in addition to the 12 undeclared first year students. Although this is not representative of all programs on campus, we found this to be a high variety of student representation for the sample size.  Opinions of UCSF HBI Video Likes of UCSF HBI Video Many participants found the video “interesting” and “clear”, and were left having made the connection that “intake” of “SSBs” was “bad” (see fig. 5). A noticeable amount of participants also mentioned they “already” knew the risks of excess sugar consumption through  Laird, Leung, Huang 22   SSBs intake. Several mentioned they already “don’t” consume SSBs after being exposed to the risks prior to having watched the video. Additionally, a liking to the animations/visual appeal was mentioned 19 times by participants (see fig. 6). They liked how colourful the animations were, the visual representations of the quantities of sugar the video spoke to, and the diverse cultural representation. A liking to the statistics and facts provided was also mentioned 19 times by participants. The facts on sugar and SSBs consumption, the impact of excess sugar consumption on health, body composition, and disease, were all elements that participants remembered after having watched the video. 11 participants also found the video had a clear message and was easy to listen to and stay engaged in watching. Lastly, 7 participants found the length appropriate to express the UCSF HBI context and initiative. However, some of the same elements that participants liked about the video, others disliked. Dislikes of UCSF HBI Video 17 participants (34%) disliked certain elements of the UCSF HBI video compared to 33 participants (66%) that expressed zero dislikes. The dislikes in descending order of frequency were a problem with the information provided, length and pacing, video “feel”, other, and context (see fig. 7). Problems with the information provided meant there was either too much or too little information provided in the video, not enough statistics or graphs or not enough of an explanation on the research studies providing the facts. Problems with the length and pacing were contradictory to the likes of other participants. Some found the length and pacing of the video too long and slow, others too short and fast-paced. The video “feel” was alluded to as either boring, over-dramatic, scary, or musically distasteful. Other dislikes included an unclear message and lack of captions. Lastly, it was mentioned twice that the US context of the video reduced its relevance and validity to them as Canadian students.  Laird, Leung, Huang 23   Influence on Consumption Habits  The video made 74% of participants reflect on their own consumption habits, but failed to influence the remaining 26% (Appendix H). The reasons the video didn’t make them reflect on their own consumption habits were because 92% had already heard of the health effects of SSBs consumption the video talked about, and 8% said their love for consuming SSBs outweighed its health effects. Furthermore, 60% of participants wouldn’t change their consumption habits despite the video influencing an extra 14% to reflect on them (Appendix H). Fortunately, 40% of the people who wouldn’t change their consumption habits already don’t consume SSBs. 13.3% said it was because the video itself wasn’t enough to change their consumption habits. Therefore, changes would need to be made to the video itself, or the format in which the message is spread, for them to make a lifestyle change. Further emphasizing that excess sugar consumption has negative health effects could intensify their understanding of SSBs (Euna and Powell 43). The remaining participants didn’t expand on why they wouldn’t change their consumption habits - expressing that they simply just felt that way. Understanding how effective the video format was as a way to spread the awareness of the health effects of SSBs was helpful in further understanding the ability of the UCSF’s HBI video to influence consumption habits. Effectiveness of Video Format  Directly after watching the UCSF HBI video we asked the participants “Are there any points of the video you need clarification on?” to see how sufficient the video was in providing a clear message. The overwhelming response was “no”, with 9 participants mentioning they needed clarification on the definitions of SSBs,  healthy beverages or specifics of the initiative (Appendix F). In other words, the video was unclear in informing all participants with a clear  Laird, Leung, Huang 24   message. We then asked “What are your initial thoughts about this video?” This question was asked to garner immediate impressions of the video and a generalized interpretation of the video. The intention of asking this question early was to see the initial impact the video had on participants if used as a way to promote the HBI.  The video was an effective format to spread the awareness of the health effects of SSBs to 74% of the participants. The remaining 18% found it was only partially effective and 8% found it not at all effective (see fig. 8). Therefore, there were several suggestions from participants to both adapt the video format, or the format style entirely. The suggestions from the 26% who didn’t find the video an effective format listed their video suggestions and also suggested face-to-face interactions, posters/infographics, and/or social media advertisements as alternative or additional format options (see table 1). These suggestions were used to guide our recommendations for a HBI at UBC. Opinions of UCSF HBI Overall, over half of the participants (56%) liked how UCSF replaced SSBs with healthier beverage options (see fig 9). One claimed it was “a big step for universities…” and others noted it as an effective way to promote a healthier lifestyle in students (Appendix F). Some participants acknowledged it would be a reluctant adjustment, but good for the long-term health of students, thus liking the overall aim of the UCSF HBI. On the other hand, 6% of students did not like UCSF replacing SSBs with healthier beverage options (see fig. 9). These students said they were pro-choice, expanding that having the opportunity to make the healthy choice themselves was better than the complete removal of SSBs. These people were both students who claimed they either regularly consumed SSBs or didn’t often drink SSBs but still enjoyed the ability to “treat” themselves occasionally (Appendix  Laird, Leung, Huang 25   F). The low number of students that did not like the actions of the HBI at UCSF was worth mentioning as it showed that most students were not opposed to the idea of eliminating sales of sugar-sweetened beverages for the betterment of their health. However, there were some notable speculations on the UCSF HBI.  34% of the participants had speculations regarding the HBI at UCSF (see fig. 9). Several had concerns on how they themselves or other students would respond to the complete removal of beverages that students so frequently depend on. Some wondered why diet sodas would still be sold at outlets when they should be considered unhealthy. Others questioned the revenue of sales, brought up environmental concerns regarding plastic water bottles, and found it inapplicable to their geographical context insufficient. It is important to note these speculations were based on only having watched a two minute video regarding the UCSF HBI. Thus, such speculations could likely be resolved with further education on the UCSF HBI. Despite speculations, 58% of these participants still mentioned that they liked the idea of the HBI, which helped us understand that by addressing their concerns mentioned above, we could potentially garner full support from them. Support for a HBI at UBC When asked if the HBI was something the participants would support at UBC, 62% of them answered “yes” (see fig. 10). It was important that of these 62%, 77.4% of them were from a faculty other than Land and Food Systems (LFS). Since LFS students were likely more educated on the effects of sugar and SSBs consumption, having most of the participants from a faculty other than LFS support an HBI at UBC was positive. It showed that students of various educational backgrounds value the goal of a HBI and are willing to support its outcomes.  Laird, Leung, Huang 26   We also looked more specifically into people who claimed they consumed SSBs. We were less concerned with the participants who don’t consume SSBs, as a HBI would not have as large of an effect on them. Of the people who consume SSBs, 54.29% would support a HBI at UBC (see fig. 11). Although these participants were consumers of SSBs, they were still willing to change their consumption habits. Therefore, they would support the initiative on campus on the basis of just having watched the UCSF HBI video. Also, we were impressed that 64% of the 92% of first years that consume SSBs would support a HBI at UBC. The students interviewed gave reasons to support a HBI at UBC as an opportunity for themselves or others to form healthier lifestyle habits. As for the 20% of students who would not support the HBI at UBC, they valued choice and moderation over complete elimination of SSBs. One participant found the HBI too extreme, others were simply worried about the negative outcry of students. Also, the effectiveness of the initiative was questioned, namely, the dietary changes could only be made to campus and not other locations the students may frequent. Finally, the 18% of participants who said they would partially support a HBI at UBC provided conditions which could render complete support. These conditions included changes to the initiative that will be discussed further in our recommendations. The level of support could be improved by addressing major participant concerns and misconceptions. Major Concerns and Misconceptions  The exposure of participants to the UCSF HBI video was short and prompted several questions regarding its purpose, context and outcomes. One concern was the lack of choice if implemented at UBC, where the misconception was that students couldn’t still consume SSBs. However, the UCSF HBI video clarified that students could still bring SSBs to campus and was  Laird, Leung, Huang 27   the example made for a HBI at UBC (Healthy Schools BC n.p.). Another concern surrounded plastic bottle usage and its effect on the environment. Although not a direct aim of the UCSF HBI, the video did clarify its support of tap water over any other beverage type. Thus, the misconception was that reducing plastic bottle waste would not be addressed by implementing a HBI at UBC. However, providing safe water sources will address this issue by providing a safe and accessible alternative to water bottles (Centers for Disease Control and Prevention n.p.). Finally, there were concerns on keeping diet sodas as a beverage option. The misconception was that they thought by diet sodas not being eliminated, they were then promoted as a healthy beverage options on campus. However, the initiative aimed to promote tap water over all other beverage options and diet sodas were not a source of added sugar like the SSBs. In other words, SSBs are targeted due to their sugar content, which diet drinks do not contain (Dietitians of Canada 3). The nature of the study likely influenced other concerns and misconceptions that were only mentioned once. Interview Limitations Since participants were only given the information provided in the UCSF HBI video, there may be some information that did not properly get across to the participants - leading to concerns and misconceptions of the HBI. Although participants did have the opportunity to ask questions throughout and following the interview, most of the participants noted that they did not require any further clarifications. This could be due to the several factors such as the participant’s willingness to have a discussion, misunderstanding of the purpose of our study, timeliness of the interview, or comfort level. More importantly, the questions themselves could have influenced participant responses.  