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Publication A Discursive Evolution: Trade Publications Explain News Deserts to United States Journalists(Cogitatio Press, 2023-09-28) Ferrucci, Patrick; Finneman, Teri; Heckman, Meg; Walck, Pamela E.Although diminishing newsrooms—and gaping holes in community news coverage—have been acknowledged in the US for over a decade, the term “news desert” did not widely emerge in discourse among industry professionals to refer to places that lacked news outlets until the fall of 2018. While much work in various disciplines, including journalism studies, aims to uncover the causes behind news deserts and the effects of their proliferation, scant research attempts to understand how journalists themselves see these issues. Utilizing metajournalistic discourse analysis of journalism trade magazines, this study examined seven publications and found 97 articles published between January 1, 2017, and September 30, 2022, that used the term “news desert.” The aim is to understand how industry insiders constructed the concept and explained the repercussions of the phenomenon to other journalists. This has broader implications for understanding how journalism as an interpretive community constructs the field and the issues confronting it, particularly in times of crisis. This study found that industry leaders cannot agree on a clear definition of news deserts, have only recently begun to acknowledge the ethnic and socioeconomic communities most affected by a lack of news coverage, and rarely articulate, beyond generalities, the effects news deserts have on citizens. These results are then considered through the lens of journalistic reflexivity, national audience response, and potential solutions.Publication International migrants and coronavirus disease 2019 vaccinations: Social Media, motivated information management, and vaccination willingness(SAGE Publications, 2022-09-22) Seo, Hyunjin; Liu, Yuchen; Ittefaq, Muhammad; Shayesteh, Fatemeh; Kamanga, Ursula; Baines, AnnaliseObjective This study examines how those who were born outside the United States and migrated to the country in the past decade used social media and other online sites to deal with uncertainties around the coronavirus disease 2019 pandemic. In particular, we examine how they used digital communication technologies to tap into online resources and social connections both in the United States and their origin country and how various aspects of online information management were associated with their willingness to get vaccinated against the virus. Method We conducted an online survey and in-depth interviews with international migrants aged 18–64 years who moved to the United States in 2011 or later and were living in two neighboring states in the US Midwest as of spring 2021. Since this research involves understanding how these international migrants dealt with uncertainties related to coronavirus disease 2019 vaccinations, we collected the survey and interview data when each state had a vaccination rate of less than 10% and very limited vaccination eligibility for those aged 64 years and below. Results Our results show that international migrants” perceived uncertainty, positive and negative emotions, efficacy, and outcome expectancy affect their information seeking related to the coronavirus disease 2019 vaccination. In addition, issue salience moderates the effect between information seeking and vaccine willingness. Conclusion This research provides relevant and timely scholarly and policy implications that help advance research in this area and better support international migrant communities during public health crises such as the coronavirus disease 2019 pandemic.Publication Knowledge overconfidence is associated with anti-consensus views on controversial scientific issues(American Association for the Advancement of Science, 2022-07-20) Light, Nicholas; Fernbach, Philip M.; Rabb, Nathaniel; Geana, Mugur V.; Sloman, Steven A.Public attitudes that are in opposition to scientific consensus can be disastrous and include rejection of vaccines and opposition to climate change mitigation policies. Five studies examine the interrelationships between opposition to expert consensus on controversial scientific issues, how much people actually know about these issues, and how much they think they know. Across seven critical issues that enjoy substantial scientific consensus, as well as attitudes toward COVID-19 vaccines and mitigation measures like mask wearing and social distancing, results indicate that those with the highest levels of opposition have the lowest levels of objective knowledge but the highest levels of subjective knowledge. Implications for scientists, policymakers, and science communicators are discussed.Publication ‘Outdated and Anachronistic, but That’s Part of the Fun’: Faculty Attitudes and Beliefs Regarding Academic Dress at a Second Land-Grant University(New Prairie Press, 2020-10-21) Wolgast, Stephen L.; Everett, Michael W.This research sought to understand attitudes and behaviours of faculty at Kansas State University and used a previous research study, at Michigan State University, to validate the instrumentation developed while comparing and contrasting results between two Land-Grant institutions. Results of this study indicated consistent trends when comparing both of the Land-Grant universities about faculty attitude and behaviour. Due