Improving Water Consumption in Underserved Elementary Schools: Implementation and Evaluation of a School-based Hydration Initiative

Abstract

Objective: Our objective was to evaluate the feasibility and effectiveness of a school-based hydration initiative in elementary schools. Methods: Hydration initiative included (1) placement of hydration stations, (2) promotional and educational activities during “Water Week,” and (3) provision of reusable water bottles. Surveys were administered at baseline and follow-up to assess student beverage intake and perceptions about the school’s environmental hydration policies and practices. Water bottle fills were assessed objectively at baseline, post-Water Week, and followup via weekly counts from hydration stations. Results: Water use increased post-Water Week (2.97±2.14), declining to 0.71±0.47 2 weeks later. At follow-up, frequency of soda consumption decreased (-.01 times/day; p < .001), self-reported water refill station use increased (p = .011), and a decrease (-.04 cups/day) in overall daily water intake (p = .043). At follow-up, there was an increase in the percentage of school personnel who reported their school promoted water as the best choice (p = .039). Students and teachers reported positive attitudes towards hydration stations, with some concerns about water bottle use in classrooms. Conclusion: The intervention reduced soda consumption and improved school hydration culture. Results can inform hydration policy and programming efforts for elementary school students.