Providing drinking water to U.S. children during school meals is a recommended health
promotion strategy and part of national nutrition policy. Urban school systems have
struggled with providing drinking water to children, and little is known about how
to ensure that water is served, particularly in afterschool settings.
To assess the effectiveness of an intervention designed to promote water as the beverage
of choice in afterschool programs.
The Out of School Nutrition and Physical Activity Initiative (OSNAP) used a community-based
collaboration and low-cost strategies to provide water after school. A group RCT was
used to evaluate the intervention. Data were collected in 2010–2011 and analyzed in
Twenty afterschool programs in Boston were randomized to intervention or control (delayed
Intervention sites participated in learning collaboratives focused on policy and environmental
changes to increase healthy eating, drinking, and physical activity opportunities
during afterschool time (materials available at www.osnap.org
). Collaboration between Boston Public Schools Food and Nutrition Services, afterschool
staff, and researchers established water-delivery systems to ensure children were
served water during snack time.
Main outcome measures
Average ounces of water served to children per day was recorded by direct observation
at each program at baseline and 6-month follow-up over 5 consecutive school days.
Secondary measures directly observed included ounces of other beverages served, other
snack components, and water-delivery system.
Participation in the intervention was associated with an increased average volume
of water served (+3.6 ounces/day; p=0.01) during snack. On average, the intervention led to a daily decrease of 60.9
kcals from beverages served during snack (p=0.03).
This study indicates the OSNAP intervention, including strategies to overcome structural
barriers and collaboration with key actors, can increase offerings of water during
afterschool snack. OSNAP appears to be an effective strategy to provide water in afterschool
settings that can be helpful in implementing new U.S. Department of Agriculture guidelines
regarding water availability during lunch and afterschool snack.