Advertisement

Middle School Student Attitudes About School Drinking Fountains and Water Intake

      Abstract

      Objective

      To describe middle school student attitudes about school drinking fountains, investigate whether such attitudes are associated with intentions to drink water at school, and determine how intentions relate to overall water intake.

      Methods

      Students (n = 3211) in 9 California middle schools completed surveys between 2009 and 2011. We used multivariate linear regression, adjusting for school sociodemographic characteristics, to examine how attitudes about fountains (5-point scale; higher scores indicating more positive attitudes) were associated with intentions to drink water at school and how intentions to drink water at school were related to overall water intake.

      Results

      Mean age of students was 12.3 (SD = 0.7) years; 75% were Latino, 89% low income, and 39% foreign born. Fifty-two percent reported lower than recommended overall water intake (<3 glasses/day), and 30% reported that they were unlikely or extremely unlikely to drink water at school. Fifty-nine percent reported that school fountains were unclean, 48% that fountain water does not taste good, 33% that fountains could make them sick, 31% that it was not okay to drink from fountains, and 24% that fountain water is contaminated. In adjusted analyses, attitudes about school drinking fountains were related to intentions to drink water at school (β = 0.41; P < .001); intentions to drink water at school were also associated with overall water intake (β = 0.20; P < .001).

      Conclusions

      Students have negative attitudes about school fountains. To increase overall water intake, it may be important to promote and improve drinking water sources not only at school but also at home and in other community environments.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wang Y.C.
        • Ludwig D.S.
        • Sonneville K.
        • Gortmaker S.L.
        Impact of change in sweetened caloric beverage consumption on energy intake among children and adolescents.
        Arch Pediatr Adolesc Med. 2009; 163: 336-343
        • Patel A.I.
        • Bogart L.M.
        • Elliott M.N.
        • et al.
        Increasing the availability and consumption of drinking water in middle schools: a pilot study.
        Prev Chronic Dis. 2011; 8: A60
        • Muckelbauer R.
        • Libuda L.
        • Clausen K.
        • et al.
        Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial.
        Pediatrics. 2009; 123: e661-e667
        • Ebbeling C.B.
        • Feldman H.A.
        • Chomitz V.R.
        • et al.
        A randomized trial of sugar-sweetened beverages and adolescent body weight.
        N Engl J Med. 2012; 367: 1407-1416
        • de Ruyter J.C.
        • Olthof M.R.
        • Seidell J.C.
        • Katan M.B.
        A trial of sugar-free or sugar-sweetened beverages and body weight in children.
        N Engl J Med. 2012; 367: 1397-1406
        • Loughridge J.L.
        • Barratt J.
        Does the provision of cooled filtered water in secondary school cafeterias increase water drinking and decrease the purchase of soft drinks?.
        J Hum Nutr Diet. 2005; 18: 281-286
        • Visscher T.L.
        • van Hal W.C.
        • Blokdijk L.
        • et al.
        Feasibility and impact of placing water coolers on sales of sugar-sweetened beverages in Dutch secondary school canteens.
        Obes Facts. 2010; 3: 109-115
        • Bogart L.M.
        • Cowgill B.O.
        • Elliott M.N.
        • et al.
        A randomized controlled trial of students for nutrition and exercise: a community-based participatory research study.
        J Adolesc Health. 2014 Apr 28; (pii: S1054-139X(14)00115-3. doi: 10.1016/j.jadohealth.2014.03.003. [Epub ahead of print])
        • Feldens C.A.
        • Vitolo M.R.
        • Drachler Mde L.
        A randomized trial of the effectiveness of home visits in preventing early childhood caries.
        Community Dent Oral Epidemiol. 2007; 35: 215-223
      1. Institute of Medicine. Dietary reference intakes: water, potassium, sodium, chloride, and sulfate. Available at: http://www.iom.edu/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx. Accessed September 7, 2013.

        • Park S.
        • Sherry B.
        • O’Toole T.
        • Huang Y.
        Factors associated with low drinking water intake among adolescents: the Florida Youth Physical Activity and Nutrition Survey, 2007.
        J Am Diet Assoc. 2011; 111: 1211-1217
      2. Sebastian RS, Wilkinson Enns C, Goldman JD. Drinking water intake in the US: what we eat in America, NHANES 2005–2008. Food Surveys Research Group Dietary Data Brief No. 7. September 2011. Available at: http://ars.usda.gov/Services/docs.htm?docid=19476.

