At the 2019 American Public Health Association’s (APHA) Annual Meeting and Expo in Philadelphia, PA, James Daly will present on drinking water access in a large urban school district, and Erica Kenney will present on improvements in dietary intake due to a food policy change. Details are below.
Date: Sunday, November 3, 2019
Time: 5:00-6:00pm
Session: 2103.0 – FN Section Poster I
Program: Food and Nutrition
Board 6: A mixed methods investigation of how drinking water access and quality concerns influence student health in a large urban school district
Introduction: Although federal and state policies require that schools provide access to drinking water, recent evidence suggests that many schools struggle to do this. It is unclear how school drinking water access issues are impacting health. This study aims to explore student and staff perceptions about school water access and its influence on health and well-being.
Methods: In this mixed methods study in six urban schools, we documented the functionality of 75 school water sources; 350 students were observed drinking water. Sixty-three students completed quantitative surveys about water consumption and health and participated in ten focus groups; 30 school staff members participated in seven focus groups. Chi-squared tests compared the odds of health-related outcomes among students reporting drinking water often at lunch compared to none.
Results: Water access varied widely from school to school. Between 0-26% of students were observed drinking water during school lunch, drinking only 2.4 ounces on average. Students who reported not drinking water were more likely to report having had a headache (p=0.009), a stomachache (p=0.008) and trouble concentrating (p=0.016). Qualitative data suggested that concerns about water quality, especially lead, make students reluctant to drink, but also that replacing tap water with bottled water coolers is not a tenable solution due to problems with cleanliness and reduced access.
Discussion: With aging infrastructure and growing concerns around drinking water safety in schools, identifying student and staff perceptions of school drinking water quality and access can help to inform strategies to improve student water consumption, health, and well-being.
Learning Areas
- Chronic disease management and prevention
- Public health or related organizational policy, standards, or other guidelines
- Public health or related public policy
- Public health or related research
- Social and behavioral sciences
Learning Objectives
- Explain how students and staff perceive drinking water access at school.
- Compare the self-reported health and well-being of children who report drinking water to those who do not.
- Describe promising strategies to improve student water consumption, health, and well-being.
Keyword(s)
- Water & Health
- School-Based Health
Authors
James G. Daly, MPH
Harvard T.H. Chan School of Public Health
Steven L. Gortmaker, PhD
Harvard T.H. Chan School of Public Health
Rebecca S. Mozaffarian, MS, MPH
Harvard T.H. Chan School of Public Health
Rebekka M. Lee, ScD
Harvard T.H. Chan School of Public Health
Erica L. Kenney, ScD
Harvard T.H. Chan School of Public Health
Date: Tuesday, November 5, 2019
Time: 3:00pm-3:20pm
Session: 4342.0 Improvements in dietary intake among children attending family child care homes participating in the Child and Adult Care Food Program: A quasi-experimental study of a food policy change
Introduction: Changes to the Child and Adult Care Food Program (CACFP) meal pattern in Fall 2017, which required increased whole grains servings and decreased fruit juice, among other changes, were designed in part to improve young children’s diets. However, the actual impact of this policy change on children’s diets, particularly in family child care homes (FCCHs),which are often under-resourced, is unknown.
Methods: In a natural, experimental study of 13 CACFP-participating FCCHs in Boston, MA, two registered dieticians used several days’ worth of digital photographs taken of children’s plates before and after consumption to measure children’s dietary intake in FCCHs both prior to implementation of the new standards and again one year later. Generalized estimating equations tested for change in average intake (servings per day) of fruits, vegetables, whole grains, 100% juice, grain-based desserts, lean protein, and milk, adjusting for clustering of observations within providers.
Results: Sixty-one observations of children’s daily intake at the 13 FCCHs were recorded at baseline, and 125 observations were recorded at follow-up. Intake of servings of fruit and vegetables (adjusted change: +0.87 servings, 95% CI: 0.11, 1.63), and whole grains (+0.46 servings, 95% CI 0.14, 0.83) increased significantly after the meal pattern change. Juice intake declined slightly.
Discussion: Young children’s dietary intake in CACFP-participating FCCHs improved following the change in CACFP meal patterns, particularly intake of fruits/vegetables and whole grains, which were targets of the new policy. Additional research should examine impacts of the changes in other child care settings and locales.
Learning Areas
-
Conduct evaluation related to programs, research, and other areas of practice -
Public health or related organizational policy, standards, or other guidelines
Learning Objectives
-
Describe the impact of changes to the Child and Adult Care Food Program’s meal patterns on the diets of young children. -
Discuss unique attributes of the family child care setting that may influence the success of the change to the Child and Adult Care Food Program on the diets of young children.
Keyword(s)
- Nutrition
- Public Policy
Authors
Erica L. Kenney, ScD
Harvard T.H. Chan School of Public Health
Mary Kathryn Poole, MPH
Harvard T.H. Chan School of Public Health
Hannah Cory, MPH
Harvard T.H. Chan School of Public Health
Angie L. Cradock, ScD, MPE
Harvard T.H. Chan School of Public Health