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Water Security Experiences and Water Intake among Elementary Students at Low Income Schools: A Cross-Sectional Study

      Abstract

      Objective

      To examine students’ experiences of water security at school and how experiences relate to intake of water from different sources of water at school.

      Design/Methods

      In this cross-sectional study, 651 students in grades 3-5 in 12 low-income public elementary schools in the San Francisco area completed surveys about their daily intake of water from different sources of water at school, experiences of water security including safety, cleanliness, and taste of water at school, and their demographics. Multivariable linear regressions examined associations between students’ water security experiences at school and reported intake from different sources of water at school.

      Results

      Approximately half of students were Latino (56.1%) and had overweight/obesity (50.4%). Most (74.5%) had some negative water security experience at school. Students drank from the school fountain or water bottle filling station a mean of 1.2 times/day (SD=1.4), sinks 0.2 times/day (SD=0.7), tap water dispensers 0.2 times/day (SD=0.6), and bottled water 0.5 times/day (SD=1.0). In multivariable linear regression, students with more negative experiences of school water security drank less frequently from fountains (-0.5 times/day, p-value <0.001), but more frequently from tap water dispensers (0.1 times/day, p-value 0.040) and sinks (0.1 times/day, p-value 0.043), compared to students with no negative perceptions.

      Conclusion

      On average, students had negative school water security experiences, which decreased their consumption of water from tap water sources. However, relationships between negative water security experiences and reported water intake appeared to be mitigated by water source. Schools should consider installing more appealing water sources to promote water intake.

