Increasing Water Access and Appeal in Community Recreation Centers

Overview

This study is a cluster randomized controlled trial with n=28 City of Philadelphia recreation centers (14 matched pairs) designed to determine the effectiveness of a comprehensive multi-level intervention to increase water access and appeal in community recreation centers on 1) center-level water intake as measured by water meters, and 2) purchase of outside beverages as measured by observations of recreation center youth.

Full Title of Study: “A Randomized Trial of a Comprehensive Multi-level Intervention to Increase Water Access and Appeal in Community Recreation Centers”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: September 30, 2018

Interventions

  • Behavioral: Hydrate Philly
    • Hydrate Philly is a multi-component intervention that includes water safety testing, provision of 1-2 hydration stations per recreation center, distribution of reusable water bottles for youth, a campaign to promote the acceptability of tap water, and the reduction of access to competing unhealthy beverages through vending machine standards and discouraging “black bags” (characteristic small, black, plastic bags provided to customers with their corner store purchases, typically including a sugar sweetened beverage and/or unhealthy snack foods).

Arms, Groups and Cohorts

  • Experimental: Hydrate Philly Intervention
    • Intervention group that receives hydration station intervention
  • No Intervention: Control
    • Control group that receives no intervention, but observational data is collected; converted to wait-listed intervention status after enrollment and randomization was completed

Clinical Trial Outcome Measures

Primary Measures

  • Center water consumption
    • Time Frame: Three measurement periods, each lasting 2 weeks, will occur: baseline (2-4 months pre-intervention), mid-point (3-5 months post intervention), and post (7-10 months post intervention).
    • Change in average gallons of water per day used at the center drinking water source as measured by flow meters over each 2-week measurement period.
  • Outside beverages during programs
    • Time Frame: Three measurement periods, each lasting 2 weeks, will occur: baseline (2-4 months pre-intervention), mid-point (3-5 months post intervention), and post (7-10 months post intervention).
    • Changes in the average number of sugary beverages per day brought to summer camp.

Secondary Measures

  • Single use beverage containers
    • Time Frame: Three measurement periods, each lasting 2 weeks, will occur: baseline (2-4 months pre-intervention), mid-point (3-5 months post intervention), and post (7-10 months post intervention).
    • Average number of single use containers (bottled water + sugary beverages) as measured by recreation center staff daily reports
  • Staff consumption of sugary beverages
    • Time Frame: Three measurement periods, each lasting 2 weeks, will occur: baseline (2-4 months pre-intervention), mid-point (3-5 months post intervention), and post (7-10 months post intervention).
    • Change in frequency of staff consumption of sugary beverages (i.e., number of days in past 30 days with sugary beverages consumed) as measured by the Beverage Intake Questionnaire (BEVQ-15) survey assessing past 30 day recall of overall beverage intake. Range is 0 – 30 with higher values indicating more days sugary beverages were consumed.
  • Fountain related maintenance problems
    • Time Frame: Questionnaire administered 2-5 times per site up to 8 months post intervention
    • Average maintenance rating of scale with 8 items (4-point scale; i.e., everyday, 3-4 times, once or twice, or never) at post as measured by staff self-report. Subscales include average routine maintenance (3 items) versus average maintenance problems (5 items).
  • Center attendance
    • Time Frame: Three measurement periods, each lasting 2 weeks, will occur: baseline (2-4 months pre-intervention), mid-point (3-5 months post intervention), and post (7-10 months post intervention).
    • The number of youth attending the recreation center program daily

Participating in This Clinical Trial

Inclusion Criteria

  • Recreation center is located in a low-income neighborhood in the City of Philadelphia, defined by ≥20% of the residents in the zip code at or below Federal Poverty Level – Recreation center includes both summer and after-school programming – Recreation center is willing to comply with City of Philadelphia Healthy Vending standards and discourage sugar sweetened beverage consumption – Recreation center has water lines appropriate for installing indoor hydration stations Exclusion Criteria:

  • Unwilling to accept randomization

Gender Eligibility: All

Minimum Age: 3 Years

Maximum Age: 100 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Philadelphia Department of Public Health
  • Collaborator
    • Stanford University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Hannah Lawman, Director of Research and Evaluation, Get Healthy Philly – Philadelphia Department of Public Health
  • Overall Official(s)
    • Hannah G Lawman, PhD, Principal Investigator, Philadelphia Department of Public Health, Division of Chronic Disease Prevention

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