        • Saylor A.
        • Prokopy L.S.
        • Amberg S.
        What’s wrong with the tap? Examining perceptions of tap water and bottled water at Purdue University.
        Environ Manage. 2011; 48: 588-601
        • Gorelick M.H.
        • Gould L.
        • Nimmer M.
        • et al.
        Perceptions about water and increased use of bottled water in minority children.
        Arch Pediatr Adolesc Med. 2011; 165: 928-932
        • Hobson W.L.
        • Knochel M.L.
        • Byington C.L.
        • et al.
        Bottled, filtered, and tap water use in Latino and non-Latino children.
        Arch Pediatr Adolesc Med. 2007; 161: 457-461
        • Patel A.I.
        • Shapiro D.J.
        • Wang Y.C.
        • Cabana M.D.
        Sociodemographic characteristics and beverage intake of children who drink tap water.
        Am J Prev Med. 2013; 45: 75-82
        • Edmonds C.J.
        • Jeffes B.
        Does having a drink help you think? 6–7-year-old children show improvements in cognitive performance from baseline to test after having a drink of water.
        Appetite. 2009; 53: 469-472
        • D'Anci K.E.
        • Constant F.
        • Rosenberg I.H.
        Hydration and cognitive function in children.
        Nutr Rev. 2006; 64: 457-464
        • Popkin B.M.
        • D'Anci K.E.
        • Rosenberg I.H.
        Water, hydration, and health.
        Nutr Rev. 2010; 68: 439-458
        • Stookey J.D.
        • Brass B.
        • Holliday A.
        • Arieff A.
        What is the cell hydration status of healthy children in the USA? Preliminary data on urine osmolality and water intake.
        Public Health Nutr. 2012; 15: 2148-2156
        • Patel A.I.
        • Chandran K.
        • Hampton K.E.
        • et al.
        Observations of drinking water access in school food service areas before implementation of federal and state school water policy, California, 2011.
        Prev Chronic Dis. 2012; 9: E121
        • Hood N.E.
        • Turner L.
        • Colabianchi N.
        • et al.
        Availability of drinking water in US public school cafeterias.
        J Acad Nutr Diet. 2014; 14: S2212-S2672
        • Patel A.I.
        • Hecht K.
        • Hampton K.E.
        • et al.
        Free drinking water access and barriers to improving water availability in California public schools.
        Am J Public Health. 2014; 104: 1314-1319
        • Patel A.I.
        • Bogart L.M.
        • Uyeda K.E.
        • et al.
        Perceptions about availability and adequacy of drinking water in a large California school district.
        Prev Chronic Dis. 2010; 7: A39
        • Onufrak S.J.
        • Park S.
        • Sharkey J.R.
        • et al.
        Perceptions of tap water and school water fountains and association with intake of plain water and sugar-sweetened beverages.
        J School Health. 2014; 84: 195-204
        • Jones A.Q.
        • Dewey C.E.
        • Dore K.
        • et al.
        Public perceptions of drinking water: a postal survey of residents with private water supplies.
        BMC Public Health. 2006; 6: 94
        • Onufrak S.J.
        • Park S.
        • Sharkey J.R.
        • Sherry B.
        The relationship of perceptions of tap water safety with intake of sugar-sweetened beverages and plain water among US adults.
        Public Health Nutr. 2014; 17: 179-185
        • Doria M.F.
        Bottled water versus tap water: understanding consumers' preferences.
        J Water Health. 2006; 4: 271-276
        • Fishbein M.
        • Ajzen I.
        Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading.
        Addison-Wesley, Mass1975
      3. Beverage consumption among high school students—United States, 2010.
        MMWR Morb Mortal Wkly Rep. 2011; 60: 778-780
        • Claire Wang Y.
        • Gortmaker S.L.
        • Taveras E.M.
        Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976–2006.
        Int J Pediatr Obes. 2011; 6: 12-20
        • Patel A.I.
        • Bogart L.M.
        • Uyeda K.E.
        • et al.
        School site visits for community-based participatory research on healthy eating.
        Am J Prev Med. 2009; 37: S300-S306
        • Comrey A.L.
        • Lee H.B.
        A First Course in Factor Analysis.
        2nd ed. Lawrence Erlbaum, Hillsdale, NJ1992
        • Kant A.K.
        • Graubard B.I.
        Contributors of water intake in US children and adolescents: associations with dietary and meal characteristics—National Health and Nutrition Examination Survey, 2005–2006.
        Am J Clin Nutr. 2010; 92: 887-896
        • Patel A.I.
        • Hampton K.E.
        Encouraging consumption of water in school and child care stettings: access, challenges, and strategies for improvement.
        Am J Public Health. 2011; 101: 1370-1379