Effects of a School-based Intervention to Increase the Water Consumption in Elementary School Children

Process and Outcome Evaluation of an Intervention to Increase the Water Consumption of Elementary School Children in Lower Austria - a Pilot Study

The purpose of this controlled intervention study is to evaluate the effectiveness of a school-based intervention aiming at increasing the water consumption in elementary school children. The intervention schools received refillable water bottles and drying racks for all school children as well as educational material. The focus of the intervention is the promotion of drinking tap water.

This pilot project, called "H2NOE-Wasserschulen" (Water Schools in Lower Austria), aims to increase the water consumption of school children in elementary schools, to raise awareness of water drinking in children, parents and school teachers and to promote water drinking in Lower Austria in general.

By increasing the consumption of water, the consumption of sugar-sweetened beverages may decrease and in the long run may have a positive impact on children's body weight and tooth status.

All intervention schools receive refillable water bottles for each school child and drying racks for each classroom. Furthermore, in each school an information session for all school teachers is held and the teachers receive prepared educational material. The control schools do not receive the water bottles nor the educational material.

For the study, the investigators recruited 22 intervention schools and 32 control schools. Outcomes will be measured by paper and pencil questionnaires of school children at third grade of participating elementary schools in Lower Austria and with online questionnaires of teachers at baseline, at the end of the intervention (after one school year/June 2019) and at the one-year follow-up (after two school years/June 2020).

For process evaluation outcomes, the investigators will carry out focus group discussions with a subsample of school children and teachers and include questions in the respective questionnaires for school children, teachers and school headmasters. Parents will have the possibility to give feedback online.

For the intervention schools:

Inclusion criteria:

• elementary school in Niederösterreich (Upper Austria, a province of Austria)
• no juice provided with the school milk programme

For the school children taking part in the survey:

Inclusion criteria:

• school children in third class of elementary school (at baseline)
• written declaration of consent by a parent/guardian