RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

PROFOMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 NAME OF THE CANDIDATE AND ADDRESS

SR. NEENA JOSEPH.

BGS COLLEGE OF NURSING KUVEMPUNAGAR,MYSORE

2 NAME OF THE INSTITUTION BGS COLLEGE OF NURSING KUVEMPUNAGAR,MYSORE

3 COURSE OF STUDY AND SUBJECT

M.SC.NURSING 1 YEAR

CHILD HEALTH NURSING

4 DATE OF ADMISSION TO THE COURSE

30-06-2011

5 TITLE OF THE TOPIC “ A STUDY TO ASSESS THE

EFFECTIVENESS OF PLANNED

TEACHING PROGRAMME ON

KNOWLEDGE AND ATTITUDE

REGARDING ILL EFFECTS OF SOFT

DRINKS ON HEALTH AMONG

ADOLESCENTS IN SELECTED PRE-

UNIVERSITY COLLEGES AT MYSORE.”

Brief Resume of the Intended work: Introduction

“Today’s adolescents are tomorrow’s adults and citizens of India” .

Adolescence is a fascinating period of life and it is the most important age after

childhood in all societies. Peer influences and education are of highest importance and

these experiences ultimately instigate pattern of their life style, especially health habits

etc. It is also a vital period because of the so –called socialization process viz

development of secondary sexual organs, transmission of attitudes, customs, behavior

and character formation. These adolescents are the vulnerable group for adopting any

unhealthy practices under peer sway.1

Currently there is a renewed awareness that the determinant of chronic diseases in later

life and health behavior are well established by the end of adolescent period. One the

adolescent becomes an adult his ideas and values are almost fixed and then it is difficult

to expect a great change in behavior and attitude .A focus on children and adolescent in

the primary prevention of health risk and disorders such as diabetes, hyper tension,

obesity, anemia etc have been suggested in many report, published throughout the

world. Such a focus is important in India as it has a huge adolescent and children

population along with economic, social and health inequalities among general population.

Around 22percentage of Indian population fall into the adolescent age group of 10-19

years.2

Soft drinks are non alcoholic, flavored, carbonated beverage, usually commercially

prepared and sold in bottles or cans. Nonalcoholic beverage, usually carbonated,

consisting of water (soda water), flavoring, and a sweet syrup or artificial sweetener. 3

Due to the modernization and high habit of consumption of fast foods now a days

adolescents are consuming soft drinks. One extra soft drink a day gave a child a 60

percent greater chance of becoming obese. One could even link specific amounts of soda

to specific amounts of weight gain.3 Life style has greatly contributed to obesity among

adolescent girls over the last five years and obese children have been reported to be

physically less active, more home-bound, spending more time on internet, playing video

games and watching TV, as well as having easy access to fast foods in urban settings. 4

Taking into consideration the eating habits of teenagers there is a trend to adopt the

stylish behaviors of their role models especially the film stars. Tremendous challenges

happening in an around the world which makes them to be lean always for participation

in the reality shows which pursue them to adopt the unhealthy eating habits. With or

without knowledge the younger generation is being unhealthy due to the consumption of

fast foods, soft drinks junk food, and stressful technical occupation….ect. Let us join

hands for the build of healthier, mightier adolescents who are the back born of our

country. "Giving up soft drinks can be one of the best things you can do to improve

your health," 5

Need of the study

By understanding the ill effects of the soft drink consumption in adolescents there was a

letter forwarded to the Hon’ble Prime Minister from the Ministers of Health & Family

Welfare, for Consumer Affairs, Food & Public Distribution, Government of India

regarding the harm full effects and the global dump of soft drinks . According to the WHO

strategy for betterment of our younger generation. Since there many studies proved the

harm full effects of soft drinks. This shows how the soft drink consumption is badly

affected the health of adolescents. 6

The Union health ministry on February 2007 informed the Supreme Court that a

definitive study is now being undertaken by the National Institute of Nutrition

( Hyderabad) "to assess the effects of consumption of carbonated water beverages and

soft drinks on health of adolescents and young adults". The final report of the study is

expected to come by February 2012. After the screening a letter written by ICMR

scientist Dr G S Toteja said the study being conducted by NIN involved the screening of

