Dental Caries, Obesity Prevention
Conditions
Keywords
hydration, water, sugar-sweetened beverages, dental caries, overweight and obesity
Brief summary
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.
Detailed description
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).
Interventions
BEHAVIORALHydration
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.
Sponsors
Virginia Commonwealth University
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
Stepped wedge cluster randomized controlled trial; 4 groups of schools sequentially receive the intervention each year over 3 years. Assessments of all 12 schools occur at all timepoints over the 3 years.
Eligibility
Sex/Gender
ALL
Age
4 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Lunchroom observations: All students (K-5th \[Pre-Kindergarten if applicable\]) who eat lunch in the cafeteria on assessment days are eligible * BMI and dental caries assessments: 1) student enrolls in study while in 3rd grade (followed through 5th g) * Student surveys: Students in 4th-5th grade are eligible to complete surveys assessing beverage intake and perceptions of hydration practices within their school district. * Staff surveys: All staff in the target schools will be eligible to complete the Personnel Survey.
Exclusion criteria
* Lunchroom observations: None. * BMI and dental caries assessments: Students are ineligible if they are unable to complete assessments due to developmental or physical reasons, 2) planning to move in the study duration * Student surveys: None. * Staff surveys: None.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Water Station Usage | Years 1-3 | Ounces of water per student per day measured by hydration station flow meters. |
| Dental Caries Status | up to 3 years | Tooth decay or cavities will be measured using a modified International Caries Detection and Assessment System (ICDAS) |
| Body Mass Index (BMI) | up to 3 years | NHANES Anthropometry methods used to measure height and weight. Age and sex-specific BMIz-score and BMI percentile will be calculated using Epi Info |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Water Bottle Usage at Lunch | up to 3 years | % of students with water bottles in school |
| Beverage Selection at Lunch | up to 3 years | % of each beverage selected (water, white milk, flavored milk, 100% juice, soda, sports-drink, other sugar-sweetened beverage (SSB), other non-SSB, unknown) |
| Academics | up to 3 years | Standards of Learning scores ranging from 0-600 with higher scores representing higher academic proficiency. |
| Beverage Intake | up to 3 years | 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. |
| Water Source Assessment | up to 3 years | 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 |
| School Personnel Knowledge | up to 3 years | 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 |
| School Environment | up to 3 years | Measured via semi-structured interview: assessing water and SSB-related access, policies and practices in their school |
| Beverage Sales | up to 3 years | We will evaluate purchases of white milk, sugar-sweetened milk, 100% juice, and other beverages. |
| National School Lunch Program (NSLP) Participation | up to 3 years | Daily and monthly NSLP participation rates will be obtained |
Countries
United States
Contacts
CONTACTSarah Farthing, MS
CONTACTMelanie K Bean, PhD
Outcome results
None listed