Laird, Leung, Huang 28    We didn’t ask certain questions in our interview, that if included, could have improved our qualitative results. Firstly, we didn’t ask the participants specifically if they consumed SSBs or didn’t consume SSBs prior to the interview. Therefore, we could only generate an understanding about their consuming of SSBs if they explicitly offered that information in their interview responses. If we had asked this question, we could have better interpreted how influential the video itself was in spreading the message of the health effects of SSBs to change consumption habits by decreasing their consumption. Secondly, we also didn’t ask a question pertaining to whether the student lived on or off campus. This would have been helpful in better understanding the breadth of potential influence a HBI at UBC would have. In our interviews, a point was made by a participant that they commute to UBC. They don’t consume SSBs on campus, but consume a lot when they go home. Therefore, they exposed the question of how influential an HBI at UBC would be to ultimately change lifestyle habits if only the campus itself lacks access to SSBs. Additionally, the initiative could have a greater effect on those students who live on campus. This is why we looked into the opinions of first years more deeply and targeted on-campus residences for interviews. Despite targeting multiple locations, we still could have gathered a more representative UBC student sample.  We could have improved on our sample variation by increasing the number of interviews, thereby increasing the likelihood that our random sample encompassed more of the UBC student body. The time spent approaching potential participants at random was longer than expected. Also, the success of interviews influenced the number of people we were able to include in our study. For these reasons, we had to limit the number of interviews we did to 50 instead of the originally anticipated 100. Given more time and a higher number of success interviews, we could  Laird, Leung, Huang 29   have gathered more of a representative sample of other faculties, programs, and graduate students specifically. Our data analysis process added to our time constraints. We also spent a lot of time on data analysis since all themes and relationships were found manually. In face-to-face interviews, we generated a lot of qualitative results that required a lot of interpretation. These interpretations were also made by us as researchers and may have had an influence on the results we concluded. The rejection rate was relatively high (48%), which may have influenced how random our sample truly was since the people who we interviewed were those most interested in the research topic. However, the fact that all of our interviews were face-to-face added quality to the results that other methods may not have encompassed. Recommendations and Conclusion Recommendations for Future Research Format for HBI Awareness  Many aspects of the UCSF video could be adapted for a HBI at UBC. Changes could include the pacing, amount of information provided, and overall tone. From our interviews, we found these aspects were of the biggest problems participants had regarding the UCSF HBI video. Having a variety of videos that vary in length, style, and content would cater to the feedback. Further research could be done by experts in marketing to effectively and efficiently relay the details of the HBI through a video a compelling manner. Ultimately, the video should refer to a resource whereby students could learn more information on the HBI. A HBI at UBC As an initiative that plans to eliminate the sales of SSBs, further research needs to be done to investigate how sugar can be targeted and perceived by others. It was discovered from  Laird, Leung, Huang 30   our interviews that the statistics in the UCSF HBI video scared some students into wanting to cut back sugar, but they were unclear on how. More specifically, the video referenced overall sugar consumption and one participant thought this meant she also needed to cut back on her fruit intake. We recommend nutrition students from the Food, Nutrition, and Health program or future LFS 450 students at UBC to do some research on how other dietary changes could support the overall goal of the HBI. As participants questioned whether sugar should be villainized, methods on how sugar should be portrayed in the initiative is important in addition to other healthy lifestyle changes. Methods on effectively providing ample information to the UBC students, staff, and faculty members needs to be looked at for HBI support. Since many of the participants responded that they would not support the initiative for their concerns and misconceptions, providing clarity regarding some points of the UCSF HBI video is an important consideration  for the stakeholders to address. Recommendations for Action and Implementation Wellbeing and Student Housing and Hospitality Services Stakeholders As mentioned previously, a video format is an effective method to promote an HBI at UBC. Therefore, we recommend our stakeholders find a team to produce a video while considering the attributes of a video previously mentioned and working in partnership with media experts. In addition, adding multi-language subtitles to the UBC HBI video is recommended to quickly and directly spread the awareness of HBI. As 24% of our participants had a preferred language that was not English, adding the subtitles could engage all students to watch it and make it easier for them to understand the initiative. Other formats could support this understanding of a HBI, especially if used complementary to a video format.  Laird, Leung, Huang 31    Using some additional methods such as social media advertisements, posters, infographics and face-to-face interactions were suggestions of the participants (see table 1). These complementary methods could also be used as a way to reference the video and other information online. Given the concerns and misconceptions on the HBI and the number of participants who wouldn’t fully support a HBI at UBC, we also recommend having educators and students hold face-to-face workshops or events that could educate other students and members. Workshops and events can elaborate on the adverse health effects of excessive sugar consumption, the benefits of tap water consumption and the HBI itself to help them become more capable of choosing healthy beverage options and familiarize them to the initiative. An important objective of the workshops or events should be to provide definitions of SSBs and healthier beverage options. Differentiating between sodas and diet sodas, and milk and 100% fruit juices versus water would also be helpful. Involving all members of the community in the initiative process could prevent the negative student outcry mentioned in our interviews. Also, further consultation of students would help in supporting our research findings. UBC Building Operations and Sustainable + Engineering To create a healthy campus environment, we suggest the UBC Building Operations works with Sustainable Engineering to implement sustainable water sources. The objective of implementing a HBI is to reduce sugar consumption and encourage healthy beverage options that do not contain added sugar. Therefore, water is the healthiest choice for this initiative. Since SSBs are removed, promoting tap water would be more successful if students had a safe and convenient source to access it. Based on our literature review, there are many ways for students to access water, such as using disposable cups, refillable bottles and also purchasing water   Laird, Leung, Huang 32   (“Understanding Provision” 4). If the UBC Building Operations builds more filtered water fountains with the support of Sustainable Engineering, the usage of disposable plastic bottles would also be reduced. Water fountains are currently hard to find around the campus and so adding more convenient healthy beverage options would increase the likelihood that all community members make the healthier choice (Campus + Community Planning). Conclusion • We gathered opinions of UCSF HBI and their promotional video by interviewing 50 random UBC students for 10 minutes each • The majority of students interviewed would support a HBI at UBC ● A video format is effective in spreading the awareness of the health effects of SSBs ● Clear initiative outcomes should be outlined to best inform decision making ○ Having nutrition students or future LFS 450 students research sugar as the target for a HBI and other potential dietary changes could empower healthy lifestyle changes beyond just SSBs ○ Framing the initiative in a positive manner (i.e. promoting tap water consumption instead of reducing sugar consumption) could aid in clarifying the concerns and misconceptions of UBC students ● Those implementing the HBI at UBC should partner with UBC Building Operations and Sustainable Engineering to install more filtered water fountains on campus ○ Doing this will make the healthier choice more convenient and more likely ● Stakeholders should create a HBI video with the support of marketing and media experts and consider the suggestions of interview participants when creating a HBI at UBC  Laird, Leung, Huang 33   ○ Adding subtitles is important for video clarity and to cater to UBC’s cultural diversity ○ The video should inform key elements of the HBI, while maintaining the attention of UBC students as the main audience and directing them to further information online ● Use a complementary method to the video to best support a HBI at UBC ○ Social media advertisements, posters, infographics, and face-to-face interactions were suggested by interview participants ○ It is important to refer to a location, preferably online, where community members can access more information on the HBI ● Pre-initiative is important for HBI success at UBC ○ Educating community members prior to complete implementation can provide them with another opportunity to share their opinions and suggestions ○ Involve students in the process ○ Have educators and students hold face-to-face workshops or events to educate community members on the effects of excessive sugar consumption, the benefits of tap water consumption and specifics of the HBI ■ Clarify HBI objectives and definitions such as SSBs and healthier beverage options - making it clear that water is the best choice ■ Ensure students understand the university doesn't wish to profit from the sales of SSBs and their tuition will not be affected     Laird, Leung, Huang 34   Appendices Appendix A: Interview Questions 1. Are you a graduate or undergraduate student? 2. What year standing are you at UBC? 3. Which faculty are you primarily associated with? 4. What program are you in at UBC? 5. Are you a domestic or international student? 6. What language do you prefer to communicate in? [watched UCSF HBI video] 7. Are there any points of the video you need clarification on? 8. What are your initial thoughts about this video? 9. Was there something in the video in particular that you liked? 10. Was there something in the video in particular that you disliked? 11. Was there a part of the video that made you reflect on your own consumption habits? 12.  a. Is there something you would change about your consumption habits after watching the video? b. What is the change and what prompted the change? 13. How do you feel about UCSF replacing SSBs with healthier beverage options? 14.  a. How effective was the video format as a way to spread the awareness of the health effects of SSBs? b. What other formats do you see as being more effective? 15.  a. Would this be an initiative that you’d support at UBC?  (YES) What specifically about this initiative do you support? b. (NO) What concerns do you have about this initiative? 16. Do you have any other thoughts or comments or questions about the video? [space for additional notes]   Laird, Leung, Huang 35   Appendix B: Map of Interview Locations on UBC Vancouver Campus  Fig. 1. The interview locations are starred in red.   Laird, Leung, Huang 36   Appendix C: Recorded Location, Date and Time of Interviews  Fig. 1. Recorded dates and times at each interview location.     Laird, Leung, Huang 37   Appendix D: Interview Script  hi there, are you a student at UBC? I am from LFS450 and I am conducting an interview asking for opinions on sugar sweetened beverages. Do you have time to watch a 2 minute video and answering some questions regarding the video for a chance to win one of two $25 UBC bookstore gift cards? Before starting the interview, I would like to ask you to sign this consent form for ethical purposes. Please read the form over and sign your name at the bottom. If you would like a chance to win one of two $25 UBC bookstore gift cards,  please write your email next to your name (If they ask about the consent form): the consent form is a course-based research project procedure  to ensure confidentiality on your answers and to ensure you stay anonymous. I will need your consent before proceeding with the interview. Fig. 1. Script used when we conducted interviews.    