2,000 adolescents and young adults (aged 18-35 years) each for identification of subjects

with high and low carbonated beverage consumption levels."These subjects will then be

followed to assess harmful effects of carbonated beverages," the letter to under secretary

in the ministry Mohammad Saleem said.7

A study was carried out in 7,905 (52% girls) people, aged 12-17 years in the three regions

of Andhra Pradesh. Anthropometric measurements like height and weight, arm, waist and

hip circumference and skin fold thickness were taken. The average duration of watching

TV was higher in overweight and obese adolescents (1.4hrs/day) compared to normal

(1.2hrs/day). The consumption of fast foods and soft drink were significantly higher

among the overweight adolescents compared to the normal children." 8

NIN had earlier done a study on assessment of prevalence and determinants of

overweight and obesity among urban adolescents in three regions of Andhra Pradesh. It

clearly showed that a case of being overweight was more in the group that consumed

carbonated drinks. He added, "The latest study will establish the cause and effect

relationship. The study will have 400 people who consume high amounts of carbonated

drinks and 400 who don't." 9

A study conducted at Gwalior in MP study was aimed to find out various determinants

responsible for this rising trend of soft drinking so that effective intervention can be

undertaken to overcome this creeping problem. Results: Frequent drinking of soft drinks

was found more among the students of private schools than govt. Other reasons which

were found to be responsible by far for frequent soft drinking like lack of awareness

regarding hazards, frequent TV watching, desire of new taste, lack of health education

from the parents side etc. Conclusion: Soft drinking consumption is creeping day by day

amongst the children without knowing their hazards. And they are the future of any

country so there should be effective intervention from both sides, govt. and parents .10

Bangalore based Educational Sports surveyed nearly 4,000 school students aged between

5 to 14 years in 15 cities and found that nearly a quarter of them had a high Body Mass

Index. Nearly half of the students surveyed did not possess ideal BMI ratios while 19

percent showed lower than ideal BMI. Stating that today’s children find very less time to

indulge in physical activities, more consumption of soft drinks, lead researcher Reshma

Nayak said “Due to the constantly changing lifestyle, children have become more

passive. The space constraints that exist in the cities today has left children with no

opportunity to play enough and more consumption of carbonated beverages this has

reduced their immunity towards many health hazards. 11

Talking about the harmful elements present in the cold drinks, Dr Manisha Dwivedi,

head of the gastroenterology department "Giving up soft drinks can be one of the best

things you can do to improve your health," she said and added that soda is useless, as soft

drinks mostly consist of filtered water and refined sugars. Many people either forget or

don't realise how many extra calories they consume in what they drink. Several scientific

studies have provided experimental evidence that soft drinks are directly related to weight

gain. The relationship between soft drink consumption and body weight is so strong that

researchers calculate that for each additional soda consumed, the risk of obesity increases

1.6 times, she added. "Soft drink consumption increases the risk of metabolic syndrome,

a combination of the symptoms such as high blood pressure, obesity, high cholesterol,

and insulin resistance. There is evidence that consumption of too many soft drinks puts

you under increased risk of liver cirrhosis similar to what chronic alcoholics have."

Drinking soda not only contributes in making people fat, but it also stresses the body's

ability to process sugar. Rapidly absorbed carbohydrates like high fructose corn syrup put

more strain on insulin-producing cells than other foods. When sugar enters the

bloodstream quickly, the pancreas has to secrete large amounts of insulin for the body to

process it. "Frequent consumption of soft drinks may also increase the risk of

osteoporosis, especially in people who drink soft drinks instead of calcium-rich milk.

“Osteoporosis is a major health threat for Indians and experts say that the real culprit is

soda's displacement of milk in the diet.  This sweet-and-sour cocktail might be gripping

for the taste buds, but it is highly corrosive for teeth, especially children's. "Young tooth

enamel is quite porous and more easily dissolved by acids than mature enamel. One thing

is for sure that consuming cold drinks having natural fruits like mango or lemon as their

basic ingredient are quite safe. But, still they too uses preservatives and people go for it,

"When children's teeth are frequently exposed to acidic drinks, this dissolves the calcium

in tooth enamel and over time can lead to a crumbling of the tooth structure and tooth

erosion .12

At the same time it is also a global problem. As the surveys reveals the US is the first

rank position in consumption of soft drinks. 76% of the US adolescents consumes soft

drink which is the greatest nutritional problem leading to childhood obesity. According to

the WHO recommendations US Mayor produced a letter on august 19th of 2011 to barn

the soft drinks. But Federal officials on Friday rejected Mayor Michael R. Bloomberg’s

proposal to ban New York City’s food stamp users from buying soda and other sugary

drinks with them. The decision derailed one of the mayor’s big ideas to fight obesity and

poor nutrition in the city. Mr. Bloomberg and the city’s health commissioner, Dr. Thomas

