Agua4All: Providing Safe Drinking Water in Rural California Communities

Agua4All: Providing Safe Drinking Water in Rural California Communities

ORIGINAL RESEARCH — Volume 16 — November 14, 2019

Anisha I. Patel, MD, MSHS, MSPH1,2; Amelie A. Hecht2,3; Karla E. Hampton, JD4; Christina Hecht, PhD5; Sarah Buck6,7 (View author affiliations)

Suggested citation for this article: Patel AI, Hecht AA, Hampton KE, Hecht C, Buck S. Agua4All: Providing Safe Drinking Water in Rural California Communities. Prev Chronic Dis 2019;16:190165. DOI: http://dx.doi.org/10.5888/pcd16.190165external icon.

PEER REVIEWED

On This Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Summary

What is already known on this topic?

Increasing access to safe and appealing drinking water in schools can increase intake of water and reduce consumption of sugar-sweetened beverages, and may help prevent obesity. No studies have investigated the effect of similar programs in communities that lack potable drinking water.

What is added by this report?

Community-wide installation of safe water bottle-filling stations, particularly when coupled with site-led promotion, may increase water intake in areas without safe drinking water.

What are the implications for public health practice?

As communities increasingly encounter contaminants in drinking water, the Agua4All program offers a short-term strategy for providing safe drinking water until longer-term infrastructure improvements are in place.

Abstract

Introduction

Drinking water instead of sugar-sweetened beverages may reduce obesity and dental caries. Tap water is more affordable and sustainable than bottled water and more likely to contain fluoride, which prevents caries. To address inequities in access to safe tap water, cross-sector partners established the Agua4All safe drinking-water program in 2 rural San Joaquin Valley, California, communities. The program’s objective was to examine Agua4All’s feasibility, acceptability, and effect on water intake.

Methods

We provided bottle-filling stations dispensing safe water at 12 sites in 2 communities and provided limited promotional support. To compare the effect of different levels of promotion, sites in 1 community also received a promotions toolkit, a stipend, and assistance in developing and conducting their own promotional activities (site-led promotion). Beverage intake at sites was observed at baseline (pre-installation), at time 1 (post-installation), and at times 2 and 3 (post-promotion). Flowmeters tracked water dispensings. Staff interviews examined implementation barriers and facilitators.

Results

From baseline to time 3, a nonsignificant increase (21.16%) occurred in the proportion of people drinking water at sites with water stations and site-led promotion compared with sites with water stations and limited promotion (5.13%) (P = .14). Mean daily gallons of water taken from stations per site was 3.61 (standard deviation, 3.84). Most staff members (77%) at the sites preferred water stations to traditional drinking fountains.

Conclusion

Bottle-filling stations with safe water and site-led promotion are a promising strategy for increasing water intake in communities without safe tap water. Larger studies should examine the effects of such stations on intake of sugar-sweetened beverages and on overall health.