Laird, Leung, Huang 38   Appendix E: Consent Form Fig. 1. Page one of three of the consent form given to all participants.  Laird, Leung, Huang 39    Fig. 2. Page two of three of the consent form given to all participants.  Laird, Leung, Huang 40    Fig. 3. Page three of three of the consent form given to all participants.    Laird, Leung, Huang 41   Appendix F: Raw Interview Data  Fig. 2. Raw data from interview questions asked before participants watched the UCSF HBI video.  Laird, Leung, Huang 42    Fig. 3. Raw data from interview question 7.  Laird, Leung, Huang 43    Fig. 4. Raw data from interview question 8.   Laird, Leung, Huang 44     Fig. 5. Raw data from interview question 9.    Laird, Leung, Huang 45    Fig. 6. Raw data from interview question 10.   Laird, Leung, Huang 46    Fig. 7. Raw data from interview question 11.  Laird, Leung, Huang 47     Fig. 8. Raw data from interview question 12a.  Laird, Leung, Huang 48    Fig. 9. Raw data from interview question 12b.  Laird, Leung, Huang 49    Fig. 10. Raw data from interview question 13.  Laird, Leung, Huang 50    Fig. 11. Raw data from interview question 14a.    Laird, Leung, Huang 51    Fig. 12. Raw data from interview question 14b.    Laird, Leung, Huang 52    Fig. 13. Raw data from interview question 15a.    Laird, Leung, Huang 53    Fig. 14. Raw data from interview question 15b.  Laird, Leung, Huang 54    Fig. 15. Raw data from interview question 16.   Laird, Leung, Huang 55    Fig. 16. Additional notes on participants that could have affected their responses.  Laird, Leung, Huang 56   Appendix G: Interview Success  Fig. 1. The number of people approached at each interview location versus the number of people successfully interviewed.   Laird, Leung, Huang 57   Table 1 The count and success rate of interviews conducted at each location on UBC campus. Interview Location Number Approached Number Interviewed Success Rate (%) AMS Student Nest 10 5 50.00 Agora Café 11 6 54.55 Henry Angus Building 7 5 71.43 Forest Sciences Centre 9 5 55.56 Buchanan B 13 6 46.15 Wayne and William White Engineering Design Centre 8 4 50.00 Neville Scarfe Building 8 5 62.50 Place Vanier Residence Commonsblock 7 4 57.14 Acadia Park Residence Commonsblock 15 4 26.67 UBC Life Building 8 6 75.00 Total 96 50 52.08    Laird, Leung, Huang 58   Appendix H: Additional Interview Data Table 1 Amount of international and domestic students with first year standing at UBC. First Years (n=12) Count Frequency Frequency Percentage International 5 5/12 42% Domestic 7 7/12 58%  Table 2 The number of students in their self-reported faculty and program at UBC. Faculty Program Count Frequency Frequency Percentage Arts (n=14) Undeclared 2 2/14 14.286% Exchange Student 1 1/14 7.143% Anthropology 1 1/14 7.143% Psychology 3 3/14 21.429% Chinese Literature 1 1/14 7.143% Asian Studies 3 3/14 21.429% Human Geography 1 1/14 7.143% Sociology 1 1/14 7.143% Human Geography and Psychology 1 1/14 7.143% Applied Science (n=5) Engineering 5 5/5 100% Forestry (n=1) Master of Forestry 1 1/1 100% Kinesiology (n=1) Kinesiology 1 1/1 100%  Undeclared 1 1/8 12.5%  Laird, Leung, Huang 59   Land and Food Systems (n=8) Nutritional Sciences 1 1/8 12.5% Global Resource Systems 4 4/8 50% Applied Animal Biology 1 1/8 12.5% Food Nutrition and Health 1 1/8 12.5% Sauder School of Business (n=9) Undeclared 3 3/9 33.333% Marketing 1 1/9 11.111% Commerce 4 4/9 44.444% Finance 1 1/9 11.111% Science (n=12) Undeclared 6 6/12 50% Honours Animal Biology 1 1/12 8.333% Geological Sciences 2 2/12 16.667 Computer Science 1 1/12 8.333% Cognitive Systems 1 1/12 8.333% Integrated Sciences 1 1/12 8.333%  Table 3 Number of participants that reflected on their own consumption habits after watching the UCSF HBI video. Reflect on Consumption Habits Count Frequency Frequency Percentage Yes 37 37/50 74% No 13 13/50 26%   Laird, Leung, Huang 60   Table 4 Number of participants that said the UCSF HBI video prompted them to change their consumption habits. Would Change Consumption Habits Count Frequency Frequency Percentage Yes 16 16/50 32% Maybe 4 4/50 8% No 30 30/50 60%    Laird, Leung, Huang 61   Works Cited Campus + Community Planning. Bottled Water-Free UBC? 2013. Web. 10 Apr. 2018. Centers for Disease Control and Prevention. "Get the Facts: Sugar-Sweetened Beverages and  Consumption." Nutrition. 2017. Web. 28 Jan. 2018. Dietitians of Canada. Position Paper. DC, 2016. PDF. 10 Feb. 2018 Euna, Han, Powell, Lisa M. "Consumption Pattern of Sugar-Sweetened Beverages in the United  States." Journal of the Academy of Nutrition and Dietetics, vol. 113, no.1, 2013, pp.  43-53. Healthy Schools BC. Comprehensive School Health Knowledge Guide. n.d. British Columbia. Heart and Stroke Foundation. Position Statement. HSF, 2017. PDF. 07 Apr. 2018. James, Carrie, Rideout, Candice. “Sociodemographic Predictors of University Students’ Food  Insecurity: Insights from a Large University in Canada.”  UBC Social Ecological  Economic Development Studies (SEEDS) Student Report. 2017. PDF. 28 Jan. 2018. Hidayat Syarief, Khairunnis, Nova, and Siti Madanijah. "Association between Smoking Habits, Physical Activity, Added Sugar Consumption and Nutritional Status with Malondialdehyde (MDA) and Glucose Levels in Adults." Pakistan Journal of Nutrition, vol. 15, no. 5, 2016, pp. 439-445. Marshall, Teresa A. "Low Intake of Sugars May Reduce Risk of Dental Caries." The Journal of  Evidence-Based Dental Practice, vol. 14, no. 2, 2014, pp. 56-58. Ministry of Education. Guidelines for Food and Beverage Sales in BC Schools. 2013,  http://www2.gov.bc.ca/assets/gov/education/administration/kindergarten-to-grade- 12/healthyschools/2013_food_guidelines.pdf. National Academies of Sciences, Engineering, and Medicine. “Strategies to Limit   Laird, Leung, Huang 62   Sugar-Sweetened Beverage Consumption in Young Children: Proceedings of a workshop -- In Brief." The National Academy Press, 2017. Web. 28 Jan. 2018. Parr, Andrew, Toor, Kavie. “Proposal: UBC Healthy Beverage Initiative.” University of British          Columbia. 2017. PDF. 28 Jan. 2018. Raine, Kim D. Overweight and Obesity in Canada: A Population Health Perspective. Ottawa: Canadian Institute for Health Information, 2004. UBC Summon. Web. 10 Feb. 2018. Mathieson, Cynthia, Redish, Angela. “2016/17 Annual Report on Enrolment”. University of   British Columbia. 2017. PDF. 1 Apr. 2018. UBC Wellbeing. “UBC Action Framework for a Nutritionally Sound Campus”. 2017. PDF. 28  Jan. 2018 UC San Francisco (UCSF). “UCSF Healthy Beverage Initiative.” Youtube, 28, May 2015. Web. 28 Jan. 2018.  UCSF Campus Life Service. “Healthy Beverage Initiative FAQ” n.d. Web. 31 Mar. 2018. “Understanding Provision, Usage and Perceptions of Free Drinking Water to the Public in the   UK.”  Centre for Social Innovation. 2017. PDF. 10 Apr. 2018. Vanderlee, Lana, et al. "Sugar‐Sweetened Beverage Consumption among a  Subset of Canadian Youth." Journal of School Health, vol. 84, no. 3, 2014, pp. 168-176.   UBC Social Ecological Economic Development Studies (SEEDS) Sustainability ProgramStudent Research Report Healthy Beverage Initiative Renee Huang, Marika Laird, Tracy Leung University of British Columbia LFS 450Themes: Health, Community, Wellbeing  April 10, 2018 Disclaimer: UBC SEEDS provides students with the opportunity to share the findings of their studies, as well as their opinions, conclusions and recommendations with the UBC community. The reader should bear in mind that this is a student project/report and is not an official document of UBC. Furthermore readers should bear in mind that these reports may not reflect the current status of activities at UBC. We urge you to contact the research persons mentioned in a report or the SEEDS Coordinator about the current status of the subject matter of a project/report. Laird, Leung, Huang 2   Table of Contents  Executive Summary 4 Introduction 5 Methodology and Methods 7 Research Methodology 7 Research Methods 8 Secondary Data Collection Research Methods 8 Literature Review 8 Other Secondary Data Source 8 Primary Data Collection Research Methods 9 Primary Data 9 Results 11 Literature Review 11 Interviews 12 Description of Demographic 12 Questions Regarding UCSF HBI Video 14 Questions Regarding UCSF HBI 18 Questions Regarding a HBI at UBC 19 Discussion 20 Interpretation of Demographic 20 Opinions of UCSF HBI Video 21 Likes of UCSF HBI Video 21 Dislikes of UCSF HBI Video 22 Influence on Consumption Habits 23 Effectiveness of Video Format 23 Opinions of UCSF HBI 24 Support for a HBI at UBC 25  Laird, Leung, Huang 3   Major Concerns and Misconceptions 26 Interview Limitations 27 Recommendations and Conclusion 29 Recommendations for Future Research 29 Format for HBI Awareness 29 A HBI at UBC 29 Recommendations for Action and Implementation 30 Wellbeing and Student Housing and Hospitality Services Stakeholders 30 UBC Building Operations and Sustainable + Engineering 31 Conclusion 32 Appendices 34 Appendix A: Interview Questions 34 Appendix B: Map of Interview Locations on UBC Vancouver Campus 35 Appendix C: Recorded Location, Date and Time of Interviews 36 Appendix D: Interview Script 37 Appendix E: Consent Form 38 Appendix F: Raw Interview Data 41 Appendix G: Interview Success 56 Appendix H: Additional Interview Data 58 Works Cited 61    Laird, Leung, Huang 4   Executive Summary The University of British Columbia (UBC) aimed to explore opportunity for a Healthy Beverage Initiative (HBI) to promote tap water consumption and limit the sales of sugar-sweetened beverages (SSBs) (Parr and Toor 2). SSBs are defined as any drink that has various forms of sugar added in, including, but not limited to sodas, fruit drinks, sports drinks, energy drinks, sweetened waters, and coffee and tea beverages with added sugars (Centers for Disease Control and Prevention n.p.). The hope was that implementing a HBI at UBC would create a more sustainable and supportive environment to make informed decisions around beverage consumption on campus. The University of California San Francisco (UCSF) implemented a HBI where they eliminated all sales of SSBs and created a video to promote their HBI (“UCSF Healthy Beverage Initiative”). Our research goal was to obtain student feedback from a minimum of 50 UBC students by watching the HBI promotional video conducted by the UCSF.  Our first objective was to identify student attitudes and perceptions towards the UCSF HBI video. Our second objective was to develop recommendations to inform the implementation of a HBI at UBC. To meet our project objectives, we conducted a literature review to address specific issues related to a HBI. We also used secondary data sources to better understand planned or implemented strategies to reduce consumption of unhealthy beverages and/or increase consumption of healthy beverages. Lastly, we conducted randomized interviews at the following 10 locations on campus: AMS Student Nest, Agora Café, Henry Angus Building, Forest Sciences Centre, Buchanan B, Wayne and William White Engineering Design Centre, Neville Scarfe Building, Place Vanier Residence Commonsblock, Acadia Park Residence Commons block and UBC Life Building. Our interviews were 10 minutes in length and we had an interview success rate of 52.08%. Thus, we conducted 50 interviews with undergraduate and graduate UBC students of various programs and year levels. Following their written consent, we recorded qualitative data on their perspectives, reactions and opinions on both the UCSF HBI and video in an Excel spreadsheet. Each participant was entered to win one of two $25 UBC Bookstore gift cards provided they gave their email. We did our interview data analysis manually and used the results of that and our literature review to inform our recommendations. 