A. Farley, were quick to criticize the ruling by the United States Department of

Agriculture as a disservice to low-income residents. Schools were overweight or obese,

and that obesity was especially rampant in low-income neighborhoods. Limiting

consumption of sodas and other drinks with high sugar content, he argued, could help

reverse that trend.13

Therefore the investigator felt that, it would be beneficial if a study is conducted to assess

the knowledge and attitudes of adolescents regarding the ill effects of soft drinks. The

investigator felt that “prevention is better than cure”. By giving the information there may

be a wave of change in one mind can change the whole world which leads to build a

healthier younger generation who are the back bone of the beloved India.

6.2 REVIEW OF LITERATURE:-

Review of literature divided in the following headings.

A. Studies conducted based on the relation of soft drinks on adolescents’ health.

B. Soft drinks meaning, contents, marketing trades, list of soft drinks in general

C. The ill effects of soft drinks on human health.

A descriptive study was conducted in US on the effect of soft drink availability in

elementary school on consumption, in the view to quantify the association among soft

drink availability school based purchases, and overall consumption for elementary

schoolchildren in the U S. The analytic sample obtained from the sixth wave includes

10,215 children in fifth grade in 2,303 schools across 40 states. Chi (2) square tests and t

tests were conducted to determine significant differences across socio demographic

variables . In this study, 26% children who have access to soft drinks at school consume

them. 14

A survey was conducted to identify the factors associated with nonalcoholic carbonated

beverage (soft drink) consumption in children. : Results suggest that several factors may

be associated with soft drink intake in school-aged children, most notably taste

preferences, soft drink consumption habits of parents and friends, soft drink availability

in the home and school, and television viewing. Additional research is needed to verify

these findings in a representative sample of children.15

A study conducted to determine the prevalence of obesity among sixth- and seventh-

grade students in a school-based setting, and to identify lifestyle parameters associated

with obesity. The result was Time spent watching television and the number of soft

drinks consumed were significantly associated with obesity. Latinos spent more time

watching television and consumed more soft drinks than did non-Hispanic white or Asian

students. These findings will be beneficial in developing preventive measures for these

children.16

Department of Public Health of Netherlands conducted on the school food environment

associations with adolescent soft drink and snack consumption Adolescents’ attitudes,

subjective norms, parental and peer modeling, and intentions were positively associated

with soft drink and snack consumption. There was an inverse association between the

distance to the nearest store and the number of small food stores with soft drink

consumption. These effects were mediated partly by cognitions. This study provided little

evidence for associations of environmental factors in the school environment with soft

drink and snack consumption. Individual cognitions appeared to be stronger correlates of

intake than physical school-environmental factors. Longitudinal research is needed to

confirm this findings.17

Department of Epidemiology and Community Medicine, Institute of Population Health,

University of Ottawa, Ontario, Canada conducted an interview to examine the

relationship between consumption of sugar-sweetened beverages (eg, non diet carbonated

drinks and fruit drinks) and the prevalence of overweight among preschool-aged children

living in Canada. Regular sugar-sweetened beverage consumption between meals may

put some young children at a greater risk for overweight. Parents should limit the

quantity of sweetened beverages consumed during preschool years because it may

increase propensity to gain weight.

An article states that: There is an association between obesity and consumption of soft

drinks. Initiatives focusing on reducing the consumption of these drinks may help

to prevent a further increase in childhood obesity.18

Department of Public Health, Erasmus University Medical Centre, Rotterdam,

Netherlands, conducted a study to assess determinants of adolescents 'consumption of

carbonated soft drinks (regular and diet), both of total consumption and of consumption

at school. A total of 63% and 27% of the participants reported to drink respectively

regular and diet soft drinks twice a week or more, and 24% and 8%, respectively,

reported to drink soft drinks once a week or more at school. Preferences, accessibility,

modeling and attitudes were the strongest determinants of both regular and diet soft drink

consumption. In addition, gender, educational plans and dieting were related to both total

soft drink consumption and consumption at school. Pupils with longer distance from

school to shop and those in schools with rules concerning soft drink consumption tended

to have lower odds of drinking both regular and diet soft drinks at school.19

The vast majority of high school students today have soft drinks available to them in the

school environment both through vending machines (88%) and in the cafeteria at lunch

