142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

304371
Increasing student water consumption during school meals: A group-randomized, controlled trial

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 8:50 AM - 9:10 AM

Erica Kenney, ScD, MPH , Department of Social and Behavioral Sciences, Harvard School of Public Health Prevention Research Center, Boston, MA
Steven L. Gortmaker, PhD , Department of Social and Behavioral Sciences, Harvard School of Public Health, Prevention Research Center, Boston, MA
Jill Carter, EdM, MA , Health & Wellness, Boston Public Schools, Boston, MA
Jennifer Reiner, BA , Department of Social and Behavioral Sciences, Harvard School of Public Health Prevention Research Center, Boston, MA
Caitlin Howe, MPH , Health and Wellness Department, Boston Public Schools, Dorchester, MA
Angie L. Cradock, ScD , Department of Social and Behavioral Sciences, Harvard School of Public Health, Prevention Research Center, Boston, MA
Introduction. Increasing children’s water consumption has gained attention as an important public health strategy. However, U.S. children currently consume little water and substantial sugary beverages. Improving drinking water access and promoting water in schools may be a key intervention strategy.

Methods. We conducted a group-randomized, controlled trial in 10 schools in Boston, MA in spring 2013 to test a cafeteria-based intervention to improve water access and consumption. The intervention was co-developed with the Boston Public Schools and consisted of simple promotional signage posted near water access points, installing cup-holders next to cafeteria water access points, and stocking disposable cups. The percentage of students consuming water and other beverages during each lunch period and average ounces of water consumed were directly observed for five days at both baseline and follow-up. Mixed linear regression models adjusting for clustering were used to test for intervention impact.

Results. The percentage of students who took water during lunch nearly doubled in intervention schools compared to control schools (+9.4 percent, p<0.001) from baseline to follow-up. The average volume of water consumed per student also significantly increased, by 0.55 ounces per student (p<0.001). The percentage of students observed with sugar-sweetened beverages declined by 3.3 percentage points (p<0.005) in intervention versus control schools.

Discussion. This study shows that an inexpensive, low-resource intervention that increases student access to lunch-time drinking water can result in significant increases in the percent of students drinking water, the amount of water consumed, and decreases in observed sugary beverages.

Learning Areas:

Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Describe the impact of a low-cost, structural intervention on studentsí consumption of water and other beverages during the school day. Discuss potential public health policy implications for increasing student water consumption in school settings

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a Doctor of Science degree from the Harvard School of Public Health from the Department of Social and Behavioral Sciences. I am a member of the Prevention Research Center and work on various nutrition and physical activity interventions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.