74% of the participants found the UCSF video format an effective way to spread the awareness of the health effects of SSBs and were influenced to reflect on their own consumption habits. They liked the clarity, length, statistics/facts, animations/visual appeal of the video and 32% reported wanting to change their consumption habits after watching it. Also, 56% of UBC students said they liked UCSF replacing SSBs with healthier beverage options and 62% of all participants said they would support a HBI at UBC. Therefore, we suggest using a video for UBC’s HBI, but making the following changes: adding subtitles, changing the information context for Canada and UBC, and involving media experts in its creation. In addition to the video, we suggest adding other formats to more efficiently and effectively educate students on the HBI. Finally, involving community members in the implementation process and partnering with UBC Building Operations and Sustainable Engineering to install filtered water fountains would best support a HBI at UBC.  Laird, Leung, Huang 5   Introduction  The healthy beverage initiative (HBI) video produced by the University of California San Francisco (UCSF) mentioned high intakes of sugar in sugar-sweetened beverages (SSBs) is a worldwide concern (UCSF Healthy Beverage Initiative n.p.). According to Centers for Disease Control and Prevention, SSBs include any liquids sweetened “with added sugars of various forms such as brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, lactose, malt syrup, maltose, molasses, raw sugar, and sucrose” (n.p.). Examples of SSBs include regular sodas, fruit drinks, sports drinks, energy drinks, sweetened waters, and coffee and tea beverages with added sugars (Centers for Disease Control n.p.). Excess SSBs consumption increases the risk of obesity and diseases (National Academies of Sciences, Engineering, and Medicine 1) and is negatively associated with the intake of important micronutrients (Euna and Powell 43). Also, since excess consumption of SSBs can lead to dental caries, type 2 diabetes, and cardiovascular disease, the National Academies of Sciences, Engineering, and Medicine suggested that one method to decrease SSBs consumption is to promote water consumption (2). The University of British Columbia (UBC) can encourage healthier beverage decisions among students by providing an environment that can help guide them towards healthier habits for life. Young adults are impressionable and UBC is a community in which many students are learning to live on their own for the first time (Parr and Toor 2). Therefore, UBC aims to carry out a HBI that limits the sales of SSBs and promotes both tap water consumption and sociocultural, environmental and economic sustainability. Firstly, the sociocultural sustainability benefits of a HBI at UBC align with the goals of the 2017 UBC Action Framework for a Nutritionally Sound Campus in working towards becoming a health promoting university (UBC Wellbeing 4). A HBI at UBC follows the action plan by  Laird, Leung, Huang 6   making healthier choices available in food outlets, at events, and in vending machines across campus, thereby improving the short and long-term health and well-being of the community (UBC Wellbeing 4). Secondly, by promoting tap water over the use of plastic bottles, UBC can lower their plastic bottle usage, reducing environmental waste and greenhouse gas emissions for an environmentally sustainable campus (UBC Wellbeing 7). Thirdly, UBC is in a high-cost community, which has contributed to food insecurity for some members (UBC Wellbeing 8). In just the Faculty of Land and Food Systems at UBC alone, just over half (55%) of students are food secure, with the rest experiencing varying levels of food insecurity, ranging from mildly insecure to severely insecure (James and Rideout 4). Thus, it is important to have healthy and affordable options available to promote a diet able to fuel UBC’s academic and professional demands. The economic sustainability of UBC campus is also important. After removing SSBs, campus food and beverage establishment sales at UCSF fully recovered just two years after implementing their HBI (Parr and Toor 7). Lastly, a HBI at UBC could create opportunities for grants related to health promotion from the government, health authorities, or foundations, as well as research/campus living lab opportunities (Parr and Toor 2). This positive exposure of UBC as a sustainable and health-promoting campus and could have massive impacts regionally, provincially, nationally and internationally. UBC can lead as an example of a successful health-promoting and sustainable campus for other campuses and institutions at the regional, provincial, national and international levels (Parr and Toor 2). Regionally, the HBI directly affects UBC community members as the UBC campus will no longer sell SSBs and instead promote the consumption of healthier beverage options. In Canada, high intakes of SSBs is a large dietary contributor to an increased rate of obesity and chronic disease (Vanderlee et al. 168). The Ministry of Education has found SSBs to play a role  Laird, Leung, Huang 7   in this major public health concern (5). The HBI video produced by UCSF emphasized reducing SSBs as a way to mitigate the impact of excess sugar consumption (UCSF Healthy Beverage Initiative n.p.). Our research goal was to obtain student feedback from a minimum of 50 UBC students by watching the HBI promotional video conducted by UCSF. Our first project objective was to identify student attitudes and perceptions towards a HBI video produced by UCSF (“UCSF Healthy Beverage Initiative”) and SSBs in general. Our second project objective was to develop recommendations to inform a HBI for UBC.  Methodology and Methods Research Methodology We implemented a Community-Based Action Research Methodology by conducting interviews for feedback from community members on UBC Vancouver Campus. Community-Based Action Research seeks to change issues that are critical to a community by focusing on engaging community members and having the participants, researchers, and all other representative equally involved and voiced (Burns et al. 5). To implement Community-Based Action Research, we aimed to include all UBC student participants interviewed and equally considered each of their opinions. We were responsible for addressing the concerns of any participants, researchers, and representatives and worked to come up with the best possible solutions that would benefit as many people involved as possible. Also, we consulted our community partners Student Housing and Hospitality Services (SHHS), UBC Wellbeing Office and SEEDS Sustainability Program throughout our research.  Laird, Leung, Huang 8   Research Methods Secondary Data Collection Research Methods Literature Review  We each conducted a literature review to address a specific issue related to healthy beverage initiatives. We did this by searching keywords in the online UBC library database. One member researched tap water safety and used keywords such as “tap water”, “safety” and “tap water consumption” to search for peer-reviewed articles. Another did research on the prevalence of excess sugar consumption and obesity rates by searching keywords such as “health”, “obesity” and “sugar consumption”. Lastly, our third group member looked into habit development and behavior of students by searching keywords “children”, “students”, “sugar consumption”, “school” and “habit forming”. Literature was selected on its relevance to our community context and healthy beverage initiatives in general.  Other Secondary Data Source  In addition, our literature review, we used the HBI video that UCSF produced, as well as the UCSF HBI website and UBC HBI proposal provided to us, to review and gain a better understanding of the HBI. Accessing and watching the UCSF HBI video allowed us to develop relevant interview questions and notes on any missing or important information that was crucial for the participant to understand. Knowing the video well also provided us with enough context to understand the specific parts of the video the participants referred to and provide more specific answers when we received questions regarding the video. Also, the Healthy Beverage Initiative page on the UCSF website provided information that the video did not mention. This supplemented our understanding of the UCSF HBI and was helpful when we answered questions from participants that were beyond the scope of the video (UCSF Campus Life Services n.p.).  Laird, Leung, Huang 9   Finally, reading and understanding the proposal for the UBC HBI helped us compare it to the UCSF HBI. Primary Data Collection Research Methods Primary Data  We collected our primary data by conducting 50 face-to-face interviews of 10 minutes in length. We reduced our interview goal to 50 from 100 due to our time constraints. Additionally, we had response rate of 52.08% and conducted approximately 3 interviews per hour. Eligible participants were any undergraduate or graduate students currently enrolled at UBC Vancouver Campus since our research objectives required us to garner the opinion of UBC students specifically. We developed a list of 16 interview questions (Appendix A) and each question was designed to give insight on the participants’ views of either the UCSF HBI video or UCSF HBI and to make finding themes easier. Prior to administering our interviews, we tested the interview on our family and friends and made wording adjustments based on their feedback. Methods of Administration  We administered our interviews through random sampling. Individually, we approached every 5th person who walked through the entrance doors closest to each of the following locations: Honour Roll in AMS Student Nest, Agora Café in MacMillan Building, gift shop in Henry Angus Building, Tim Hortons in Forest Sciences Centre, cafeteria lounge in Buchanan B, Starbucks in Wayne and William White Engineering Building, library in Neville Scarfe Building, cafeteria in Place Vanier Residence Commonsblock, gym in Acadia Park Residence Commonsblock, and Starbucks in UBC Life Building (Appendix B). We picked these locations based on how busy they were and their likelihood to provide a varied student sample. We also  Laird, Leung, Huang 10   interviewed during the mornings, afternoons and evenings of at least one Monday, Tuesday, Wednesday, Thursday, Saturday and Sunday between March 7th and March 21st to provide a random sample (Appendix C). We approached every person following an interview script (Appendix D) and asked them to sign a consent form if they agreed to participate in our interview (Appendix E). We also asked the participants to put their email on the consent form if they wanted to be entered in a raffle draw for one of two $25 UBC Bookstore gift cards provided by SEEDS at the end of our research. The point of including the raffle in the interview process was to provide an incentive for them participating in our research.  After they signed the consent form, we asked a series of demographic questions to better understand them as a student at UBC. Then we asked them to watch the UCSF HBI video and asked questions about their thoughts and opinions of both the UCSF HBI video and UCSF HBI the video talked about. We also asked about their opinions on a HBI at UBC based on the information from the UCSF HBI video. There was an opportunity at the end of the interview for participants to make additional comments not embodied by our previous questions. Throughout the interview, we projected ourselves as friendly and non judgemental. Notes on the body language and/or other observations of the participant were sometimes made throughout the interview to provide additional context. Lastly, all raw data was recorded on an Excel spreadsheet on our personal computers (Appendix F). We did not record any distinguishing information that would affect the confidentiality of our participants and avoided using Google Drive or any other online methods to record data due to privacy and storage issues.  Following the interview, we manually analyzed our data by combining our Excel data on one computer and coded/themed them based on participant demographic, UCSF HBI video opinions, UCSF HBI opinions, and UBC HBI opinions. We used the preliminary questions  Laird, Leung, Huang 11   regarding participants' backgrounds to determine our participant demographic and used our literature review to inform important areas to analyze.  