(59%), with middle schools providing somewhat less access. Diet soft drinks are less

available, particularly at lunch. Most students (67% in middle and 83% in high school)

are in schools that have a contract with a bottler. Revenues to schools generated by soft

drink sales are quite modest. Hispanics are most likely to have soft drinks available

throughout the school day. The SES of the students correlates negatively with whether

the school allows advertising and promotion of soft drinks. Current school practices

regarding soft drink availability, advertising and sales would seem likely to be

contributing to the extent of overweight among American young people, and to some

extent to the higher risk faced by Hispanic and lower SES youth. 20

A soft drink (also called soda, pop, coke, soda pop, fizzy drink, tonic, or carbonated

beverage) is a non-alcoholic beverage that typically contains water (often, but not always

carbonated water), a sweetener, and a flavoring agent. The sweetener may be sugar, high-

fructose corn syrup, or a sugar substitute (in the case of diet drinks).21

Soft drinks by definition are carbonated drinks that are non-alcoholic. Carbonated soft

drinks are also referred to as soda, soda pop, pop, or tonic. A study led by Dr. David

Ludwig for the Department of Medicine at Children's Hospital in Boston and the Harvard

School of Public Health concluded that "a child's odds of becoming obese increase by 60

percent with each additional daily serving of sugar-sweetened drinks." Sugar-sweetened

soft drinks are a favorite among children and teenagers despite their high calorie and

sugar content, with some 12-ounce soft drinks containing 16 percent or more of the

recommended daily allowance for sugar. The Centers for Disease Control and Prevent

recommends giving up the sugar- sweetened drinks. 22

These things seems to be very shocking but the thing is that colas and other drinks does

not contain any special flavors but contain DDT, malathion, lindane and chlorpyrifos and

all these are deadly poisons and banned pesticides. You will feel shock but cold drinks

and other products are best toilet cleaners that original cleaners. So far as the

manufacturers of soft drinks are concerned, if the manufacturers produce these drinks

with original material they will lose a lot in business, they get profit by adding bad

products in that. The soft drink companies are clearly playing with the health of innocent

consumers. It is true that soft drinks are refreshing and thrilling but with that they are

deadly also. According to the doctors these are not directly deadly but they have no

nutrition value and cause diabetes and obesity.23

Comparison with other beverages 24

Drink Caffeine(mg/L) Caffeine (mg/oz) Mass

Pepsi 104 3.08 25 mg in 237 ml

Cola( Diet) 110-141 3.25-4.16 39-5 mg in 355 ml

Cola 95-130 2.8-3.9 34-46mg in 355 ml

Coca-cola classic 100.5 2.875 23mgin 237 ml

Coca Cola Brands: The Coca-Cola Company produces seven brands of sugar-sweetened

sodas. A 12-ounce can of Coca-Cola and Caffeine-Free Coca Cola contain 140 calories

and 39g of sugar, 13 percent of the recommended daily allowance. The vanilla and cherry

Coca-Cola flavors contain 150 calories and 42g of sugar, or 14 percent of the RDA. Fanta

comes in four flavors -- grape, orange, pineapple and strawberry. The grape, pineapple

and strawberry flavors contain 180 calories per 12-ounce can, with 48g of sugar, or 16

percent of RDA. Fanta Orange contains slightly less sugar, with 160 calories and 44g of

sugar, 14 percent of the RDA. 

Pepsi Brands: Like its competitor, Coca-Cola, Pepsi owns a variety of sugar-sweetened

brands. Its flagship brand, Pepsi, contains 150 calories per 12-ounce can, and 41g of

sugar, as does Caffeine-Free Pepsi and Pepsi Cherry Vanilla. Pepsi Natural and Pepsi

Throwback both contain 150 calories, but Throwback has 40g of sugar while Natural has

38g of sugar. Each of these products contains 170 calories per 12-ounce can and 46g of

sugar, except for Mountain Dew Throwback at 44g of sugar. Mug Root Beer comes in at

160 calories per 12-ounce can and 43g of sugar, while Mug Cream Soda contains 180

calories and 47g of sugar. Pepsi's Slice and Tropicana Twister brands contain the highest

calories as well as the highest levels of sugar. Slice flavored sodas range from 160 to 190

calories per 12-ounce can with 43g to 50g of sugar. Tropicana Twister flavors net out at

160 to 190 calories with 43g to 52g of sugar. 25

Calories and Ingredients: According to the Coca-Cola website, a 12-ounce can of Coke

has 150 calories. The average soft drink contains 140 calories. The ingredients are

carbonated water, high fructose corn syrup, phosphoric acid and artificial and natural

flavors. Some soft drinks such as colas contain caffeine and caramel color.

