Water is K’é: Pilot Results of a Community-based Intervention to Increase Healthy Beverage Consumption by Navajo Preschool Children

OBJECTIVE: We developed a culturally-grounded intervention to promote healthy beverage consumption among Navajo children aged 2-5 years. This study, which took place from 2021-2023, evaluated prepost changes in beverage habits and caregiver knowledge and attitudes. METHODS: Prospective cohort study with prepost evaluation. Children attending participating early child education sites and their primary caregivers were enrolled. Survey data were collected at baseline, during the school year, and immediately after completion of the 4-month intervention. RESULTS: Average daily water intake increased significantly from 17.0 to 22.3 fl oz, P = 0.003. There was no significant change in consumption of other specific beverages, nor in the consumption of all sugar-sweetened beverages combined (P = 0.94). The proportion of caregivers who agreed or strongly agreed that they were knowledgeable about Diné traditions about water increased from 59.3% to 87.0% (P = 0.001). Similarly, those who agreed that Diné traditions about water influenced what drink they offered their children increased from 46.3% to 81.5% (P < 0.001). CONCLUSIONS AND IMPLICATIONS: Our pilot study suggests that a culturally-grounded water promotion program for Navajo families may have a positive impact on strengthening cultural connections among caregivers and increasing water intake among children aged 2-5 years. Further research is needed to evaluate effectiveness.