title: Grab a Cup, Fill It Up! An Intervention to Promote the Convenience of Drinking Water and Increase Student Water Consumption During School Lunch.
abstract: OBJECTIVE
  We evaluated a low-cost strategy for schools to improve the convenience and appeal of drinking water.
  
  
  METHODS
  We conducted a group-randomized, controlled trial in 10 Boston, Massachusetts, schools in April through June 2013 to test a cafeteria-based intervention. Signage promoting water and disposable cups were installed near water sources. Mixed linear regression models adjusting for clustering evaluated the intervention impact on average student water consumption over 359 lunch periods.
  
  
  RESULTS
  The percentage of students in intervention schools observed drinking water during lunch nearly doubled from baseline to follow-up compared with controls (+ 9.4%; P < .001). The intervention was associated with a 0.58-ounce increase in water intake across all students (P < .001). Without cups, children were observed drinking 2.4 (SE = 0.08) ounces of water from fountains; with cups, 5.2 (SE = 0.2) ounces. The percentage of intervention students observed with sugar-sweetened beverages declined (-3.3%; P < .005).
  
  
  CONCLUSIONS
  The current default of providing water through drinking fountains in cafeterias results in low water consumption. This study shows that an inexpensive intervention to improve drinking water's convenience by providing cups can increase student water consumption.
authors.affiliation: Erica L. Kenney, Steven L. Gortmaker, Jennifer F. Reiner, and Angie L. Cradock are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. At the time of the study, Caitlin W. Howe was and Jill E. Carter is with the Health and Wellness Department, Boston Public Schools, Dorchester, MA.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Kenney
authors.affiliation: Erica L. Kenney, Steven L. Gortmaker, Jennifer F. Reiner, and Angie L. Cradock are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. At the time of the study, Caitlin W. Howe was and Jill E. Carter is with the Health and Wellness Department, Boston Public Schools, Dorchester, MA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Gortmaker
authors.affiliation: Erica L. Kenney, Steven L. Gortmaker, Jennifer F. Reiner, and Angie L. Cradock are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. At the time of the study, Caitlin W. Howe was and Jill E. Carter is with the Health and Wellness Department, Boston Public Schools, Dorchester, MA.
authors.forename: Jill E
authors.initials: JE
authors.lastname: Carter
authors.affiliation: Erica L. Kenney, Steven L. Gortmaker, Jennifer F. Reiner, and Angie L. Cradock are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. At the time of the study, Caitlin W. Howe was and Jill E. Carter is with the Health and Wellness Department, Boston Public Schools, Dorchester, MA.
authors.forename: M Caitlin W
authors.initials: MC
authors.lastname: Howe
authors.affiliation: Erica L. Kenney, Steven L. Gortmaker, Jennifer F. Reiner, and Angie L. Cradock are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. At the time of the study, Caitlin W. Howe was and Jill E. Carter is with the Health and Wellness Department, Boston Public Schools, Dorchester, MA.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Reiner
authors.affiliation: Erica L. Kenney, Steven L. Gortmaker, Jennifer F. Reiner, and Angie L. Cradock are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. At the time of the study, Caitlin W. Howe was and Jill E. Carter is with the Health and Wellness Department, Boston Public Schools, Dorchester, MA.
authors.forename: Angie L
authors.initials: AL
authors.lastname: Cradock
mesh_terms: D000293:Adolescent; D001900:Boston; D002648:Child; D060766:Drinking Water; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D012574:Schools
chemical_list: D060766:Drinking Water