Carbohydrates: A 12-ounce can of soda provides 34 grams of carbohydrates, 34 g of

sugar, 18 milligrams of sodium and 7 mg of potassium. A serving of soda has

approximately 8 teaspoons of sugar. Although carbohydrates provide your body with fuel

for energy, the best carbohydrates are those that provide other nutrients.

Fat and Protein: Sodas contain 0 g of fat. Based on a 2,000 calorie-per-day diet, fat

intake should be no more than 60 g a day. Sodas also contain 0 g of protein. Average

recommended protein intake for a sedentary person is 0.8g per 2.2 lb. of body weight.

Sodas are not a good source of fat or protein.

Caffeine: Depending on the brand your soda can contain 35 to 54 mg of caffeine per 12-

ounce serving. Two to three sodas have as much caffeine as one 6-ounce cup of coffee. If

you are having problems falling asleep at night, you might want to cut out afternoon

sodas.

Other Dietary Considerations: Per serving, soft drinks contain so-called "empty

calories." Empty-calorie foods have no nutritional value. Foods that only provide added

sugar to your diet should be consumed in moderation. Excess consumption of sodas has

been linked to childhood obesity, diabetes and an increase in triglycerides. 26

A 14-year study of 60,000 people in Singapore found that those who consume two or

more sweetened soft drinks per week have an87 percent higher risk of pancreatic cancer.

Published in the journal Cancer Epidemiology, Biomarkers & Prevention, the study was

led by Mark Pereira of the University of Minnesota who said, "The high levels of sugar in

soft drinks may be increasing the level of insulin in the body, which we think contributes

to pancreatic cancer cell growth."Nearly 38,000 people are diagnosed with cancer in the

United States each year, and over 34,000 die from the disease each year. This research

points to what may be the common culprit of all those preventable deaths: Sugary soft

drink consumption. A aural News has warned readers for years about the dangers of

consuming soft drinks. The sweetener used in most beverages high-fructose corn syrup is

linked to both diabetes and obesity. The phosphoric acid found in soft drinks is highly

acidic, stripping minerals from bones and promoting osteoporosis, kidney stone too.27

6.3 Problem Statement:- A study to assess the effectiveness of Planned

Teaching Programme on knowledge and attitude regarding ill effects of soft

drinks on health among adolescents in selected PU colleges at Mysore.

6.4 Objectives of the study:- To assess the level of knowledge regarding ill effects of soft drinks on health

among adolescents.

To assess the attitude regarding ill effects of soft drinks on health among

adolescents.

To assess the effectiveness of Planned Teaching Programme regarding the ill

effects of soft drinks on health among adolescents.

To find association between the knowledge and attitude regarding ill effects

of soft drinks among adolescents with demographic variables.

6.5 Operational definitions:- Effectiveness:-

It refers to It refers to determine the extent to which Planned Teaching Programme has

brought about result intended and is measured in terms of significant knowledge gain in

post test. Planned Teaching Programme: .

It refers to systematically designed, well planned and need based teaching materials

regarding the ill effects of soft drinks on health among adolescents.

Knowledge

In this study knowledge refers to the information of school children regarding the health

hazards of soft drink consumption assessed by structured questionnaires.

Attitude:-

In this study it refers to the change in thinking and behavioral approach of adolescents

regarding ill effects of soft drinks on health.

Soft drinks

Soft drinks are non beverages drinks contain additives such as artificial sugars (fructose,)

weak acids (phosphoric acid ,citric acid), flavoring agent (caffeine) and other

sweeteners. Colas, Pepsi, Rasna, Squash, sprite, coke, seven up. ……..ect.

Adolescents:-

In this study the children who have the age difference from 16 to 19.

Health:-

It is state of complete physical, mental, social, well being but not merely absence of

disease or infirmities.

6.6 Conceptual frame work

Health Promotion model.

6.7 Hypothesis

H1: There will be a significant difference in mean pre test and post test score

regarding the knowledge on ill effects of soft drinks on health among adolescents in

selected Pre University colleges at Mysore.

