Agua4All: Providing Safe Drinking Water in Rural California Communities

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.

Association of park drinking water source characteristics and water intake in San Francisco Bay Area parks

“…However, to substantially impact SSB intake, the promotion of tap water as a replacement for SSBs may be needed (Moghadam et al 2019). Previous studies in other community settings suggest that coupling appealing water sources with promotional activities, such as signage, can significantly increase water intake (Patel et al 2019;Lawman et al 2020). Despite the importance of promotion efforts, no parks in this study marketed tap water via posters, signage, or other materials.…”

Development and Piloting of the Enhanced Integrated Behavioral Model to Frame a Social Marketing Campaigns for Teens

“…In the interview analysis, we had difficulty teasing out whether changes were due to the campaign, the water-bottle filling stations, or some combination of the two. Patel’s et al (2019); Schwartz’s (2016) studies found that increased water access at school is linked to increased water consumption and to body mass index changes. However, other studies have shown that additional education and training are necessary to maximize impacts (James et al, 2004; Patel et al, 2011).…”