The goal of this study is to determine the effectiveness and sustainability of a community-participatory hydration intervention over 3 years within a district that has newly installed hydration stations and is operating under a policy designed to enhance heathy hydration practices and promote equitable access to drinking water.
The goal of this study is to determine the effectiveness of a hydration intervention on hydration station usage (primary outcome), Body Mass Index z-scores (zBMI) and dental caries (primary biomedical outcomes), and water bottle usage, beverage selection and intake, and academic outcomes (secondary outcomes).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
7,200
Clusters of schools will sequentially be exposed to the intervention in a stepped-wedge fashion. The intervention is a 4-month community participatory school-based hydration intervention that includes provision of refillable water bottles in schools with hydration stations in addition to: 1) social marketing, 2) behavioral reinforcement, and 3) education and outreach.
Children's Hospital of Richmond at VCU Healthy Lifestyles Center
Henrico, Virginia, United States
RECRUITINGWater Station Usage
Ounces of water per student per day measured by hydration station flow meters.
Time frame: Years 1-3
Dental Caries Status
Tooth decay or cavities will be measured using a modified International Caries Detection and Assessment System (ICDAS)
Time frame: up to 3 years
Body Mass Index (BMI)
NHANES Anthropometry methods used to measure height and weight. Age and sex-specific BMIz-score and BMI percentile will be calculated using Epi Info
Time frame: up to 3 years
Water Bottle Usage at Lunch
% of students with water bottles in school
Time frame: up to 3 years
Beverage Selection at Lunch
% of each beverage selected (water, white milk, flavored milk, 100% juice, soda, sports-drink, other sugar-sweetened beverage (SSB), other non-SSB, unknown)
Time frame: up to 3 years
Academics
Standards of Learning scores ranging from 0-600 with higher scores representing higher academic proficiency.
Time frame: up to 3 years
Beverage Intake
modified beverage intake questionnaire (BEVQ; 12-item) will assess frequency and amount of SSB and water consumption to determine average daily consumption in fl oz and kcal over the past month for each item and across categories: water, total SSBs (sweetened juice and drinks, regular carbonated beverages, sweet tea, sweetened coffee, energy drinks), milk, 100% juice.
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Time frame: up to 3 years
Water Source Assessment
Video of water sources and then coded by trained raters. Coding for: cleanliness, wear, availability of drinking vessels, filter status, obstructions, signage, trash, and water flow
Time frame: up to 3 years
School Personnel Knowledge
Measured via surveys: perceptions of water bottle use and hydration in school, knowledge and beliefs about hydration, personnel hydration practices, and awareness of and adherence to existing hydration policy
Time frame: up to 3 years
School Environment
Measured via semi-structured interview: assessing water and SSB-related access, policies and practices in their school
Time frame: up to 3 years
Beverage Sales
We will evaluate purchases of white milk, sugar-sweetened milk, 100% juice, and other beverages.
Time frame: up to 3 years
National School Lunch Program (NSLP) Participation
Daily and monthly NSLP participation rates will be obtained
Time frame: up to 3 years