Promoting Water Consumption among Children: A Three-Arm Cluster Randomized Controlled Trial Testing a Social Network Intervention

Objective: To test the effectiveness of a social network intervention (SNI) to improve children's healthy drinking behaviors. Design: A three-arm cluster randomized control trial design was used. In the SNI, a subset of children were selected and trained as 'influence agents' to promote water consumption-as an alternative to sugar-sweetened beverages (SSBs)-among their peers. In the active control condition, all children were simultaneously exposed to the benefits of water consumption. The control condition received no intervention. Setting: 11 schools in the Netherlands. Participants: 451 children (M age = 10.74, SD age =.97; 50.8% girls). Results: Structural path models showed that children exposed to the SNI consumed.20 less SSBs per day compared to those in the control condition (β =.25, p =.035). There was a trend showing that children exposed to the SNI consumed.17 less SSBs per day than those in the active control condition (β =.20, p =.061). No differences were found between conditions for water consumption. However, t