to the varied results between Kansas State and Michigan State in this study, the authors suggest further replication of the survey instrument at other Land-Grant institutions. This study builds on previous research suggesting that compelling evidence exists indicating that here are many individuals interested in the continued use of academic dress at Land-Grant universities.Publication A health/media literacy intervention improves adults’ interpretations of sugar-sweetened beverage advertising(National Association for Media Literacy Education, 2020-04-28) Chen, Yvonnes; Porter, Kathleen J.; You, Wen; Estabrooks, Paul; Zoellner, Jamie M.Although excessive sugar-sweetened beverages (SSB) intake is linked to numerous adverse health consequences, media literacy interventions rarely address the influences of food and beverage marketing with a specific focus on adults. This randomized controlled trial study investigated (1) whether media literacy education modifies adults’ perceptions of SSB advertising and (2) whether changes are moderated by health literacy. Results from the multilevel mixed-effects regression analyses with the intention-to-treat last-observation-carried-forward method showed that compared to MoveMore (a matched-contact comparison condition), SIPsmartER (an intervention condition) participants significantly enhanced their skillsets across media literacy domains (i.e., authors/audiences, messages/meanings, representation/reality) between baseline and 6-month follow-up. Baseline health literacy status did not moderate media literacy outcomes. Both low and high health literate participants improved their outcomes, suggesting that this media literacy intervention benefited adults regardless of their health literacy level. Results demonstrate the importance of cultivating critical analyses and strengthening adults’ resistance toward SSB advertising.Publication A Little Bit of That from One of Your Grandparents: Interpreting Others’ Direct-to-Consumer Genetic Ancestry Results(MDPI, 2020-04-30) Bobkowski, Piotr S.; Watson, John C.; Aromona, Olushola O.With more than 25 million tests sold by early 2019, direct-to-consumer genetic ancestry tests expose the public to critical issues of genetics, ancestry, and identity. This study examines how individuals understand the results of a genetic ancestry test. Twenty undergraduate students viewed and interpreted an unfamiliar individual’s ancestry results. In in-depth interviews, students indicated that the results were easy to read and understand, but that they had difficulty articulating the meaning of the ancestry groups presented in the results. Participants could not accurately paraphrase the test’s scientific explanation. Those who engaged with the scientific explanation developed doubts about the test’s credibility. There was little consensus about the legitimacy of identity claims from low-proportion ancestry groups. Some students reserved judgment while others identified specific thresholds for what ancestry proportions legitimize identity claims. Results contribute to the literature on the public’s understanding of ancestry, genetics, and data interpretation.Publication Digital divide and marginalized women during COVID-19: a study of women recently released from prison(2021) Seo, HyunjinABSTRACT The COVID-19 pandemic has underscored the urgency to bridge the digital divide, as those without reliable internet, adequate devices, and digital literacy skills were severely disadvantaged when most essential activities moved online. This study examines how the pandemic has affected women recently released from jail or prison, a group that was already at a disadvantage in terms of digital access and skills even before the pandemic. Our interviews with 45 women in transition show that their lack of stable access to the internet and digital devices during the pandemic influenced their post-incarceration supervision requirements, job applications, educational opportunities, and others. These women navigated the challenges by working with their social connections (e.g., friends and neighbors) and relying on emergency resources deployed by local institutions during the pandemic. Those staying in transitional houses before being fully released into communities indicated that they often depended on facility staff or family/friends in the community for pandemic-related information due to their limited access to the internet in those facilities. These and other findings from this research provide insights into the technological challenges and needs of marginalized women during the public health crisis.Publication Informal Technology Education for Women Transitioning from Incarceration(ACM Transactions on Computing Education, 2021) Seo, HyunjinAs society increasingly relies on digital technologies in many different aspects, those who lack relevant access and skills are lagging increasingly behind. Among the underserved groups disproportionately affected by the digital divide are women who are transitioning from incarceration and seeking to reenter the workforce outside the carceral system (women-in-transition). Women-in-transition rarely have been exposed to sound technology education, as they have generally been isolated from the digital environment while in incarceration. Furthermore, while women have become the fastest-growing segment of the incarcerated population in the United States in recent decades, prison education