Increasing Water Access and Appeal in Community Recreation Centers (Hydrate Philly)

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

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.

Study Overview

• Status: Completed
• Conditions: Health Behavior
• Intervention / Treatment: Behavioral: Hydrate Philly

• Study Type: Interventional
• Enrollment (Actual): 28
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19107
      • Philadelphia Department of Public Health, Division of Chronic Disease Prevention

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 years to 100 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Hydrate Philly Intervention; Intervention group that receives hydration station intervention	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).
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

What is the study measuring?

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).

Collaborators and Investigators

• Sponsor: Philadelphia Department of Public Health
• Collaborators: Children's Hospital of Philadelphia; Stanford University
• Investigators: Principal Investigator: Hannah G Lawman, PhD, Philadelphia Department of Public Health, Division of Chronic Disease Prevention

Publications and helpful links

General Publications

• Lawman HG, Grossman S, Lofton X, Tasian G, Patel AI. Hydrate Philly: An Intervention to Increase Water Access and Appeal in Recreation Centers. Prev Chronic Dis. 2020 Feb 20;17:E15. doi: 10.5888/pcd17.190277.
• Lawman HG, Lofton X, Grossman S, Root M, Perez M, Tasian G, Patel A. A randomized trial of a multi-level intervention to increase water access and appeal in community recreation centers. Contemp Clin Trials. 2019 Apr;79:14-20. doi: 10.1016/j.cct.2019.02.003. Epub 2019 Feb 13.

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2017
• Primary Completion (Actual): September 30, 2018
• Study Completion (Actual): October 30, 2018

Study Registration Dates

• First Submitted: July 31, 2018
• First Submitted That Met QC Criteria: August 16, 2018
• First Posted (Actual): August 20, 2018

Study Record Updates

• Last Update Posted (Actual): April 2, 2019
• Last Update Submitted That Met QC Criteria: April 1, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Keywords: children; youth; water intake; sugar sweetened beverages; hydration
• Other Study ID Numbers: 49200; 74395 (Other Grant/Funding Number: Robert Wood Johnson Foundation)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No