Water UP! was a whole-community intervention to curb sugary drink intake in Langley Park, MD. The community-academic partnership collaborated with six elementary schools, restaurants, early childhood center (CentroNia). You can read more about the emergence of the focus on water and the participatory design of a randomized controlled trial to test an intervention to promote drinking water instead of sugary drinks at home here.

Rationale: Introduction of sugar-sweetened beverages (SSB) early in life and consumption contribute to childhood obesity and other detrimental health consequences such as dental caries, and increased risk for diet-related chronic diseases. The Dietary Guidelines for Americans recommend that individuals drink plain water instead of SSBs but SSB intake remains elusively high and water consumption alarmingly low among low-income and other minoritized communities. Consumption behaviors may be driven by elements in systems, policies, and environments that are beyond the individual control. For instance, a body of literature from qualitative and observational studies have associated low water intake and high SSB consumption with limited access to safe, palatable tap water in Hispanic and lower-income communities, as well as with concerns about tap water safety.

Findings from our Water UP! @Home randomized controlled intervention study. The intervention delivered a low-cost water filter to use at home among parents of infants and toddlers found that families significantly increased their water intake and lowered their SSB consumption from baseline, likely due to greater access to free, palatable water at home. SSB marketing and wide availability of SSBs are further influential elements: industry targets marketing resources.

Together, this body of evidence implies that beverage choice has been driven by complex interactions between factors across sectors that are part of a larger evolving system Upstream approaches, such as improving access to safe, palatable tap water while limiting the promotion and availability of unhealthy beverages in community settings or government assistance programs, can support sustained behavior change and bolster true equity in healthy beverage choice.

To identify the systemic underlying drivers of water and sugar-sweetened beverages (SSB) consumption Studies conducted in Washington, DC, Puerto Rico, Costa Rica and Guatemala.

Research Brief: Developing shared systems and policy strategies to sustain healthy beverage choices among Hispanic families of infants and toddlers in the greater Washington DC metro area

Presentation to Healthy Eating Research Conference. Participatory Systems Mapping: Underlying Drivers and Lever Points to Reduce SSB and Increase Water Intake in Puerto RicoNorth Carolina, March 2024