Increasing Water Access and Appeal in Community Recreation Centers

Study Overview
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Brief Summary
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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.

Official Title
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A Randomized Trial of a Comprehensive Multi-level Intervention to Increase Water Access and Appeal in Community Recreation Centers

Conditions
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Health Behavior

Intervention / Treatment
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* Behavioral: Hydrate Philly


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This cluster RCT involves 14 matched pairs; study recruitment and randomization occurs at the recreation center-level. Participating sites are matched based on center size, summer program enrollment, presence of indoor gym, neighborhood income & race/ethnicity. Then, an intervention site and control site are randomly determined by a coin flip within each pair.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Hydrate Philly Intervention<br>Intervention group that receives hydration station intervention | Behavioral: Hydrate Philly<br>* 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).<br>|
| No Intervention: Control<br>Control group that receives no intervention, but observational data is collected; converted to wait-listed intervention status after enrollment and randomization was completed | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Center water consumption | 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. | 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). | 
| Outside beverages during programs | Changes in the average number of sugary beverages per day brought to summer camp. | 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). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Single use beverage containers | Average number of single use containers (bottled water + sugary beverages) as measured by recreation center staff daily reports | 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). | 
| Staff consumption of sugary beverages | 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. | 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). | 
| Fountain related maintenance problems | 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). | Questionnaire administered 2-5 times per site up to 8 months post intervention | 
| Center attendance | The number of youth attending the recreation center program daily | 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). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hydration, water intake, sugar sweetened beverages, youth, children