and reentry programs are still not well adjusted for them. Most programs are mainly designed for the dominant male population. Consequently, women-in-transition face significant post-incarceration challenges in accessing and using relevant digital technologies and thus have added difficulties in entering or reentering the workforce. Against this backdrop, our multi-disciplinary research team has conducted empirical research as part of technology education offered to women-in-transition in the Midwest. In this article, we report results from our interviews with 75 women-in-transition in the Midwest that were conducted to develop a tailored technology education program for the women. More than half of the participants in our study are women of color and face precarious housing and financial situations. Then, we discuss principles that we adopted in developing our education program for the marginalized women and participants’ feedback on the program. Our team launched in-person sessions with women-in-reentry at public libraries in February 2020 and had to move the sessions online in March due to COVID-19. Our research-informed educational program is designed primarily to support the women in enhancing their knowledge and comfort with technology and nurturing computational thinking. Our study shows that low self-efficacy and mental health challenges, as well as lack of resources for technology access and use, are some of the major issues that need to be addressed in supporting technology learning among women-in-transition. This research offers scholarly and practical implications for computing education for women-in-transition and other marginalized populations.Publication Returning to the Digital World: Digital Technology Use and Privacy Management of Women Transitioning from Incarceration(New Media and Society, 2022) Hyunjin, SeoBased on interviews with 75 women transitioning from incarceration, our research identifies technology access and skills barriers facing this population and their underlying concerns and motivations in navigating privacy online. Our results suggest precarious housing and financial situations, concerns about ex-partners, mental health issues, and lack of self-efficacy pose challenges for their access to and use of digital technologies and influence their online privacy perspectives. Many participants reported relying primarily on cellphones for various tasks including job applications. Closing public places including libraries amid the COVID-19 pandemic put them at an even greater disadvantage, as many of them depend on computers or Wi-Fi available in those places. Nothing-to-lose attitudes were salient among this group resulting in many not taking precautionary measures online or choosing to go offline. Our research highlights the importance of building academic-community partnerships to provide technology and privacy education tailored for this population’s particular needs and desires.Publication Use of a Smartphone App Versus Motivational Interviewing to Increase Walking Distance and Weight Loss in Overweight/Obese Adults With Peripheral Artery Disease: Pilot Randomized Trial(JMIR Publications, 2022-03-02) Collins, Tracie; Geana, Mugur; Overton, Kathryn; Benton, Mary; Lu, Liuqiang; Khan, Faarina; Rohleder, Mason; Ahluwalia, Jasjit; Resnicow, Ken; Zhu, YiliangBackground: Walking therapy improves functional outcomes in patients with peripheral artery disease (PAD). Less is known about the additive benefit of a dietary intervention. Objective: Our objectives were to develop a smartphone app and, as a pilot, explore its potential efficacy as compared to motivational interviewing (MI) to increase walking distance and promote weight loss in overweight/obese adults with PAD. Methods: We conducted a 3-month, 2-arm randomized pilot study at the University of Kansas. Inclusion criteria were BMI >27 kg/m2 and symptomatic PAD, defined by an ankle-brachial index <0.9. Patients were randomized into 2 groups: MI, delivered through in-person and telephone counseling, and app, a mobile smartphone app. Both interventions encouraged walking for exercise and healthy dietary habits (increasing fruits and vegetables and whole grains while reducing fat and sugary drinks). We assessed medical history at baseline. At baseline and 3 months, participants completed an assessment of 6-minute walking distance, weight, quality of life, exercise behaviors, and dietary habits. The primary outcome was 3-month change in walking distance. Secondary outcomes were changes in weight, quality of life, exercise behaviors, and dietary habits. We used a Wilcoxon rank-sum test to analyze the primary and secondary outcomes at 3 months within the MI and app groups and to compare the changes between the groups with adjustment for baseline. Results: We randomized 29 participants with a mean age of 66.03 (SD 8.12) years; 25 participants completed the trial. At baseline, mean walking distance among completers was 260.40 (SD 94.32) meters and 326.15 (SD 69.28) meters for MI and app participants, respectively. At 3 months, the mean walking distance was 298.67 (SD 101.20) meters and 331.19 (SD 58.63) meters for MI and app participants, respectively (group difference P=.03, adjusting for baseline). Increase in walking distance at 3 months was 40.5 meters (95% CI 6.77 to 61.34; P=.02) in MI group. At baseline, mean body weight was 253.10 (SD 59.45) lbs and 225.13 (SD 58.93) lbs for MI