We chose face-to-face interviews as our method of gathering feedback so we as interviewers could record any other observations or notes beyond the questions themselves, or that would be difficult to get electronically. Doing so guaranteed that the participants were able to ask any immediate questions or areas they needed clarification on and allowed us to ask them to elaborate on their responses. The ability to ask follow-up questions enhanced our responses. Furthermore, the ability to visually see reactions to the video provided us with an opportunity to record body language for a better context of student opinions.  Results Literature Review We found literary support to show that excess sugar consumption has negative health effects such as dental caries (Marshall 57) and type 2 diabetes (Hidayat, Khairunnis and Madanijah 441). In addition, there is evidence that overweight and obesity rates are rising worldwide - especially among youth (Raine 3). These rising rates relate to excess calorie consumption from sugars, wherein SSBs are a common source (Dietitians of Canada 3). The National Academies of Sciences, Engineering, and Medicine suggests that reducing or eliminating SSBs consumption by replacing them with water can result in a reduced risk of diseases later in life (2). Also, community members will be more motivated to adopt water consumption if there are safe water sources located on campus (Centers for Disease Control and Prevention n.p.).  Laird, Leung, Huang 12   Interviews Description of Demographic  Based on interview results, a diverse demographic of respondents was obtained. Success rates of number people interviewed compared to number people approached at different locations ranged from 26.67% at Acadia to 75% at UBC Life Building, with an overall interview success rate of 52.08% (Appendix G).  The first years represented 24% of our sample (see fig. 1), with 42% of them being international and 58% being domestic (Appendix H). Only one participant was a graduate student, with the remaining 49 students being undergraduate students.   Fig. 1. Distribution of students’ year standing at UBC.  Most participants represented the Faculties of Arts or Science at 28% and 24% respectively, while a smaller number of students came from Sauder School of Business, Land and Food Systems, and Applied Science (see fig. 2). Forestry and Kinesiology were most underrepresented at only 2% compared to the other faculties.  Laird, Leung, Huang 13    Fig. 2. The proportion of students from various faculties at UBC.  A wide range of programs were mentioned by participants within the Faculty of Arts, Applied Science, Forestry, Kinesiology, Land and Food Systems, Sauder School of Business, and Science (Appendix H). Our UBC student sample was 34% international and 66% domestic (see figure 3). Furthermore, 24% of all participants had a preferred language other than English (see fig. 4). The other languages mentioned as preferred were Mandarin, Cantonese, and Japanese.  Laird, Leung, Huang 14    Fig. 3. Proportion of domestic students interviewed compared to international students.   Fig. 4. The proportion of reported preferred languages.  Questions Regarding UCSF HBI Video  “Good” was the word most often used in response to interview question 8 (Appendix A) with the smallest fonts representing the least often mentioned words (see fig. 5).   Laird, Leung, Huang 15    Fig. 5. A word cloud of the initial thoughts of participants after watching the UCSF HBI video. The size of the word is representative of the number of times it was mentioned in the answer, where the larger words were mentioned more.   We found that 11 participants thought the UCSF HBI video had a clear message, 7 participants said the video was a good length, 19 participants said they enjoyed the statistics and facts provided, and 19 participants enjoyed the animations and visual appeal of the video (see fig. 6).  Laird, Leung, Huang 16    Fig. 6. The parts of the video participants liked and the amount of times each element they liked was mentioned overall. Only 17 of the 50 participants found areas of the HBI video they disliked (see fig. 7). The areas of dislike included the information provided, length and pacing, video “feel”, context, or other.  Fig. 7. The parts of the video participants disliked and the amount of times each element they disliked was mentioned overall.   Laird, Leung, Huang 17   We looked at the effectiveness of the video format as a way to influence thought on consumption habits, a change in consumption habits, and also the ability to spread awareness of the health effects of SSBs. 74% of participants said the video made them reflect on their own consumption habits (Appendix H). Of the 26% who said the video didn’t make them reflect on their own consumption habits, 92% said it was because they already knew the health effects of SSBs consumption and 8% said they liked SSBs too much to care. 60% of participants would not change their consumption habits after watching the video (Appendix H). Of these people, 40% said it’s because they already don’t consume SSBs, 13.3% said the video wasn’t enough to change their consumption habits, and the remaining participants didn’t expand on why. 74% of the participants found the video format an effective format to spread the awareness of the health effects of SSBs. 18% found that a video format is only partially effective, and 8% of the participants said a video format is not an effective format to spread awareness of health effects of SSBs (see fig. 8).  Fig. 8. The effectiveness of the UCSF HBI video as a format to spread awareness of the health effects of SSBs.  Laird, Leung, Huang 18    Several suggestions were made by participants to improve on the video format exemplified by UCSF HBI video. Other formats were also suggested to be used complementary to a video format (see table 1). Table 1 Suggestions for video and other formats to promote a HBI at UBC. Format Suggestions Video - More text to accompany visuals - Add subtitles - More clarity and conciseness of main points - More graphs - More facts contextualized to students in Canada (better yet, UBC students) - Include data from other countries - Real-life examples on a more individualized level in addition to federal level statistics (such as case studies) - More sound effects - List different kinds of sugars - More positive outlook (promoting healthy beverages instead of villainizing sugar and SSBs) - Use celebrities - Make it more entertaining so people don’t zone out Face-To-Face Interactions - In-class presentations - Give leaflets/handouts to students - Events/workshops  Posters/Infographics - Supplementing video with all the information in visual format (so people can refer to it and process the information at their own pace) Social Media Advertisements - PSAs - Advertisements on campus (such as frat parties) and social media (such as Facebook) - Memes as a humorous way to share health effects of SSBs - Compare with other schools in BC Questions Regarding UCSF HBI 28/50 (56%) of UBC students said they liked UCSF replacing SSBs with healthier beverage options, whereas 3/50 (6%) disliked this idea, 17/50 (34%) had speculations, and 2/50 (4%) didn’t know how they felt about it (see fig. 9). Of the people who had speculations, 10/17 (59%) still mentioned they liked the idea.  Laird, Leung, Huang 19    Fig. 9. The categorized responses of UBC students regarding their feelings on UCSF replacing SSBs with healthier beverage options. Questions Regarding a HBI at UBC  62% of all participants said they would support a HBI at UBC, 18% of all participants would partially support a HBI at UBC, and 20% of all participants would not support a HBI at UBC (see fig. 10). Of the people that said they would support a HBI at UBC, 77.4% were not LFS students and 22.6% were LFS students.  Fig. 10. Proportion of students who would either support, partially support, or not support a HBI at UBC.   Laird, Leung, Huang 20   Of the 30% of people that do consume SSBs, 54.29% of students would support a HBI at UBC, 21.71% would partially support it and 24% would not support it (see fig. 11). Also, of the 70% of people who did not mention they don’t consume SSBs, 80% would support a HBI at UBC where 20% would not. 92% of the first years consume SSBs and of these first years, 64% would support a HBI at UBC (Appendix H).  Fig. 11. The relationship between level of support of HBI at UBC and consumption of SSBs. Discussion  Interpretation of Demographic  We attribute the variety of demographic to our random sampling at multiple locations on campus. Firstly, there was a fairly balanced proportion of students representing each year standing from 1st and 4th year standing (see fig. 3). The one anomaly was an undergraduate student claiming 5th year standing at UBC. The interview question of “What year standing are you at UBC?” likely caused confusion among the participant since a student could spend more years at UBC than their year standing. Regardless, our balanced proportions of 22%-28% in 2nd and 4th year standing respectively were helpful in providing balanced feedback from students with varying time remaining at UBC. We looked more deeply into the opinions of students with  Laird, Leung, Huang 21   1st year standing as they were most eager to be interviewed, have the most time remaining at UBC, and have likely the least amount of campus familiarity. Of our 1st year standing sample, we had a nearly halved proportion of international and domestic students (Appendix H). This was favorable in our hope to have as much of an international and domestic student representation as possible. We looked into the proportion of all domestic to international students we interviewed and compared it to the overall proportion of domestic to international students at UBC Vancouver. The proportion of international students that we interviewed was 34% (see fig. 3) compared to the approximately 19% at UBC’s Vancouver campus in 2016/17 (Mathieson and Redish 7). The high international student representation likely related to the preferred languages of our participants (see fig. 4). Lastly, we looked into the faculties and programs of our participants. We found the percentage of participants in each faculty was closely representative of the actual size of the faculty on campus. For example, science and arts are two of the largest faculties on campus, and made up 24% and 28% of our sample respectively (Appendix H). We also had students from 23 different programs (Appendix H) in addition to the 12 undeclared first year students. Although this is not representative of all programs on campus, we found this to be a high variety of student representation for the sample size.  Opinions of UCSF HBI Video Likes of UCSF HBI Video Many participants found the video “interesting” and “clear”, and were left having made the connection that “intake” of “SSBs” was “bad” (see fig. 5). A noticeable amount of participants also mentioned they “already” knew the risks of excess sugar consumption through  Laird, Leung, Huang 22   SSBs intake. Several mentioned they already “don’t” consume SSBs after being exposed to the risks prior to having watched the video. Additionally, a liking to the animations/visual appeal was mentioned 19 times by participants (see fig. 6). They liked how colourful the animations were, the visual representations of the quantities of sugar the video spoke to, and the diverse cultural representation. A liking to the statistics and facts provided was also mentioned 19 times by participants. The facts on sugar and SSBs consumption, the impact of excess sugar consumption on health, body composition, and disease, were all elements that participants remembered after having watched the video. 11 participants also found the video had a clear message and was easy to listen to and stay engaged in watching. Lastly, 7 participants found the length appropriate to express the UCSF HBI context and initiative. However, some of the same elements that participants liked about the video, others disliked. Dislikes of UCSF HBI Video 17 participants (34%) disliked certain elements of the UCSF HBI video compared to 33 participants (66%) that expressed zero dislikes. The dislikes in descending order of frequency were a problem with the information provided, length and pacing, video “feel”, other, and context (see fig. 7). Problems with the information provided meant there was either too much or too little information provided in the video, not enough statistics or graphs or not enough of an explanation on the research studies providing the facts. Problems with the length and pacing were contradictory to the likes of other participants. Some found the length and pacing of the video too long and slow, others too short and fast-paced. The video “feel” was alluded to as either boring, over-dramatic, scary, or musically distasteful. Other dislikes included an unclear message and lack of captions. Lastly, it was mentioned twice that the US context of the video reduced its relevance and validity to them as Canadian students.  