Water is the driving force of all nature.
Leonardo da Vinci
Research and Action
Interventional Research Project in Québec Primary Schools
The ReachforWater Intervention includes both school and home-based components designed to modify behaviours relative to drinking habits – specifically those regarding drinking water and sugar containing beverages. The main objective of this research project is to test the efficacy of the ReachforWater Intervention. The Intervention was designed to prevent excess weight gain among primary school children in Québec and to educate them on the impacts associated with the practice of using recyclable plastic bottles. The Intervention will favour the consumption of non-bottled drinking water and discourage that of sugar containing beverages. To do so it will modify the children’s physical environments, will act upon their knowledge, their capacity to take action and on their expectations.
Our study design requires that the Intervention be deployed in 36 primary schools and the homes of 3600 children prior to considering upscaling the deployment of the Intervention to the provincial scale. Schools will be randomly selected from partner school boards and a subset of their students will participate unless their parents or legal guardians decline consent for their child’s participation. Parents or guardians will also be invited to participate.
Drinking water in ReachforWater schools will be of very high quality. Firstly, a complete evaluation of drinking water points, and remediation as needed, will be undertaken in each of our schools by our team of specialists who have extensive experience in this field. As well, new water fountains providing filtered cool water will be installed and maintained. Finally, an evaluation of water use patterns will be undertaken in order to identify drinking water points which are not used much as these tend to provide water of poorer quality.
To test the Intervention, a randonised cluster (schools) study, with sequential permutations, called a stepped wedge cluster study with 3 arms was chosen given the logistical difficulties associated with delivering the Intervention in all 36 schools at the beginning of any given school year. So, 1/3 of the schools (1st arm) will receive the Intervention during the first year of the 3 year study; 1/3 (2nd arm) will receive it the second year and; 1/3 (3rd arm) will receive it the third year. As such, the schools from the 1st arm will be exposed to Intervention conditions over 3 years, while those of the 2nd and 3rd arms will be exposed over 2 and 1 years respectively.
As described by socio-ecological models of human behaviour, the ReachforWater Intervention will work on three levels : 1) the built environment; 2) the social environment; and 3) the individual.
To reach its objectives, the ReachforWater Intervention will:
1) Install new modern attractive water fountains in participating schools:
1.1) they will include filtration and cooling systems and a bottle filling dispencer (these fountains have had great success in schools and ensure water quality);
1.2) they will be attractive (with the use of decorative decals) and the choice of their locations within schools will be strategic (total number of students in school, number of stories and rooms, proximity to lunch space and gymnasium);
2) Give each student of participating schools one (or more) reusable water bottle(s) (per year) and a water carafe for meals at home.
3) Provide a standardized program underlining the role of water in terms of health lifestyle habits and in terms of environmental protection. Children will be exposed through their teachers, school administrators and their daycare service providers to a culture which favours non-bottled drinking water and discourages the consumption of sugar containing drinks. The built environment will reinforce and enable these practices.
Body composition and drinking habits
Biometrics measurements will be collected before and after each year of the intervention to assess the effects of the intervention. Segmented measurements (legs, trunk, arms) of child body composition (intracellular water, extracellular water, lean mass, adipose tissue) will be measured by bioelectrical impedance analysis (InBody570, GE Healthcare). The only result provided directly to children will be their % of body water on a human pictogram with ranges of % of body water.
Validated questionnaires will document child eating and drinking habits, parents’ drinking patterns, socio-demographic characteristics (income, education, number of siblings, etc.) and children’s lifestyle (puberty, physical activity, sedentary, etc.). These questionnaires will be filled out with parents/guardians on our cyberplatform.