      Keywords

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      Reference

        • Brooks CJ
        • Gortmaker SL
        • Long MW
        • Cradock AL
        • Kenney EL.
        Racial/Ethnic and Socioeconomic Disparities in Hydration Status Among US Adults and the Role of Tap Water and Other Beverage Intake.
        Am J Public Health. 2017; 107: 1387-1394https://doi.org/10.2105/AJPH.2017.303923
        • Giles, Catherine M
        • Giles; Kenney Erica
        • Gortmaker SL.
        Increasing Water Availability During Afterschool Snack: Evidence, Strategies, and Partnerships from a Group Randomized Trial.
        Am J Prev Med. 2012; 43: S136-S142https://doi.org/10.1016/J.AMEPRE.2012.05.013
        • Ebbeling CB
        • Feldman HA
        • Osganian SK
        • Chomitz VR
        • Ellenbogen SJ
        • Ludwig DS.
        Effects of decreasing sugar-sweetened beverage consumption on body weight in adolescents: a randomized, controlled pilot study.
        Pediatrics. 2006; 117: 673-680https://doi.org/10.1542/peds.2005-0983
        • Muckelbauer R
        • Libuda L
        • Clausen K
        • Toschke AM
        • Reinehr T
        • Kersting M.
        Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial.
        Pediatrics. 2009; 123https://doi.org/10.1542/PEDS.2008-2186
        • Wang YC
        • Ludwig DS
        • Sonneville K
        • Gortmaker SL.
        Impact of change in sweetened caloric beverage consumption on energy intake among children and adolescents.
        Arch Pediatr Adolesc Med. 2009; 163: 336-343https://doi.org/10.1001/archpediatrics.2009.23
        • Drewnowski A
        • Rehm CD
        • Constant F.
        Water and beverage consumption among children age 4-13y in the United States: analyses of 2005-2010 NHANES data.
        Nutr J. 2013; 12: 85https://doi.org/10.1186/1475-2891-12-85
        • Patel AI
        • Hecht CE
        • Cradock A
        • Edwards MA
        • Ritchie LD.
        Drinking Water in the United States: Implications of Water Safety.
        Access, and Consumption. 2020; 40 (https://doi.org/101146/annurev-nutr-122319-035707doi:10.1146/ANNUREV-NUTR-122319-035707): 345-373
        • Drewnowski A
        • Rehm CD
        • Constant F.
        Water and beverage consumption among adults in the United States: cross-sectional study using data from NHANES 2005-2010.
        BMC Public Health. 2013; 13: 1068https://doi.org/10.1186/1471-2458-13-1068
        • Park S
        • Blanck HM
        • Sherry B
        • Brener N
        • O'Toole T.
        Factors associated with low water intake among US high school students - National Youth Physical Activity and Nutrition Study, 2010.
        J Acad Nutr Diet. 2012; 112: 1421-1427https://doi.org/10.1016/j.jand.2012.04.014
        • Rosinger AY
        • Patel AI
        • Weaks F.
        Examining recent trends in the racial disparity gap in tap water consumption: NHANES 2011–2018.
        Public Health Nutr. 2021; : 1-7https://doi.org/10.1017/S1368980021002603
        • Onufrak SJ
        • Park S
        • Sharkey JR
        • 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: 179-185https://doi.org/10.1017/S1368980012004600
        • Gostin LO.
        Lead in the Water: A Tale of Social and Environmental Injustice.
        JAMA. 2016; 315: 2053-2054https://doi.org/10.1001/JAMA.2016.5581
        • Hobson WL
        • Knochel ML
        • Byington CL
        • Young PC
        • Hoff CJ
        • Buchi KF.
        Bottled, Filtered, and Tap Water Use in Latino and Non-Latino Children.
        Arch Pediatr Adolesc Med. 2007; 161: 457-461https://doi.org/10.1001/ARCHPEDI.161.5.457
        • Gorelick MH
        • Gould L
        • Nimmer M
        • et al.
        Perceptions About Water and Increased Use of Bottled Water in Minority Children.
        Arch Pediatr Adolesc Med. 2011; 165: 928https://doi.org/10.1001/archpediatrics.2011.83
        • Rosinger AY
        • Young SL.
        In-Home Tap Water Consumption Trends Changed Among U.S. Children, but Not Adults, Between 2007 and 2016.
        Water Resour Res. 2020; 56https://doi.org/10.1029/2020WR027657
        • Onufrak SJ
        • Park S
        • Sharkey JR
        • Merlo C
        • Dean WR
        • Sherry B.
        Perceptions of tap water and school water fountains and association with intake of plain water and sugar-sweetened beverages.
        J Sch Health. 2014; 84: 195-204https://doi.org/10.1111/josh.12138
        • Rosinger AY
        • Bethancourt H
        • Francis LA.
        Association of Caloric Intake From Sugar-Sweetened Beverages With Water Intake Among US Children and Young Adults in the 2011-2016 National Health and Nutrition Examination Survey.
        JAMA Pediatr. 2019; 173: 602-604https://doi.org/10.1001/JAMAPEDIATRICS.2019.0693
        • Park S
        • Sherry B
        • Wethington H
        • Pan L.
        Use of parks or playgrounds: reported access to drinking water fountains among US adults, 2009.
        J Public Health. 2012; 34 (Bangkok): 65-72https://doi.org/10.1093/pubmed/fdr047
        • Scharf RJ
        • DeBoer MD.
        Sugar-Sweetened Beverages and Children's Health.
        Annu Rev Public Health. 2016; 37: 273-293https://doi.org/10.1146/annurev-publhealth-032315-021528
        • Hu FB.
        Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases.
        Obes Rev. 2013; 14: 606-619https://doi.org/10.1111/obr.12040
        • Vos MB
        • Kaar JL
        • Welsh JA
        • et al.
        Added sugars and cardiovascular disease risk in children: A scientific statement from the American Heart Association.
        Circulation. 2017; 135: e1017-e1034https://doi.org/10.1161/CIR.0000000000000439
        • Kell KP
        • Cardel MI
        • Brown MMB
        • Fernandez JR.
        Added sugars in the diet are positively associated with diastolic blood pressure and triglycerides in children.
        Am J Clin Nutr. 2014; 100: 46-52https://doi.org/10.3945/ajcn.113.076505
        • Bleich SN
        • Vercammen KA
        • Koma JW
        • Li Z.
        Trends in Beverage Consumption Among Children and Adults, 2003-2014.
        Obesity. 2018; 26: 432-441https://doi.org/10.1002/oby.22056
        • Kenney EL
        • Gortmaker SL
        • Carter JE
        • Howe MCW
        • Reiner JF
        • Cradock AL.
        Grab a cup, fill it up! an intervention to promote the 1 of drinking water and increase student water consumption during school lunch.
        Am J Public Health. 2015; 105: 1777-1783https://doi.org/10.2105/AJPH.2015.302645
        • Schwartz AE
        • Leardo M
        • Aneja S
        • Elbel B.
        Effect of a School-Based Water Intervention on Child Body Mass Index and Obesity.
        JAMA Pediatr. 2016; 170: 220-226https://doi.org/10.1001/JAMAPEDIATRICS.2015.3778
        • Patel AI
        • Bogart LM
        • Klein DJ
        • et al.
        Middle school student attitudes about school drinking fountains and water intake.
        Acad Pediatr. 2014; 14: 471-477https://doi.org/10.1016/j.acap.2014.05.010
        • Moreno GD
        • Schmidt LA
        • Ritchie LD
        • et al.
        A cluster-randomized controlled trial of an elementary school drinking water access and promotion intervention: Rationale, study design, and protocol HHS Public Access.
        Contemp Clin Trials. 2021; 101106255https://doi.org/10.1016/j.cct.2020.106255
        • California Department of Education
        DataQuest - Educational Demographic reports - select additional parameters.
        2019 (Accessed December 17)
        • Neuhouser ML
        • Lilley S
        • Lund A
        • Johnson DB.
        Development and Validation of a Beverage and Snack Questionnaire for Use in Evaluation of School Nutrition Policies.
        J Am Diet Assoc. 2009; 109: 1587-1592https://doi.org/10.1016/J.JADA.2009.06.365
      1. Fram MS, Frongillo EA, Draper CL, Fishbein EM. Development and Validation of a Child Report Assessment of Child Food Insecurity and Comparison to Parent Report Assessment. http://dx.doi.org/101080/193202482013790775. 2013;8(2):128-145. doi:10.1080/19320248.2013.790775