and app participants, respectively. At 3 months, mean body weight was 242.14 (SD 58.54) lbs and 223.44 (SD 59.54) lbs for MI and app, respectively (group difference P=.006, adjusting for baseline). Pre-post study decrease in weight was 10.1 lbs (95% CI –17.9 to –3.0) and 2.3 lbs (95% CI –3.4 to –0.7) in MI and app group, respectively. Comparing baseline to 3 months, there were no statistically significant differences in quality of life, exercise behaviors, or dietary habits. Conclusions: Our study demonstrates that MI can promote walking and weight loss in overweight/obese adults with PAD. The smartphone app showed a small weight loss but no statistically significant increase in walking distance. As this was a pilot study, future large-scale studies are needed to replicate the efficacy of MI to promote weight loss in overweight or obese adults with PAD.Publication Social Facilitation in Fear Appeals Creates Positive Affect but Inhibits Healthy Eating Intentions(Frontiers Media, 2022-03-03) Bailey, Rachel L.; Wang, Tianjiao Grace; Liu, Jiawei; Clayton, Russell B.; Kwon, Kyeongwon; Diwanji, Vaibhav; Karimkhanashtiyani, FarzanehThe social facilitation of eating plays a significant role in influencing individuals’ eating decisions. However, how social eating cues are processed in health promotion messages is unclear. This study examined individuals’ food craving in response to social cues in images (Experiment 1) and emotional experiences, perceived threat, perceived efficacy, behavioral intentions, and motivational coactivation elicited by social eating cues in obesity prevention fear appeals (Experiment 2). Results suggested that the presence of a group of people eating in an image facilitated food craving for the presented foods. Moreover, fear appeals that presented obesity and its consequences with more social eating cues, versus individual eating cues, generated greater positive emotional responses, perceived threat severity, response and self-efficacy, and motivational coactivation indicating more attention and threat vigilance. However, these cues also generated fewer self-reported intentions to change unhealthy eating behaviors. Implications and suggestions for future research are discussed.Publication Walking the party line: The growing role of political ideology in shaping health behavior in the United States(Elsevier, 2021-12-16) Geana, Mugur V.; Rabb, Nathaniel; Sloman, StevenObjective To assess the extent to which political ideology affects COVID-19 preventive behaviors and related beliefs and attitudes in the U.S. Methods Two surveys, one using a convenience sample and another using a nationally representative sample, were conducted in September and November 2020, respectively. Multiple regressions compared political ideology with identified COVID-19 risk factors and demographics as well as knowledge measures. Surveys were followed by a review of the emerging COVID-19 behavioral literature (completed in January 2021) to assess the frequency of ideological effects in publicly reported data. Results In the survey data, political ideology was a significant predictor for all dependent variables in both surveys, and the strongest predictor for most of them. Out of 141 estimates from 44 selected studies, political ideology was a significant predictor of responses in 112 (79%) and showed the largest effect on COVID-19-related measures in close to half of these estimates (44%). Conclusions This study reinforces previous research that found partisan differences in engaging in behaviors with long-term health consequences by showing that these ideologically-driven differences manifest in situations where the possibility of severe illness or death is immediate and the potential societal impact is significant. The substantial implications for public health research and practice are both methodological and conceptual.Publication #Scamdemic, #Plandemic, or #Scaredemic: What Parler Social Media Platform Tells Us about COVID-19 Vaccine(MDPI, 2021-04-22) Baines, Annalise; Ittefaq, Muhammad; Abwao, MauryneThis study aims to understand public discussions regarding COVID-19 vaccine on Parler, a newer social media platform that recently gained in popularity. Through analyzing a random sample (n = 400) of Parler posts using the hashtags #COVID19Vaccine and #NoCovidVaccine, we use the concept of echo chambers to understand users’ discussions through a text analytics approach. Thematic analysis reveals five key themes: reasons to refuse the COVID-19 vaccine (40%), side effects of the COVID-19 vaccine (28%), population control through the COVID-19 vaccine (23%), children getting vaccinated without parental consent (5%), and comparison of other health issues with COVID-19 (2%). Textual analysis shows that the most frequently used words in the corpus were: nocovidvaccine (348); vaccine (264); covid (184); covid19 (157); and vaccines (128). These findings suggest that users adopted different terms and hashtags to express their beliefs regarding the COVID-19 vaccine. Further, findings revealed that users used certain hashtags such as “echo” to encourage like-minded people to reinforce their existing beliefs on COVID-19 vaccine efficacy and vaccine acceptance. These findings have implications for public health communication in attempts to correct false narratives on social media platforms. Through widely sharing the scientific findings of COVID-19 vaccine-related studies can help