title: Observations of drinking water access in school food service areas before implementation of federal and state school water policy, California, 2011.
abstract: BACKGROUND
  Recent legislation requires schools to provide free drinking water in food service areas (FSAs). Our objective was to describe access to water at baseline and student water intake in school FSAs and to examine barriers to and strategies for implementation of drinking water requirements.
  
  
  METHODS
  We randomly sampled 24 California Bay Area public schools. We interviewed 1 administrator per school to assess knowledge of water legislation and barriers to and ideas for policy implementation. We observed water access and students' intake of free water in school FSAs. Wellness policies were examined for language about water in FSAs.
  
  
  RESULTS
  Fourteen of 24 schools offered free water in FSAs; 10 offered water via fountains, and 4 provided water through a nonfountain source. Four percent of students drank free water at lunch; intake at elementary schools (11%) was higher than at middle or junior high schools (6%) and high schools (1%). In secondary schools when water was provided by a nonfountain source, the percentage of students who drank free water doubled. Barriers to implementation of water requirements included lack of knowledge of legislation, cost, and other pressing academic concerns. No wellness policies included language about water in FSAs.
  
  
  CONCLUSIONS
  Approximately half of schools offered free water in FSAs before implementation of drinking water requirements, and most met requirements through a fountain. Only 1 in 25 students drank free water in FSAs. Although schools can meet regulations through installation of fountains, more appealing water delivery systems may be necessary to increase students' water intake at mealtimes.
authors: Department of Pediatrics, Philip R. Lee Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA 94118, USA. PatelA@peds.ucsf.edu
authors: Anisha I
authors: AI
authors: Patel
authors: Kumar
authors: K
authors: Chandran
authors: Karla E
authors: KE
authors: Hampton
authors: Kenneth
authors: K
authors: Hecht
authors: Jacob M
authors: JM
authors: Grumbach
authors: Amanda T
authors: AT
authors: Kimura
authors: Ellen
authors: E
authors: Braff-Guajardo
authors: Claire D
authors: CD
authors: Brindis
mesh_terms: D000288:Administrative Personnel / Q000523:psychology / Q000706:statistics & numerical data; D001628:Beverages / Q000706:statistics & numerical data; D002140:California; D060766:Drinking Water / Q000592:standards*; D035082:Federal Government; D005380:Financing, Government; D005522:Food Services / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D018673:Nutrition Policy / Q000191:economics; D011633:Public Facilities; D036301:Qualitative Research; D012574:Schools / Q000706:statistics & numerical data*; D040241:Social Marketing; D013219:State Government; D011795:Surveys and Questionnaires; D014186:Transportation / Q000379:methods; D014881:Water Supply
chemical_list: D060766:Drinking Water