Laird, Leung, Huang 23   Influence on Consumption Habits  The video made 74% of participants reflect on their own consumption habits, but failed to influence the remaining 26% (Appendix H). The reasons the video didn’t make them reflect on their own consumption habits were because 92% had already heard of the health effects of SSBs consumption the video talked about, and 8% said their love for consuming SSBs outweighed its health effects. Furthermore, 60% of participants wouldn’t change their consumption habits despite the video influencing an extra 14% to reflect on them (Appendix H). Fortunately, 40% of the people who wouldn’t change their consumption habits already don’t consume SSBs. 13.3% said it was because the video itself wasn’t enough to change their consumption habits. Therefore, changes would need to be made to the video itself, or the format in which the message is spread, for them to make a lifestyle change. Further emphasizing that excess sugar consumption has negative health effects could intensify their understanding of SSBs (Euna and Powell 43). The remaining participants didn’t expand on why they wouldn’t change their consumption habits - expressing that they simply just felt that way. Understanding how effective the video format was as a way to spread the awareness of the health effects of SSBs was helpful in further understanding the ability of the UCSF’s HBI video to influence consumption habits. Effectiveness of Video Format  Directly after watching the UCSF HBI video we asked the participants “Are there any points of the video you need clarification on?” to see how sufficient the video was in providing a clear message. The overwhelming response was “no”, with 9 participants mentioning they needed clarification on the definitions of SSBs,  healthy beverages or specifics of the initiative (Appendix F). In other words, the video was unclear in informing all participants with a clear  Laird, Leung, Huang 24   message. We then asked “What are your initial thoughts about this video?” This question was asked to garner immediate impressions of the video and a generalized interpretation of the video. The intention of asking this question early was to see the initial impact the video had on participants if used as a way to promote the HBI.  The video was an effective format to spread the awareness of the health effects of SSBs to 74% of the participants. The remaining 18% found it was only partially effective and 8% found it not at all effective (see fig. 8). Therefore, there were several suggestions from participants to both adapt the video format, or the format style entirely. The suggestions from the 26% who didn’t find the video an effective format listed their video suggestions and also suggested face-to-face interactions, posters/infographics, and/or social media advertisements as alternative or additional format options (see table 1). These suggestions were used to guide our recommendations for a HBI at UBC. Opinions of UCSF HBI Overall, over half of the participants (56%) liked how UCSF replaced SSBs with healthier beverage options (see fig 9). One claimed it was “a big step for universities…” and others noted it as an effective way to promote a healthier lifestyle in students (Appendix F). Some participants acknowledged it would be a reluctant adjustment, but good for the long-term health of students, thus liking the overall aim of the UCSF HBI. On the other hand, 6% of students did not like UCSF replacing SSBs with healthier beverage options (see fig. 9). These students said they were pro-choice, expanding that having the opportunity to make the healthy choice themselves was better than the complete removal of SSBs. These people were both students who claimed they either regularly consumed SSBs or didn’t often drink SSBs but still enjoyed the ability to “treat” themselves occasionally (Appendix  Laird, Leung, Huang 25   F). The low number of students that did not like the actions of the HBI at UCSF was worth mentioning as it showed that most students were not opposed to the idea of eliminating sales of sugar-sweetened beverages for the betterment of their health. However, there were some notable speculations on the UCSF HBI.  34% of the participants had speculations regarding the HBI at UCSF (see fig. 9). Several had concerns on how they themselves or other students would respond to the complete removal of beverages that students so frequently depend on. Some wondered why diet sodas would still be sold at outlets when they should be considered unhealthy. Others questioned the revenue of sales, brought up environmental concerns regarding plastic water bottles, and found it inapplicable to their geographical context insufficient. It is important to note these speculations were based on only having watched a two minute video regarding the UCSF HBI. Thus, such speculations could likely be resolved with further education on the UCSF HBI. Despite speculations, 58% of these participants still mentioned that they liked the idea of the HBI, which helped us understand that by addressing their concerns mentioned above, we could potentially garner full support from them. Support for a HBI at UBC When asked if the HBI was something the participants would support at UBC, 62% of them answered “yes” (see fig. 10). It was important that of these 62%, 77.4% of them were from a faculty other than Land and Food Systems (LFS). Since LFS students were likely more educated on the effects of sugar and SSBs consumption, having most of the participants from a faculty other than LFS support an HBI at UBC was positive. It showed that students of various educational backgrounds value the goal of a HBI and are willing to support its outcomes.  Laird, Leung, Huang 26   We also looked more specifically into people who claimed they consumed SSBs. We were less concerned with the participants who don’t consume SSBs, as a HBI would not have as large of an effect on them. Of the people who consume SSBs, 54.29% would support a HBI at UBC (see fig. 11). Although these participants were consumers of SSBs, they were still willing to change their consumption habits. Therefore, they would support the initiative on campus on the basis of just having watched the UCSF HBI video. Also, we were impressed that 64% of the 92% of first years that consume SSBs would support a HBI at UBC. The students interviewed gave reasons to support a HBI at UBC as an opportunity for themselves or others to form healthier lifestyle habits. As for the 20% of students who would not support the HBI at UBC, they valued choice and moderation over complete elimination of SSBs. One participant found the HBI too extreme, others were simply worried about the negative outcry of students. Also, the effectiveness of the initiative was questioned, namely, the dietary changes could only be made to campus and not other locations the students may frequent. Finally, the 18% of participants who said they would partially support a HBI at UBC provided conditions which could render complete support. These conditions included changes to the initiative that will be discussed further in our recommendations. The level of support could be improved by addressing major participant concerns and misconceptions. Major Concerns and Misconceptions  The exposure of participants to the UCSF HBI video was short and prompted several questions regarding its purpose, context and outcomes. One concern was the lack of choice if implemented at UBC, where the misconception was that students couldn’t still consume SSBs. However, the UCSF HBI video clarified that students could still bring SSBs to campus and was  Laird, Leung, Huang 27   the example made for a HBI at UBC (Healthy Schools BC n.p.). Another concern surrounded plastic bottle usage and its effect on the environment. Although not a direct aim of the UCSF HBI, the video did clarify its support of tap water over any other beverage type. Thus, the misconception was that reducing plastic bottle waste would not be addressed by implementing a HBI at UBC. However, providing safe water sources will address this issue by providing a safe and accessible alternative to water bottles (Centers for Disease Control and Prevention n.p.). Finally, there were concerns on keeping diet sodas as a beverage option. The misconception was that they thought by diet sodas not being eliminated, they were then promoted as a healthy beverage options on campus. However, the initiative aimed to promote tap water over all other beverage options and diet sodas were not a source of added sugar like the SSBs. In other words, SSBs are targeted due to their sugar content, which diet drinks do not contain (Dietitians of Canada 3). The nature of the study likely influenced other concerns and misconceptions that were only mentioned once. Interview Limitations Since participants were only given the information provided in the UCSF HBI video, there may be some information that did not properly get across to the participants - leading to concerns and misconceptions of the HBI. Although participants did have the opportunity to ask questions throughout and following the interview, most of the participants noted that they did not require any further clarifications. This could be due to the several factors such as the participant’s willingness to have a discussion, misunderstanding of the purpose of our study, timeliness of the interview, or comfort level. More importantly, the questions themselves could have influenced participant responses.  Laird, Leung, Huang 28    We didn’t ask certain questions in our interview, that if included, could have improved our qualitative results. Firstly, we didn’t ask the participants specifically if they consumed SSBs or didn’t consume SSBs prior to the interview. Therefore, we could only generate an understanding about their consuming of SSBs if they explicitly offered that information in their interview responses. If we had asked this question, we could have better interpreted how influential the video itself was in spreading the message of the health effects of SSBs to change consumption habits by decreasing their consumption. Secondly, we also didn’t ask a question pertaining to whether the student lived on or off campus. This would have been helpful in better understanding the breadth of potential influence a HBI at UBC would have. In our interviews, a point was made by a participant that they commute to UBC. They don’t consume SSBs on campus, but consume a lot when they go home. Therefore, they exposed the question of how influential an HBI at UBC would be to ultimately change lifestyle habits if only the campus itself lacks access to SSBs. Additionally, the initiative could have a greater effect on those students who live on campus. This is why we looked into the opinions of first years more deeply and targeted on-campus residences for interviews. Despite targeting multiple locations, we still could have gathered a more representative UBC student sample.  