Measuring and Promoting Water as the Primary Beverage within Afterschool Programs

Background: Sugar-sweetened beverage (SSB) consumption contributes to childhood obesity in the US. The YMCA-Harvard Afterschool Evaluation aims to improve children's nutrition and physical activity through environmental change within afterschool programs. One of six nutrition standards is to serve water as a primary beverage everyday and to eliminate SSB. We assessed water serving practices in 30 afterschool sites in 4 regions of the US and water consumption of children within these programs.

Methodology: Data on water were collected at the environmental and individual level. Sites submitted monthly snack menus and site observations were made at over half of the programs. Site directors' interviews documented implementation. Child consumption data were collected through parent/child diaries pre and post and in a validation sub-study.

Results: Menu analyses indicate 6 intervention and 6 control sites served water everyday at baseline. An additional 4 intervention and 1 control sites served water daily by follow-up. Site observations validated to menu data (r=0.74, p<0.01). Child observations indicate children took water when it was served to them 57% of the time; of these, 83% drank all or most of what they were served. Further analyses are examining potential barriers to implementation of this environmental change and evidence for change in children's daily water and SSB consumption.

Discussion: Our findings indicate the promise of simple environmental and policy changes to promote water consumption in afterschool settings and future obesity prevention efforts.