individuals understand the COVID-19 vaccines efficacy accurately.Publication Evidence-based Digital Literacy Class for Low-income African-American Older Adults(Journal of Applied Communication Research, 2019) Seo, Hyunjin; Erba, Joseph; Altschwager, Darcey; Geana, MugurBased on our community engagement project involving 47 low-income African-American older adults from a senior community center, this study analyzes how an underserved population acquires knowledge and skills related to digital technologies. We discuss the conceptualization, implementation and evaluation of a weekly, four-month long computer class for members of the senior community center. Our mixed-method research shows the importance of taking into account both the multidimensional nature of adult learning and the social and cultural contexts in which learning occurs when working with underserved adult populations. Findings from our formative and evaluative research offer insight into changes in the computer class participants’ attitudes toward and perspectives on key digital literacy issues including security and privacy online and online information verification. Scholarly and policy implications are discussed in the context of digital competency and adult learning for marginalized populations.Publication Country Characteristics, Internet Connectivity and Combating Misinformation: A Network Analysis of Global North-South(Proceedings of the 54th Hawaii International Conference on System Sciences, 2021) Seo, Hyunjin; Thorson, Stuart; Blomberg, Matthew; Appling, Scott; Bras, Andrea; Davis-Roberts, Avery; Altschwager, DarceyAnalyzing data on 152 countries using network and regression analyses, this study examined how countries’ positions in the global Internet network are associated with their political, economic, and technological characteristics, and how those characteristics are related to media, information, and digital (MID) education programs in the countries. This research shows countries with higher levels of international Internet bandwidth capacity, Internet use, and press freedom status are more likely to have MID programs that are comprehensive. Differences between Global North and Global South countries were significant both in terms of Internet capacity and use and in terms of MID complexity and dimensions. MID literacy education is an important long-term solution to misinformation, as such education informs people’s epistemological beliefs which in turn have direct effects on their comprehension of various issues and topics. This study offers important scholarly and policy implications in the areas of digital connectivity, MID literacies, misinformation, and international communication. In particular, it offers guidance for comparative studies in this area.Publication Special Section on Comparative Approaches to Mis/Disinformation: Introduction(International Journal of Communication, 2021) Seo, Hyunjin; Faris, RobertFrom misleading news articles around elections in Brazil and the United States to mob lynchings fueled by false social media messages in India to made-up stories about COVID-19 vaccination, a deluge of disinformation and misinformation is affecting various aspects of citizens’ lives around the world. Although there is an increasing number of research papers dealing with disinformation or misinformation, a majority of these have focused on the United States. This Special Section on comparative approaches to mis/disinformation features conceptual and data-informed articles with international and global perspectives on the prevalence, impact, and diffusion of mis/disinformation in different countries. Articles selected for the Special Section provide new theoretical and empirical contributions to existing bodies of knowledge whether focusing on one country or offering comparative perspectives involving multiple countries. The articles, individually and collectively, offer important scholarly and policy implications for studying and combating mis/disinformation around the world.Publication Computable Approaches to Rational Choice and Decision-Making(Proceedings of the 54th Hawaii International Conference on System Sciences, 2021) Seo, Hyunjin; Thorson, StuartThe capacity of agents to act rationally, that is to make choices that positively reflect their interests, is a core assumption underlying democratic governance systems, microeconomics, decision science, market driven economies, and many agent based modeling efforts. In this paper we investigate axiomatic theories of rational choice from the perspective of computability. Using algorithmic complexity, we show highly general conditions under which no effective procedure can exist enabling these theories to identify sequences of choices as random. While axiomatic theories of rational choice yield powerful descriptions of choice behavior, this power comes at the expense of axioms which can be brittle with regard to computability limits.Publication ''Does Pakistan still have polio cases?": Exploring discussions on polio and polio vaccine in online news comments in Pakistan(Elsevier, 2021-01-15) Ittefaq, Muhammad; Baines, Annalise; Abwao, Mauryne; Shah, Sayyed Fawad Ali; Ramzan, TayyabIntroduction: Polio, which is caused by poliovirus, is a contagious, potentially crippling, and deadly disease. Pakistan is one of the countries in which polio is still endemic in the 21st century. In 2019, 146 polio cases were reported across