Fidelity evaluation of the Water First intervention for promoting tap water consumption in school-age children
Gupta A, Ryu K, Peralta Y, Ordonez V, McCulloch CE, Schmidt LA, Ritchie LD, Patel AI
BMC public health · 0 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- NHLBI NIH HHS
- Gobierno
- National Heart, Lung, and Blood Institute of the National Institutes of Health
Según 3 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2026-06-13 · BMC Public Health · vol. 26 · número 1
- Editorial
- BioMed Central
- Citado
- 0 citas · más que el 43% de estudios similares · 0.0× el promedio de su campo
- Referencias
- 0 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Obesity, Physical Activity, Diet · School Health and Nursing Education · Health Policy Implementation Science
- Palabras clave
- implementation fidelity, tap water consumption, elementary school students, beverage consumption, sugar-sweetened beverages, fruit juice, milk consumption, body mass index, childhood overweight prevention, school canteens, water promotion, school health promotion
- MeSH
- humans, body mass index, program evaluation, drinking, schools, beverages, child, health promotion, female, male, overweight, drinking water
8 autores
- Anjali Gupta🇺🇸Stanford Medicine; Stanford University
- Keejeong Ryu🇺🇸Stanford Medicine; Stanford University
- Yadira Peralta🇲🇽Centro de Investigación y Docencia Económicas
- Valeria M Ordonez🇺🇸Stanford Medicine; Stanford University
- Charles E. McCulloch🇺🇸University of California, San Francisco
- Laura A. Schmidt🇺🇸University of California, San Francisco; Philip R. Lee Institute for Health Policy Studies
- Lorrene Davis Ritchie🇺🇸University of California System; University of California Division of Agriculture and Natural Resources
- Anisha I. Patel🇺🇸 · autor de correspondenciaStanford Medicine; Stanford University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
A cluster-randomized controlled trial examining the impact of the Water First water promotion and access program in 18 elementary schools found that the intervention increased water consumption and prevented overweight. This study describes a secondary analysis of implementation fidelity and its association with change in students' beverage intake and body mass index (BMI) z-score in the intervention arm.
Methods
Researchers observed Water First fidelity (visible water promotional material, quality of study-provided water sources and drinking vessels in classrooms, school cafeterias, high-traffic areas) 2 times/week during the intervention period, with data collected via yes/no questions. Responses indicating high fidelity were assigned a value of 1 and low fidelity were assigned 0; these were averaged to generate a summary score for each location (0 to 1). Home-engagement activity completion (%) was calculated per student based on returned class assignments. Anthropometrics and past-week frequency of beverage intake (instrument adapted from the validated Beverage and Snack Questionnaire) were assessed at baseline, 7-months, and 15-months. Mixed-effects linear regression models examined associations of fidelity with the primary (water intake) and secondary (sugar-sweetened beverage [SSB], milk, 100% fruit juice intake, BMI z-score) outcomes. The primary predictor was the fidelity score (0.1-unit increase) by time interaction. Beverage frequencies were log-transformed, and regression coefficients were exponentiated to derive the percent change in outcomes.
Results
Fidelity was highest in the cafeteria (mean: 0.87, SD: 0.06) compared to high-traffic water station areas (0.66, SD: 0.15) and classrooms (0.73, SD: 0.13). Mean home-engagement activity completion rate was 0.41 (SD: 0.33). There were no associations of fidelity with water intake. Each 0.1 unit increase in classroom fidelity was associated with a decreased intake of 100% fruit juice (0.95; Cl: 0.91-0.99). Higher high-traffic area fidelity was associated with decreased intake of SSB (0.94; Cl: 0.91-0.98) and plain milk (0.92; Cl: 0.89-0.96). Higher cafeteria fidelity was associated with 0.027 decrease in BMI z-score (Cl: -0.046, -0.008). No significant associations were observed for home-engagement activity completion.
Conclusions
The intervention was largely implemented with high fidelity, with scores ranging from 0.66 to 0.87. Higher cafeteria fidelity was associated with reductions in BMI z-score, while home-engagement activity completion was not associated with changes in beverage outcomes or BMI z-score.
Trial registration
The trial was preregistered (2017-06-09) at clinicaltrials.gov (NCT03181971).
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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