        • Benítez-Porres J
        • López-Fernández I
        • Raya JF
        • Álvarez Carnero S
        • Alvero-Cruz JR
        • Álvarez Carnero E
        Reliability and Validity of the PAQ-C Questionnaire to Assess Physical Activity in Children.
        J Sch Health. 2016; 86: 677-685https://doi.org/10.1111/JOSH.12418
        • National Center for Health Statistics
        National Health and Nutrition Examination Survey Anthropometry Procedures Manual.
        2017
        • Kuczmarski RJ
        • Ogden CL
        • Guo SS
        • et al.
        2000 CDC growth charts for the United States: Methods and development. Vital Heal Stat Ser 11 Data from Natl Heal Surv.
        Natl Heal Nutr Exam Surv Hisp Heal Nutr Exam Surv. 2002; 11
        • Park S
        • Onufrak S
        • Cradock A
        • et al.
        Correlates of Infrequent Plain Water Intake Among US High School Students: National Youth Risk Behavior Survey.
        Am J Heal Promot. 2017; 34 (2020): 549-554https://doi.org/10.1177/0890117120911885
        • Vieux F
        • Maillot M
        • Rehm CD
        • Barrios P
        • Drewnowski A.
        Trends in tap and bottled water consumption among children and adults in the United States: Analyses of NHANES 2011-16 data.
        Nutr J. 2020; 19: 1-14https://doi.org/10.1186/S12937-020-0523-6/TABLES/5
        • Rosinger AY
        • Herrick KA
        • Wutich AY
        • Yoder JS
        • Ogden CL.
        Disparities in plain, tap and bottled water consumption among USadults: National Health and Nutrition Examination Survey (NHANES)2007–2014.
        Public Health Nutr. 2018; 21: 1455https://doi.org/10.1017/S1368980017004050