We could have improved on our sample variation by increasing the number of interviews, thereby increasing the likelihood that our random sample encompassed more of the UBC student body. The time spent approaching potential participants at random was longer than expected. Also, the success of interviews influenced the number of people we were able to include in our study. For these reasons, we had to limit the number of interviews we did to 50 instead of the originally anticipated 100. Given more time and a higher number of success interviews, we could  Laird, Leung, Huang 29   have gathered more of a representative sample of other faculties, programs, and graduate students specifically. Our data analysis process added to our time constraints. We also spent a lot of time on data analysis since all themes and relationships were found manually. In face-to-face interviews, we generated a lot of qualitative results that required a lot of interpretation. These interpretations were also made by us as researchers and may have had an influence on the results we concluded. The rejection rate was relatively high (48%), which may have influenced how random our sample truly was since the people who we interviewed were those most interested in the research topic. However, the fact that all of our interviews were face-to-face added quality to the results that other methods may not have encompassed. Recommendations and Conclusion Recommendations for Future Research Format for HBI Awareness  Many aspects of the UCSF video could be adapted for a HBI at UBC. Changes could include the pacing, amount of information provided, and overall tone. From our interviews, we found these aspects were of the biggest problems participants had regarding the UCSF HBI video. Having a variety of videos that vary in length, style, and content would cater to the feedback. Further research could be done by experts in marketing to effectively and efficiently relay the details of the HBI through a video a compelling manner. Ultimately, the video should refer to a resource whereby students could learn more information on the HBI. A HBI at UBC As an initiative that plans to eliminate the sales of SSBs, further research needs to be done to investigate how sugar can be targeted and perceived by others. It was discovered from  Laird, Leung, Huang 30   our interviews that the statistics in the UCSF HBI video scared some students into wanting to cut back sugar, but they were unclear on how. More specifically, the video referenced overall sugar consumption and one participant thought this meant she also needed to cut back on her fruit intake. We recommend nutrition students from the Food, Nutrition, and Health program or future LFS 450 students at UBC to do some research on how other dietary changes could support the overall goal of the HBI. As participants questioned whether sugar should be villainized, methods on how sugar should be portrayed in the initiative is important in addition to other healthy lifestyle changes. Methods on effectively providing ample information to the UBC students, staff, and faculty members needs to be looked at for HBI support. Since many of the participants responded that they would not support the initiative for their concerns and misconceptions, providing clarity regarding some points of the UCSF HBI video is an important consideration  for the stakeholders to address. Recommendations for Action and Implementation Wellbeing and Student Housing and Hospitality Services Stakeholders As mentioned previously, a video format is an effective method to promote an HBI at UBC. Therefore, we recommend our stakeholders find a team to produce a video while considering the attributes of a video previously mentioned and working in partnership with media experts. In addition, adding multi-language subtitles to the UBC HBI video is recommended to quickly and directly spread the awareness of HBI. As 24% of our participants had a preferred language that was not English, adding the subtitles could engage all students to watch it and make it easier for them to understand the initiative. Other formats could support this understanding of a HBI, especially if used complementary to a video format.  Laird, Leung, Huang 31    Using some additional methods such as social media advertisements, posters, infographics and face-to-face interactions were suggestions of the participants (see table 1). These complementary methods could also be used as a way to reference the video and other information online. Given the concerns and misconceptions on the HBI and the number of participants who wouldn’t fully support a HBI at UBC, we also recommend having educators and students hold face-to-face workshops or events that could educate other students and members. Workshops and events can elaborate on the adverse health effects of excessive sugar consumption, the benefits of tap water consumption and the HBI itself to help them become more capable of choosing healthy beverage options and familiarize them to the initiative. An important objective of the workshops or events should be to provide definitions of SSBs and healthier beverage options. Differentiating between sodas and diet sodas, and milk and 100% fruit juices versus water would also be helpful. Involving all members of the community in the initiative process could prevent the negative student outcry mentioned in our interviews. Also, further consultation of students would help in supporting our research findings. UBC Building Operations and Sustainable + Engineering To create a healthy campus environment, we suggest the UBC Building Operations works with Sustainable Engineering to implement sustainable water sources. The objective of implementing a HBI is to reduce sugar consumption and encourage healthy beverage options that do not contain added sugar. Therefore, water is the healthiest choice for this initiative. Since SSBs are removed, promoting tap water would be more successful if students had a safe and convenient source to access it. Based on our literature review, there are many ways for students to access water, such as using disposable cups, refillable bottles and also purchasing water   Laird, Leung, Huang 32   (“Understanding Provision” 4). If the UBC Building Operations builds more filtered water fountains with the support of Sustainable Engineering, the usage of disposable plastic bottles would also be reduced. Water fountains are currently hard to find around the campus and so adding more convenient healthy beverage options would increase the likelihood that all community members make the healthier choice (Campus + Community Planning). Conclusion • We gathered opinions of UCSF HBI and their promotional video by interviewing 50 random UBC students for 10 minutes each • The majority of students interviewed would support a HBI at UBC ● A video format is effective in spreading the awareness of the health effects of SSBs ● Clear initiative outcomes should be outlined to best inform decision making ○ Having nutrition students or future LFS 450 students research sugar as the target for a HBI and other potential dietary changes could empower healthy lifestyle changes beyond just SSBs ○ Framing the initiative in a positive manner (i.e. promoting tap water consumption instead of reducing sugar consumption) could aid in clarifying the concerns and misconceptions of UBC students ● Those implementing the HBI at UBC should partner with UBC Building Operations and Sustainable Engineering to install more filtered water fountains on campus ○ Doing this will make the healthier choice more convenient and more likely ● Stakeholders should create a HBI video with the support of marketing and media experts and consider the suggestions of interview participants when creating a HBI at UBC  Laird, Leung, Huang 33   ○ Adding subtitles is important for video clarity and to cater to UBC’s cultural diversity ○ The video should inform key elements of the HBI, while maintaining the attention of UBC students as the main audience and directing them to further information online ● Use a complementary method to the video to best support a HBI at UBC ○ Social media advertisements, posters, infographics, and face-to-face interactions were suggested by interview participants ○ It is important to refer to a location, preferably online, where community members can access more information on the HBI ● Pre-initiative is important for HBI success at UBC ○ Educating community members prior to complete implementation can provide them with another opportunity to share their opinions and suggestions ○ Involve students in the process ○ Have educators and students hold face-to-face workshops or events to educate community members on the effects of excessive sugar consumption, the benefits of tap water consumption and specifics of the HBI ■ Clarify HBI objectives and definitions such as SSBs and healthier beverage options - making it clear that water is the best choice ■ Ensure students understand the university doesn't wish to profit from the sales of SSBs and their tuition will not be affected     Laird, Leung, Huang 34   Appendices Appendix A: Interview Questions 1. Are you a graduate or undergraduate student? 2. What year standing are you at UBC? 3. Which faculty are you primarily associated with? 4. What program are you in at UBC? 5. Are you a domestic or international student? 6. What language do you prefer to communicate in? [watched UCSF HBI video] 7. Are there any points of the video you need clarification on? 8. What are your initial thoughts about this video? 9. Was there something in the video in particular that you liked? 10. Was there something in the video in particular that you disliked? 11. Was there a part of the video that made you reflect on your own consumption habits? 12.  a. Is there something you would change about your consumption habits after watching the video? b. What is the change and what prompted the change? 13. How do you feel about UCSF replacing SSBs with healthier beverage options? 14.  a. How effective was the video format as a way to spread the awareness of the health effects of SSBs? b. What other formats do you see as being more effective? 15.  a. Would this be an initiative that you’d support at UBC?  (YES) What specifically about this initiative do you support? b. (NO) What concerns do you have about this initiative? 16. Do you have any other thoughts or comments or questions about the video? [space for additional notes]   Laird, Leung, Huang 35   Appendix B: Map of Interview Locations on UBC Vancouver Campus  Fig. 1. The interview locations are starred in red.   Laird, Leung, Huang 36   Appendix C: Recorded Location, Date and Time of Interviews  Fig. 1. Recorded dates and times at each interview location.     Laird, Leung, Huang 37   Appendix D: Interview Script  hi there, are you a student at UBC? I am from LFS450 and I am conducting an interview asking for opinions on sugar sweetened beverages. Do you have time to watch a 2 minute video and answering some questions regarding the video for a chance to win one of two $25 UBC bookstore gift cards? Before starting the interview, I would like to ask you to sign this consent form for ethical purposes. Please read the form over and sign your name at the bottom. If you would like a chance to win one of two $25 UBC bookstore gift cards,  please write your email next to your name (If they ask about the consent form): the consent form is a course-based research project procedure  to ensure confidentiality on your answers and to ensure you stay anonymous. I will need your consent before proceeding with the interview. Fig. 1. Script used when we conducted interviews.    Laird, Leung, Huang 38   Appendix E: Consent Form Fig. 1. Page one of three of the consent form given to all participants.  Laird, Leung, Huang 39    Fig. 2. Page two of three of the consent form given to all participants.  Laird, Leung, Huang 40    Fig. 3. Page three of three of the consent form given to all participants.    Laird, Leung, Huang 41   Appendix F: Raw Interview Data  Fig. 2. Raw data from interview questions asked before participants watched the UCSF HBI video.  Laird, Leung, Huang 42    Fig. 3. Raw data from interview question 7.  Laird, Leung, Huang 43    Fig. 4. Raw data from interview question 8.   Laird, Leung, Huang 44     Fig. 5. Raw data from interview question 9.    Laird, Leung, Huang 45    Fig. 6. Raw data from interview question 10.   Laird, Leung, Huang 46    Fig. 7. Raw data from interview question 11.  Laird, Leung, Huang 47     Fig. 8. Raw data from interview question 12a.  Laird, Leung, Huang 48    Fig. 9. Raw data from interview question 12b.  Laird, Leung, Huang 49    Fig. 10. Raw data from interview question 13.  Laird, Leung, Huang 50    Fig. 11. Raw data from interview question 14a.    Laird, Leung, Huang 51    Fig. 12. Raw data from interview question 14b.    Laird, Leung, Huang 52    Fig. 13. Raw data from interview question 15a.    Laird, Leung, Huang 53    Fig. 14. Raw data from interview question 15b.  Laird, Leung, Huang 54    Fig. 15. Raw data from interview question 16.   Laird, Leung, Huang 55    Fig. 16. Additional notes on participants that could have affected their responses.  Laird, Leung, Huang 56   Appendix G: Interview Success  Fig. 1. The number of people approached at each interview location versus the number of people successfully interviewed.   