the country with some resulting in deaths. Following the spread of rumors insinuating that children were falling sick after receiving an anti-polio vaccine, a mob attacked and set fire to a small hospital in the Peshawar district in April 2019. The present study investigates readers' discussions that emerged from Dawn's online readers' comments on polio-related news stories in Pakistan. Methods: Using thematic analysis, we analyzed (N = 2216) comments made by readers in the polio-related news stories published on Dawn.com from January 1, 2012, to March 1, 2020. Results: Seven major themes emerged from the analysis of the comments: 1) reasons for and challenges resulting in the failure to eradicate polio; 2) proposed solutions and policy changes to eradicate polio; 3) misinformation; 4) criticism, frustration, and shame; 5) comparison of Pakistan to other countries; 6) the internet as a public sphere; 7) suffering, empathy, and appreciation. Overall, our findings suggested that commenters are knowledgeable about polio vaccines and consider polio a serious threat to public health in Pakistan. Conclusion: Our study not only validated previous study findings such as reasons, challenges, and issues related to polio vaccination, but also found new challenges in online news sites concerning misinformation on polio and polio vaccination in Pakistan.Publication The Role of Structural Factors in Antibiotic Use Among European Union Citizens: A Multilevel Analysis(Annenberg School for Communication & Journalism, 2019) Chen, Yvonnes; Vu, Hong TienUsing the 2016 European Commission’s Eurobarometer survey, this study analyzed how a multitude of factors are associated with identification and intention of following proper antibiotic treatment. Multilevel analyses showed that knowledge and information from medical professionals and mass media (individual-level predictors), and advanced access to education (a structural-level factor) are associated with identification. For intention, structural factors (Access to Information & Communications, Health & Wellness, Nutrition & Basic Medical Care) contributed significant variances to the model, in addition to the individual-level effects (sources and trust in medical professionals and mass media). Results demonstrate a need to consider these structural-level influences to shed light on the process though which antibiotic resistance preventions and interventions might impact individuals’ health literacy and behavioral outcomes.Publication Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: Findings from a randomized control trial(BMC, 2018-10-04) Zoellner, Jamie M.; You, Wen; Estabrooks, Paul A.; Chen, Yvonnes; Davy, Brenda M.; Porter, Kathleen J.; Hedrick, Valisa E.; Bailey, Angela; Kružliaková, NatalieBackground Although reducing sugar-sweetened beverage (SSB) intake is an important behavioral strategy to improve health, no known SSB-focused behavioral trial has examined maintenance of SSB behaviors after an initial reduction. Guided by the RE-AIM framework, this study examines 6–18 month and 0–18 month individual-level maintenance outcomes from an SSB reduction trial conducted in a medically-underserved, rural Appalachia region of Virginia. Reach and implementation indicators are also reported. Methods Following completion of a 6-month, multi-component, behavioral RCT to reduce SSB intake (SIPsmartER condition vs. comparison condition), participants were further randomized to one of three 12-month maintenance conditions. Each condition included monthly telephone calls, but varied in mode and content: 1) interactive voice response (IVR) behavior support, 2) human-delivered behavior support, or 3) IVR control condition. Assessments included the Beverage Intake Questionnaire (BEVQ-15), weight, BMI, and quality of life. Call completion rates and costs were tracked. Analysis included descriptive statistics and multilevel mixed-effects linear regression models using intent-to-treat procedures. Results Of 301 subjects enrolled in the 6-month RCT, 242 (80%) were randomized into the maintenance phase and 235 (78%) included in the analyses. SIPsmartER participants maintained significant 0–18 month decreases in SSB. For SSB, weight, BMI and quality of life, there were no significant 6–18 month changes among SIPsmartER participants, indicating post-program maintenance. The IVR-behavior participants reported greater reductions in SSB kcals/day during the 6–18 month maintenance phase, compared to the IVR control participants (− 98 SSB kcals/day, 95% CI = − 196, − 0.55, p < 0.05); yet the human-delivered behavior condition was not significantly different from either the IVR-behavior condition (27 SSB kcals/day, 95% CI = − 69, 125) or IVR control condition (− 70 SSB kcals/day, 95% CI = − 209, 64). Call completion rates were similar across maintenance conditions (4.2–4.6 out of 11 calls); however, loss to follow-up was greatest in the IVR control condition. Approximated costs of IVR and human-delivered calls were remarkably similar (i.e., $3.15/participant/month or $38/participant total for the 12-month maintenance phase), yet implications for scalability and sustainability differ. Conclusion Overall, SIPsmartER participants maintained improvements in SSB behaviors. Using IVR to support SSB behaviors is effective and may offer advantages as a scalable maintenance strategy for real-world systems in rural regions to address excessive SSB consumption.