Water To Go: Increasing Water Intake among Children in Santa Clara - - PowerPoint PPT Presentation

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Water To Go: Increasing Water Intake among Children in Santa Clara - - PowerPoint PPT Presentation

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Water To Go: Increasing Water Intake among Children in Santa Clara County Santa Clara County Healthier Kids Foundation Symposium Anisha Patel, MD, MSPH University of California, San Francisco FIRST 5 Santa Clara County May 11, 2015

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Water To Go: Increasing Water Intake among Children in Santa Clara County

Santa Clara County Healthier Kids Foundation Symposium

May 11, 2015

Anisha Patel, MD, MSPH University of California, San Francisco FIRST 5 Santa Clara County

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Presentation Goals

  • Why is water provision and promotion important?
  • Overview of Water To Go Project and evaluation
  • Preliminary results from Water To Go evaluation
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Background

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Improving Water Intake Among Children is Important

  • Drinking water instead of sugary drinks can prevent
  • besity and dental caries
  • Being properly hydrated can help children learn
  • Most U.S. children and adolescents do not drink

enough water during the day

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Many Children May Not Drink from Fountains

  • Fountains are the most common water source
  • Children may not drink from fountains due to

concerns about:

  • Tap water safety
  • Poor water palatability
  • Improper fountain upkeep
  • Inadequate access
  • Lack of cups or water bottles
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Access to Appealing Water Increases Water Intake

30 39 34 50 49 34 10 20 30 40 50 60 70 80 90 100 Dispenser Cooler Fountains Baseline Follow-up

Students Reporting Water Intake at Lunch (%)

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Water to Go Program

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The Water to Go Program

  • Purpose:

Water to Go aims to increase access to and utilization of safe, fresh tap water for children and families through the installation and promotion of 100 water bottle filling stations.

  • Water to Go Partners:
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Water to Go – Inspired by Legislation

  • California SB1413
  • Enacted in September 2010
  • Requires all schools in California to provide access to free, fresh

drinking water during meal times

  • Healthy, Hunger-Free Kids Act
  • Enacted in December 2010
  • Improves child nutrition policy in many important ways

‒ Includes a provision requiring schools participating in federal meals programs to make free drinking water available with school meals

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Water to Go – Selection Criteria

  • FIRST 5 and Santa Clara Valley Water District School

Selection Criteria:

  • Schools with children with body mass index (BMI) scores

considered “high risk”

  • Schools located near pre-school/childcare centers or FIRST 5

Santa Clara County Family Resource Centers

  • Broad geographic representation
  • Santa Clara County Public Health Site Selection Criteria:
  • Areas accessible to the public
  • Fill a need for drinking water access
  • In an area with high use by children and families
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Water to Go School Affiliated Sites

SCHOOL DISTRICT SCHOOL SITES

Alum Rock Union Chavez, Arbuckle, Hubbard, Linda Vista, Lyndale, Cureton, McEntee/Russo, McCollam Berryessa Union Northwood Campbell Union Sherman Oaks East Side High School District Overfelt, Yerba Buena, Evergreen Valley Franklin McKinley Dahl, Santee, Kennedy Gilroy Unified Rod Kelley Moreland Leroy Anderson Morgan Hill Unified El Toro Mountain View-Whisman Theurkauf

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Water to Go – Elementary School Program

  • Installation of hydration stations (reusable water bottle filling stations)

in school cafeterias

  • Promotion of stations
  • “Potter the Otter” signs near stations
  • Short Sugar Savvy presentation for students/teachers
  • Potter the Otter play (preschool-3rd grade)
  • Potter the Otter books for students to take home (TK-3rd grade)
  • Water bottle distribution to students and teachers
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Hydration Stations and Signs

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Promotional Launch Events

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Distribution of Water Bottles

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Program Evaluation

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Water to Go – School Evaluation

  • Participants:
  • Water To Go “intervention” schools and matched control schools
  • Evaluation before and after the program
  • Main outcomes:
  • Number and function of existing water sources (school water audit)
  • Student intake of water, SSBs, milk, and juice

‒ Student surveys ‒ Lunchtime observations of student intake ‒ Flowmeter readings from water stations and fountains

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Water to Go – School Evaluation

  • Secondary outcomes
  • Beverage offerings in child care centers near study schools

‒ Child care provider surveys

  • Teacher and child care provider intake of beverages at school/child

care centers ‒ Teacher surveys ‒ Child care provider surveys

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Baseline Results

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School Characteristics by Intervention Status

CHARACTERISTIC INTERVENTION (n=10) CONTROL (n=10)

Enrollment (mean) 508.5 537.3 Free and Reduced Price Lunch Eligibility 89% 71% English Language Learners 62% 52% Race/Ethnicity Latino Asian African-American Caucasian Other 78% 17% 1% 2% 1% 55% 34% 2% 7% 2%

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Water Access in Evaluation Schools

7 4 4 5 5 10 15 20 Station Jug Fountain No Water

N=20

Types of Water Sources (n)

N=5 schools had no water access

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Time to Fill a Water Bottle by Water Source in School Cafeterias

4.6 6.4 10.9 2 4 6 8 10 12 Station Jugs Fountain

Fill Time (seconds)

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Mean Temperature of Cafeteria Water Sources (Fº)

Fountain 67.5 Station 59.9 Jug 58

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Unappealing Cafeteria Water Access

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Provision of Cups

  • 8 of 15 schools with cafeteria

water access provided cups

  • 3-4 ounce paper cups
  • Cost covered by food service
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Promotional Signage

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Students Observed Accessing Free Water in School Cafeterias at Lunch

1 7 8 10 20 30 40 50 60 70 80 90 100 Fountains Jugs Stations Students (%)

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Students Observed Accessing Free Water in School Cafeterias at Lunch

2 10 10 20 30 40 50 60 70 80 90 100 No Cups Cups Students (%)

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Students Observed Accessing Free Water in School Cafeterias at Lunch

4 7 13 10 20 30 40 50 60 70 80 90 100 Stations without Cups Jugs with Cups Stations with Cups Students (%)

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Students Observed Drinking Beverages from Home in Cafeterias at Lunch

1 2 2 4 1 2 3 4 5 6 7 8 9 10 Juice Single-Use Water Reusable Water Bottles SSB Students (%)

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Conclusion

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  • Few students drink water in school cafeterias
  • Installation of stations improves palatability and intake
  • Improves temperature and water bottle filling time
  • Leads to an 8-fold increase in the percent of students

who drink from cafeteria water sources at lunch

  • Installation of appealing water sources without cups or

reusable water bottles may not sufficiently increase intake

  • SSBs are the most common beverages from home

Discussion

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  • Examine Water to Go Program’s impact on:
  • Intake of water and other beverages among

students in child care and elementary schools

  • Teacher and child care provider intake of water

and other beverages

Next Steps