Abstract
IntroductionDrinking water instead of sugar-sweetened beverages may reduce obesity and dental caries. Tap water is more affordable and sustainable than bottled water and more likely to contain fluoride, which prevents caries. To address inequities in access to safe tap water, cross-sector partners established the Agua4All safe drinking-water program in 2 rural San Joaquin Valley, California, communities. The program’s objective was to examine Agua4All’s feasibility, acceptability, and effect on water intake.MethodsWe provided bottle-filling stations dispensing safe water at 12 sites in 2 communities and provided limited promotional support. To compare the effect of different levels of promotion, sites in 1 community also received a promotions toolkit, a stipend, and assistance in developing and conducting their own promotional activities (site-led promotion). Beverage intake at sites was observed at baseline (pre-installation), at time 1 (post-installation), and at times 2 and 3 (post-promotion). Flowmeters tracked water dispensings. Staff interviews examined implementation barriers and facilitators.ResultsFrom baseline to time 3, a nonsignificant increase (21.16%) occurred in the proportion of people drinking water at sites with water stations and site-led promotion compared with sites with water stations and limited promotion (5.13%) (P = .14). Mean daily gallons of water taken from stations per site was 3.61 (standard deviation, 3.84). Most staff members (77%) at the sites preferred water stations to traditional drinking fountains.ConclusionBottle-filling stations with safe water and site-led promotion are a promising strategy for increasing water intake in communities without safe tap water. Larger studies should examine the effects of such stations on intake of sugar-sweetened beverages and on overall health.
Highlights
Drinking water instead of sugar-sweetened beverages may reduce obesity and dental caries
Bottle-filling stations with safe water and site-led promotion are a promising strategy for increasing water intake in communities without safe tap water
Low tap water intake is often attributed to the perception that bottled water is more convenient and better tasting [11], low consumption may be due to concerns about tap water’s safety [12,13]
Summary
Drinking water instead of sugar-sweetened beverages may reduce obesity and dental caries. Tap water is more affordable and sustainable than bottled water and more likely to contain fluoride, which prevents caries. Drinking water instead of sugar-sweetened beverages (SSBs) can reduce calorie and sugar intake [1] and help prevent obesity and dental caries [2,3,4,5]. Either tap or bottled water can meet hydration needs, tap water is more affordable, leaves a smaller environmental footprint, and is more likely than bottled water to contain fluoride, which can prevent caries [8]. In California’s San Joaquin Valley, the setting for this study, approximately 1.36 million residents who are predominantly low-income and Latino lacked access to safe drinking water in 2013 because of contaminants in the water, both naturally occurring and from agricultural and industrial activities [13]
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