Laird, Leung, Huang 57   Table 1 The count and success rate of interviews conducted at each location on UBC campus. Interview Location Number Approached Number Interviewed Success Rate (%) AMS Student Nest 10 5 50.00 Agora Café 11 6 54.55 Henry Angus Building 7 5 71.43 Forest Sciences Centre 9 5 55.56 Buchanan B 13 6 46.15 Wayne and William White Engineering Design Centre 8 4 50.00 Neville Scarfe Building 8 5 62.50 Place Vanier Residence Commonsblock 7 4 57.14 Acadia Park Residence Commonsblock 15 4 26.67 UBC Life Building 8 6 75.00 Total 96 50 52.08    Laird, Leung, Huang 58   Appendix H: Additional Interview Data Table 1 Amount of international and domestic students with first year standing at UBC. First Years (n=12) Count Frequency Frequency Percentage International 5 5/12 42% Domestic 7 7/12 58%  Table 2 The number of students in their self-reported faculty and program at UBC. Faculty Program Count Frequency Frequency Percentage Arts (n=14) Undeclared 2 2/14 14.286% Exchange Student 1 1/14 7.143% Anthropology 1 1/14 7.143% Psychology 3 3/14 21.429% Chinese Literature 1 1/14 7.143% Asian Studies 3 3/14 21.429% Human Geography 1 1/14 7.143% Sociology 1 1/14 7.143% Human Geography and Psychology 1 1/14 7.143% Applied Science (n=5) Engineering 5 5/5 100% Forestry (n=1) Master of Forestry 1 1/1 100% Kinesiology (n=1) Kinesiology 1 1/1 100%  Undeclared 1 1/8 12.5%  Laird, Leung, Huang 59   Land and Food Systems (n=8) Nutritional Sciences 1 1/8 12.5% Global Resource Systems 4 4/8 50% Applied Animal Biology 1 1/8 12.5% Food Nutrition and Health 1 1/8 12.5% Sauder School of Business (n=9) Undeclared 3 3/9 33.333% Marketing 1 1/9 11.111% Commerce 4 4/9 44.444% Finance 1 1/9 11.111% Science (n=12) Undeclared 6 6/12 50% Honours Animal Biology 1 1/12 8.333% Geological Sciences 2 2/12 16.667 Computer Science 1 1/12 8.333% Cognitive Systems 1 1/12 8.333% Integrated Sciences 1 1/12 8.333%  Table 3 Number of participants that reflected on their own consumption habits after watching the UCSF HBI video. Reflect on Consumption Habits Count Frequency Frequency Percentage Yes 37 37/50 74% No 13 13/50 26%   Laird, Leung, Huang 60   Table 4 Number of participants that said the UCSF HBI video prompted them to change their consumption habits. Would Change Consumption Habits Count Frequency Frequency Percentage Yes 16 16/50 32% Maybe 4 4/50 8% No 30 30/50 60%    Laird, Leung, Huang 61   Works Cited Campus + Community Planning. Bottled Water-Free UBC? 2013. Web. 10 Apr. 2018. Centers for Disease Control and Prevention. "Get the Facts: Sugar-Sweetened Beverages and  Consumption." Nutrition. 2017. Web. 28 Jan. 2018. Dietitians of Canada. Position Paper. DC, 2016. PDF. 10 Feb. 2018 Euna, Han, Powell, Lisa M. "Consumption Pattern of Sugar-Sweetened Beverages in the United  States." Journal of the Academy of Nutrition and Dietetics, vol. 113, no.1, 2013, pp.  43-53. Healthy Schools BC. Comprehensive School Health Knowledge Guide. n.d. British Columbia. Heart and Stroke Foundation. Position Statement. HSF, 2017. PDF. 07 Apr. 2018. James, Carrie, Rideout, Candice. “Sociodemographic Predictors of University Students’ Food  Insecurity: Insights from a Large University in Canada.”  UBC Social Ecological  Economic Development Studies (SEEDS) Student Report. 2017. PDF. 28 Jan. 2018. Hidayat Syarief, Khairunnis, Nova, and Siti Madanijah. "Association between Smoking Habits, Physical Activity, Added Sugar Consumption and Nutritional Status with Malondialdehyde (MDA) and Glucose Levels in Adults." Pakistan Journal of Nutrition, vol. 15, no. 5, 2016, pp. 439-445. Marshall, Teresa A. "Low Intake of Sugars May Reduce Risk of Dental Caries." The Journal of  Evidence-Based Dental Practice, vol. 14, no. 2, 2014, pp. 56-58. Ministry of Education. Guidelines for Food and Beverage Sales in BC Schools. 2013,  http://www2.gov.bc.ca/assets/gov/education/administration/kindergarten-to-grade- 12/healthyschools/2013_food_guidelines.pdf. National Academies of Sciences, Engineering, and Medicine. “Strategies to Limit   Laird, Leung, Huang 62   Sugar-Sweetened Beverage Consumption in Young Children: Proceedings of a workshop -- In Brief." The National Academy Press, 2017. Web. 28 Jan. 2018. Parr, Andrew, Toor, Kavie. “Proposal: UBC Healthy Beverage Initiative.” University of British          Columbia. 2017. PDF. 28 Jan. 2018. Raine, Kim D. Overweight and Obesity in Canada: A Population Health Perspective. Ottawa: Canadian Institute for Health Information, 2004. UBC Summon. Web. 10 Feb. 2018. Mathieson, Cynthia, Redish, Angela. “2016/17 Annual Report on Enrolment”. University of   British Columbia. 2017. PDF. 1 Apr. 2018. UBC Wellbeing. “UBC Action Framework for a Nutritionally Sound Campus”. 2017. PDF. 28  Jan. 2018 UC San Francisco (UCSF). “UCSF Healthy Beverage Initiative.” Youtube, 28, May 2015. Web. 28 Jan. 2018.  UCSF Campus Life Service. “Healthy Beverage Initiative FAQ” n.d. Web. 31 Mar. 2018. “Understanding Provision, Usage and Perceptions of Free Drinking Water to the Public in the   UK.”  Centre for Social Innovation. 2017. PDF. 10 Apr. 2018. Vanderlee, Lana, et al. "Sugar‐Sweetened Beverage Consumption among a  Subset of Canadian Youth." Journal of School Health, vol. 84, no. 3, 2014, pp. 168-176.   Healthy Beverage InitiativeGroup 5 - Marika Laird, Renee Huang, Tracy LeungAgendaBackground Context- Project Description- Literary SupportOur Research- Goal- Objectives- Methods- ResultsPreliminary Recommendations- Potential Actions- Potential ResearchBackground/ContextProject DescriptionUCSF HBI - 2 Minute Video- Discussed consequences of sugar consumption- Eliminated sugar-sweetened beverages (SSBs)- Replaced SSBs by selling only zero-calorie waters, plain milk, coffee, tea, diet beverages and 100% pure fruit juices- Implemented “Smart Choice”Sugar-Sweetened BeveragesHealthier Beverage OptionsNO CALORIC SWEETENERS 100% PURE FRUIT JUICESDIET ONLYUBCUBC HBIStakeholdersStudent-Lead Research ProjectsBenefits of UBC HBIü Improved short- and long-term health and wellbeing of each UBC community memberüProvides an opportunity for UBC to work towards becoming a wellbeing promoting institution➔ Consumption of SSBs has positiveassociations with body weight and risk of obesity and negative associations with intake of important micronutrients (Euna and Powell 43)➔ Dhillon’s study on 11,000 students in BC concluded that availability of unhealthy foods was linked to higher consumption of these foods (n.p.)Literary Support➔ Potentially lead to health problems in the future, such as body weight issues, dental caries, type 2 diabetes, and cardiovascular disease (Euna and Powell 43)➔ Young adults are impressionable and encouraging tap water in place of SSBs in school settings can help form healthy habits, even later in life outside of school (Parr and Toor 2)➔ Reducing or eliminating SSB consumption and replacing it with water consumption can result in a reduced risk of diseases later in life (National Academies of Sciences, Engineering, and Medicine 2)Literary Support➔ Students’ dietary intakes improved when access to healthy foods at school increased (Mansfield and Savaiano 543)Our ResearchResearch GoalTo obtain UBC student feedback on the healthy beverage initiative (HBI) implemented at the University of California - San Francisco (UCSF) by evaluating a video UCSF created for their HBI.1. Identify student attitudes and perceptions towards UCSF’s HBI video and SSBs in general.2. To develop recommendationsto inform the implementation of a HBI at UBC.Research ObjectivesResearch Methods (Literature Review)What? Our individual papers and the confidential document provided by our stakeholdersWho? Us and our stakeholdersWhen? Prior to interviewingWhy? To help us make preliminary recommendationsResearch Methods (Interviews)What? Community-Based Action Research -InterviewsWho? 50 undergrad/grad UBC students from various faculties and programsHow? Approached every 5th person near the front doors of each locationShowed HBI video by UCSFAsked 16 questions totalRecorded answers in Excel spreadsheet on personal computersManually analyzed and coded dataWhy? Locations were picked to accommodate variety of UBC studentsInterviews held to obtain student feedback and concernsWhere?Questions (pre-video)1. Are you a graduate or undergraduate student?2. What year standing are you in at UBC?3. Which faculty are you primarily associated with?4. What program are you in at UBC?5. Are you a domestic or international student?6. What language do you prefer to communicate in?Questions (post-video)7. Are there any points of the video you need clarification on?8. What are your thoughts about this video?9. Was there something in the video in particular that you liked?10. Was there something in the video in particular that you disliked?11. Was there a part of the video that made you reflect on your own consumption habits?12. a) Is there something you would change about your consumption habits after watching the video? b) What is the change and what prompted the change?13. How do you feel about UCSF replacing SSBs with healthier beverage options?14. a) How effective was the video format as a way to spread the awareness of the health effects of SSBs?b) What other formats do you see as being more effective?7. a) Would this be an initiative that you’d support at UBC? (YES) What specifically about this initiative do you support? b) (NO) What concerns do you have about this initiative?8. Do you have any other thoughts or comments or questions about the video?[space for miscellaneous information about the interviewee]52% SUCCESS RATE 3 interviews/hour“8. What are your initial thoughts about the video?Research Results“9. Was there something in the video in particular that you liked?Research ResultsClarityStatistics/FactsLengthAnimations/Visual Appeal“10. Was there something in the video in particular that you disliked?Research Results“16. Would this be an initiative that you’d support at UBC? (YES) What specifically about this initiative do you support? (NO) What concerns do you have about this initiative?Research ResultsYES PARTIALLY NO62% 18% 20%“16. Would this be an initiative that you’d support at UBC? (YES) What specifically about this initiative do you support? (NO) What concerns do you have about this initiative?Research ResultsYES PARTIALLY NO62% 18% 20%77.4% were NOT LFS studentsPreliminary RecommendationsPotential ActionsKEEP IMPROVEü Video formatü Statistics, facts and animations in videoü Move forward with HBI at UBCü Choice to still bring own beverages on campusü Students involved in the implementation process• Need additional formats to compliment video• Add subtitles• Clear promotion of water over diet beverages, milk and 100% fruit juices• Improved pre-initiative for better education on initiative purpose• Clarify that cost for students won’t be affectedShould we be targeting/villainizing sugar?Plastic bottles                  filtered water fountains/sourcesThe relationship between “diet” beverages and healthPotential ResearchConclusion- Gathered opinions of UCSF video and UCSF HBI by interviewing 50 random UBC students for 10 minutes each- Video format is effective but additional formats required- Majority of students interviewed would support HBI at UBC- More research and actions are necessary to address student concernsQUESTIONS/COMMENTS?Burns, Janice C., Cooke, Deanna Y., Sweidler, Christine. “A Short Guide to Community Based Participatory Action Research.” Healthy City, 2011. Web. 28 Jan. 2018.Dhillon, Sunny. "UBC study links access to sugary drinks to student obesity" Globe & Mail (Toronto, Canada), 2014, pp. A7.Euna, Han, Powell, Lisa M. "Consumption Pattern of Sugar-Sweetened Beverages in the United States." Journal of theAcademy of Nutrition and Dietetics, vol. 113, no.1, 2013, pp. 43-53.Mansfield, Jennifer L., and Dennis A. Savaiano. "Effect of School Wellness Policies and the Healthy, Hunger-Free Kids Acton Food-Consumption Behaviors of Students, 2006–2016: A Systematic Review."Nutrition Reviews, vol. 75, no. 7, 2017, pp. 533-552.National Academies of Sciences, Engineering, and Medicine. “Strategies to Limit Sugar-Sweetened Beverage Consumptionin Young Children: Proceedings of a workshop -- In Brief." The National Academy Press, 2017. Web. 28 Jan. 2018.Parr, Andrew, Toor, Kavie. “Proposal: UBC Healthy Beverage Initiative.” University of British Columbia. 2017. PDF. 28 Jan. 2018.Works Cited

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