Project Grant R01MD021373

The National Institute for Minority Health and Health Disparities awarded the University of Virginia $806,797 on September 1, 2026, under the Minority Health and Health Disparities Research program (CFDA 93.307) to conduct a hybrid type 3 effectiveness-implementation trial of Kids SipSmarter, a school-based behavioral and health literacy intervention targeting sugar-sweetened beverage consumption among middle school students and caregivers in rural Appalachia.

The project will execute in two phases over a period of performance through March 31, 2031, with place of performance in Charlottesville, Virginia. Phase 1 employs human-centered design to understand teachers' needs and experiences and guide development of automated bundled implementation strategies for Kids SipSmarter. Phase 2 is a cluster adaptive randomized trial across 60 rural Appalachian middle schools designed to evaluate the intervention's implementation strategies and outcomes. All schools will receive an automated bundle including an intervention action plan for fidelity-consistent modifications, teacher-specific fidelity benchmarks, web-based teacher training, fidelity monitoring with feedback, and reminders. Schools unable to achieve fidelity benchmarks (defined as greater than 80 percent of targets) with the automated bundle alone will receive adaptive precision human-supported facilitation strategies tested within the trial. The project is guided by the Integrated Promoting Action on Research Implementation in Health Services framework and builds from prior success of Kids SipSmarter in Appalachian middle schools in reducing sugar-sweetened beverage consumption.