Evaluation of the Impact of Water Access and Promotion in Parks on Beverage Intake

Study Overview
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Brief Summary
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Sugar-sweetened beverages (SSBs) are a major caloric source and the largest source of added sugars in the American diet. While many cities around the country have adopted anti-SSB policies such as soda taxes to reduce SSB intake, there has yet to be any studies to evaluate if the effects of these taxes, coupled with increased water access and promotion effort can lead to decreased sugar sweetened beverage consumption and increased water consumption. This quasi-experimental study evaluates how implementation of SSB taxes, installation of new water stations, and a multicultural water promotion campaign in parks impacts beverage intake in these settings as compared to soda taxes alone.

Detailed Description
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Consumption of water, in place of sugar sweetened beverages (SSBs), can help prevent obesity and dental carries. While drinking water is associated with these and many other positive health outcomes, many do not meet the recommended dietary intake of water. This is more profound in low income and minority communities that are more likely to drink less water and drink more SSBs. School-based water promotion interventions have shown that improved access to clean drinking water coupled with promotion leads to increases in water consumption and improved health outcomes. No studies have studied the impact of similar strategies on beverage intake and health in parks and public spaces. Parks are an inconspicuous and widely utilized public space, with the majority of Americans going to a park in the last month. This study's central hypothesis is that visitors in parks with SSB taxes coupled with increased access to appealing drinking water and rigorous promotion of its consumption will be more likely to drink water and less likely to drink SSBs, compared to visitors in parks with only SSB taxes. This quasi-experimental study makes use of naturally-occurring policy changes in the San Francisco (SF) Bay Area to disentangle the impacts of anti- SSB policies, water station installation, and multicultural water promotion efforts, using control groups to isolate the effects of anti-SSB policies alone or no intervention. This study will analyze beverage consumption in 10 SF parks that received new water stations and a multicultural water promotion campaign compared to 20 matched control parks (10 parks SF and 10 parks in Oakland) with only SSB taxes.

Official Title
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Drink Tap: A Multi-Sector Effort to Promote Water Access and Intake in San Francisco Parks to Improve Beverage Intake and Promote Health

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Drink Tap


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Park visitors within a defined geographic boundary Exclusion Criteria: Park visitors outside a defined geographic boundary
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: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Improved Water Access, Promotion, and SSB taxes<br>Intervention parks will receive installation of water stations, multicultural water promotion campaign, and SSB taxes | Behavioral: Drink Tap<br>* The Drink Tap intervention consists of increased access to safe and appealing drinking water, multicultural water promotion, and soda taxes.<br>|
| No Intervention: Control<br>SSB taxes | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in beverage consumption | Changes in beverage consumption will be measured through site observations to tally the proportion of visitors drinking water and SSBs in parks. | Visitors in each park will be observed during four one-hour intervals for a maximum of four hours if they visit the park for that duration of time. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Water, Parks, Public spaces, Sugar-sweetened beverages