H2: There will be a significant difference in mean pre and post test score regarding

the attitude on ill effects of soft drinks on health among adolescents in selected Pre

University at Mysore.

H3 : There will be a significant association between post test score of knowledge

regarding the ill effects of soft drinks with the selected back ground variables.

H4 : There will be a significant association between post test score of attitude

regarding the ill effects of soft drinks with the selected back ground variables

6.8 Assumptions:- The researcher assumes that:-

1. Adolescents may have inadequate knowledge on ill effects of soft drinks.

2. Planned teaching Programme may improve the level of knowledge of adolescents

regarding ill effects of soft drinks.

3. After knowing the ill effects of soft drinks the children may reduce the consumption

of soft drinks.

6.9 Delimitations:-

The study is limited those who are

Adolescents age group of 16-19 yrs

Studying in urban pre university colleges

Able to read and write English.

Willing to participate in this study.

7. MATERIAL AND METHOD :-

7.1 Source of data

o The data will be collected from the adolescents of selected PU colleges at Mysore.

o Method of data collection: The data will be collected by direct administration of

knowledge questionnaire on ill effects of soft drinks and using demographic Performa.

7.1.1 Research Design

Pre experimental design one group pre and post test

Reaearch Approach :

Evaluative and Educative approach

Research design:

Pre experimental (one group pre test and post-test design)

O1 -

Administration of structured knowledge questionnaire to the Adolescents

X –Administration planned teaching programme.

O2-Administration of structured knowledge questionnaire after 7 days of administration

of planned teaching programme.

7.1.2 Variables

Independent Variable:

In this study Planned Teaching Programme is the independent variable

  Dependent Variables:-

The level of the knowledge and attitude of the adolescents is dependent

variables

Demographic variables:

Age, Sex, Education level, Socio economic Status,…..ect.

Group Pre-test Intervention Post- test

Adolescents O1 X O2

7.1.3 Setting

The study will be conducted in selected Pre –University colleges at Mysore.

7.1.4 Population

The population consists of adolescents in Pre- University colleges at Mysore.

7.2 METHOD OF DATA COLLECTION:-

7.2.1 Sampling Technique: Simple Random Sampling

7.2.2 Sample Size: 6o samples

7.2.3 Inclusion criteria:

Adolescents who are

Studying in English Medium Pre University colleges.

Willing to participate in this study

7.2.4 Exclusion criteria:

Those who are

Not interested in this study

Adolescents below 16 age.

7.2.5 Instruments used:

The tool is organized in three sections:

Section 1: Socio demographic variables of adolescents

Section 2: structured knowledge questionnaire regarding Ill effects of soft

drinks.

Section 3: structured attitude scale will be used for attitude regarding ill effects.

7.2.6 Data collection method:

Self administered structured questionnaires and structured attitude scale will be

used for data collection

7.2.7 Plan for Data Analysis:

The data will be analyzed by means of descriptive and inferential statistics.

Descriptive statistics

Mean median, percentage distribution and standard deviation will be

used to assess the knowledge and attitude of adolescents on ill effects

of soft drinks on health.

Inferential statistics

Paired‘t’ test will be used to assess the effectiveness of the planned

teaching programme. Chi-square test will be used to associate the

knowledge and attitude of adolescents (16-19 years) with selected

demographic variables.

7.3 Does the study require any Investigations or interventions to be conducted

on patients or other humans or animals? If so please describe briefly?

Yes, planned teaching programme on ill effects of soft drinks will be provided

with the consent of school authorities.

7.4. Has ethical clearness being obtained from your institution:

Yes. Due permission from college authorities will be obtained

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9. SIGNATURE OF THECANDIDATE :

10. REMARKS OF THE GUIDE THIS STUDY MAY IMPROVE AWARENESS TOWARDS ILL EFFECTS OFSOFT DRINKS AND REDUCE INTAKE AMONG ADOLESCENTS.

11. NAME AND DESIGNATION OF GUIDE :

Mr. ARUL.V. HOD OF PEDIATRICSBGS COLLEGE OF NURSING, MYSORE.

11.1 SIGNATURE :

12. HEAD OF THEDEPARTMENT

:Mr.ARUL.V HOD OF PEDIATRICSBGS COLLEGE OF NURSING, MYSORE.

13. SIGNATURE :

14. REMARKS OF THEPRINCIPAL

:

15. SIGNATURE OF THE PRINCIPAL :