Bright Spot: OSNAP Initiative: Strategies to increase drinking water access

Photo by Johnny McClung on Unsplash

This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

Overview

Detailed Description

The Out of School Nutrition and Physical Activity (OSNAP) Initiative is a research-tested intervention designed to increase healthy nutrition for children, including the frequency with which water is served during snack at afterschool programs. By promoting water, the OSNAP Initiative decreases the caloric impact of beverages served in afterschool programs.

*The Harvard School of Public Health Prevention Research Center developed OSNAP and the Center for Training and Research Translation worked with them to develop detailed guidance on how to implement it in practice.*

Expected Outcomes

The OSNAP Initiative has the potential to reach a large number of children with one of the key evidence-based interventions for obesity prevention replacing the consumption of sugar sweetened beverages with water. Sites implementing this intervention have realized statistically significant: Increases in volume of water served per day per child, decreases in calories from beverages served per day, and increases in the frequency of water being served to children

Key Principles

Complete assessment of current afterschool program practices

Programs should assess their policies and practices related to healthy eating, beverages, and physical activity. This should include collecting data on beverages currently being served to children as an afterschool snack.
Hold learning communities, including training of afterschool program coordinators and writing afterschool wellness policies
Invite afterschool program directors and staff to participate in a series of three learning community sessions (see resource tab for more details). Meetings should be held at the participating site during various times of the day to ensure participation. As part of the sessions, staff should set actionable goals to improve program practices and communicated changes.
Review and revise district snack menus and beverage serving plans. Your team should partner with the school's food and nutrition services to review snack menus and provide nutritional and price analyses to support modifications to menus and beverage serving plans. These modified menus promoted water as the primary beverage.
Establish water-delivery systems to ensure children are served water during snack time. Water-serving plans should be determined based on infrastructure issues, program size, and applicable costs. Each plan should be tailored to the needs of the school or organization operating the after-school program. Options for providing water have ranged from tap water in pitchers or jugs to bottled water in coolers.
Engage stakeholders through parent newsletters, and get buy-in from food and nutrition services and school administrators
Understanding and acceptance of the program by parents and school staff are essential to its success. OSNAP provides sample language and templates for parent communications (see resources tab).
Implement hydration units from Food Fun Afterschool Curriculum in afterschool programs
Afterschool staff should have received the Food Fun curriculum during learning communities and had the option to receive training on implementation of the curriculum. Example curriculum includes involving children in art activities and weekly water-helper duties.

For more detailed information, please visit the OSNAP website.

Cost Details

As of May 2014 the cost of this intervention is as follows:

8-ounce Styrofoam recyclable cups = $0.01 per student per snack (this is the cost that Boston Public Schools were able to provide to students through their vendor contracts) 5-gallon water coolers = $25-$121 each depending on type; one 5 gallon container is needed per 75 students (in Boston, programs acquired water coolers for $117 each, but cheaper water coolers are available from Amazon.com)

Cost for increased water consumption = $0.013/gallon tap water (tap water cost per gallon, taken from survey; average of 50 largest cities in the US, 2009/2010) Pitchers = $10 each; 1 needed per 25 kids (based on experience in Boston) OSNAP provided stipends for afterschool staff to attend the learning communities @ $40 stipend per staff member per meeting.

OSNAP costs for stipends for afterschool staff to participate in learning communities: 3 meetings per year, average of 2 staff per afterschool site, with approximately 10 sites participating = $2400.

For the latest cost details, please contact the OSNAP program directly.

Key Steps for Implementation

Complete assessment of current after school program practices

Programs should assess their policies and practices related to healthy eating, beverages, and physical activity. This should include collecting data on beverages currently being served to children as an afterschool snack.

Hold learning communities, including training of after school program coordinators and writing after school wellness policies

Invite after school program directors and staff to participate in a series of three learning community sessions (see resource tab for more details).

Meetings should be held at the participating site during various times of the day to ensure participation. As part of the sessions, staff should set actionable goals to improve program practices and communicated changes.

Review and revise district snack menus and beverage serving plans. Your team should partner with the school's food and nutrition services to review snack menus and provide nutritional and price analyses to support modifications to menus and beverage serving plans. These modified menus promoted water as the primary beverage.

Establish water-delivery systems to ensure children are served water during snack time. Water-serving plans should be determined based on infrastructure issues, program size, and applicable costs. Each plan should be tailored to the needs of the school or organization operating the afterschool program. Options for providing water have ranged from tap water in pitchers or jugs to bottled water in coolers.

Engage stakeholders through parent newsletters, and get buy-in from food and nutrition services and school administrators. Understanding and acceptance of the program by parents and school staff are essential to its success. OSNAP provides sample language and templates for parent communications (see resources tab).

Implement hydration units from Food Fun After school Curriculum in after school programs. After school staff should have received the Food Fun curriculum during learning communities and had the option to receive training on implementation of the curriculum. Example curriculum includes involving children in art activities and weekly water-helper duties. For more detailed information, please visit the Website.

Other Key Requirements

Employ the learning community approach to achieve organizational and stakeholder support Allow program staff to set individual- or family-ized goals for their particular afterschool program
Engage food service staff in identifying solutions
Collaborate effectively with school food service staff, using such strategies as: Encourage program staff and/or OSNAP facilitator to meet with either afterschool site-level or district-level staff to introduce themselves and communicate goals
Become familiar with the rules and regulations of the program(s) that support afterschool snacks: the National School Lunch Program, the Child and Adult Care Feeding Program, etc.
Offer to assist school food service staff by making sure afterschool program staff and students follow rules and regulations Develop a convenient and low-cost method for providing drinking water at afterschool snack

Partnerships

Possible sponsoring afterschool programs include: YMCA, Boys Girls Club, and Centers for Youth and Families. A partnership with food and nutrition services may be necessary to review snack menus and provide nutritional and price analyses to support modifications to menus and beverage serving plans.

Cups
Water Coolers
Pitchers
Food Fun Hydration Curriculum

Types of Staff

OSNAP coordinator, site director

Outcome Measures

Increased awareness of the importance of drinking water among students, parents, Afterschool Program (ASP) coordinators, and Food and Nutrition Service (FNS) staff
Increased knowledge of the importance of drinking water among students, parents, ASP coordinators, and FNS staff
Increased availability of drinking water in afterschool programs
Increased number of wellness policies to address drinking water
Unintended Consequences (Increased water consumption among parents and ASP coordinators, students consume more calories elsewhere)

Process Measures

Example process measures include (for more measures and detailed data collection questions please see the evaluation plan):

Number of newsletters distributed to parents
Number and percentage of Afterschool Program (ASP) staff reached
Number and percentage, and representativeness of students reached by ASP changes
Number and percentage of Afterschool Programs (ASPs) that adopted food and beverage changes
Number of ASP wellness policies written
Number of learning collaboratives held
Number of ASPs fully implementing hydration curriculum
Number of times outside food and non-water beverages are consumed per week