# A Multi-Level Intervention to Promote Healthy Beverage Intake through Childcare

> **NIH NIH R01** · STANFORD UNIVERSITY · 2024 · $520,582

## Abstract

PROJECT SUMMARY
There is little debate that sugar-sweetened beverages (SSBs; drinks with added sugar) lack nutrition, are a
major source of added sugar and calories, and promote obesity and poor cardiometabolic health, especially
when consumed during early childhood. Nearly half of children aged 2-5 drink SSBs on a daily basis, with
heavier consumption in low-income Latino children. After decades of research, it is clear that there is no single
“magic bullet” for solving obesity. What we need are bundled interventions that combine incremental changes
that transform food environments with targeted behavior changes that steer people towards those healthy
options. Childcare centers, which serve 12.5 million children per year, provide an efficient way to intervene
early by engaging childcare providers and parents to make resonant, mutually reinforcing changes in both the
home and childcare environment. Interventions that promote water consumption in place of SSBs have shown
promise for preventing childhood obesity in schoolchildren. Yet, no studies have examined whether
interventions to promote intake of water instead of SSBs in childcare could prevent childhood obesity at an
even earlier stage of development. The proposed cluster-randomized controlled trial will test the efficacy of an
intervention called Healthy Drinks, Healthy Futures (Bebidas Saludables, Futuros Saludables) that is culturally
adapted for Latino children and families. Following the Social-Ecological Model and Social Learning Theory,
the intervention supports complementary changes in the childcare and home food environments that promote
water consumption while reducing SSB availability. This is combined with education for childcare providers and
children, and a one-on-one brief motivational counseling intervention with parents to reduce SSB intake and
encourage water consumption in the home. Fourteen childcare centers serving low-income, predominately
Latino children (n=420) will participate in this trial. The primary outcome is child BMI z-score (BMI standard
deviation score). Key secondary outcomes are intake of water and beverage calories at centers and at home.
Outcomes will be captured using anthropometrics (weight, height), plate waste measurements (water and
caloric intake at centers), and Automated Self-Administered 24-hour dietary recalls (water and caloric intake at
home) at baseline, 6, and 12 months post-intervention. Surveys of childcare providers and parents will allow us
to explore possible mediators of the intervention effect. We hypothesize that the childcare-based healthy
beverage intervention will increase intake of water and reduce beverage calories consumed at both childcare
and at home. BMI z-score will also improve among children in intervention centers vs. control centers. If shown
to be effective, the Healthy Drinks, Healthy Futures intervention will offer a strategy for intervening early to
prevent obesity for millions of low-income children attending chil...

## Key facts

- **NIH application ID:** 10846841
- **Project number:** 5R01DK127124-04
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Anisha Indravadan Patel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $520,582
- **Award type:** 5
- **Project period:** 2021-08-24 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10846841

## Citation

> US National Institutes of Health, RePORTER application 10846841, A Multi-Level Intervention to Promote Healthy Beverage Intake through Childcare (5R01DK127124-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10846841. Licensed CC0.

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