Background Reading for the Healthy Out of School Time (HOST) Project on Developing National Quality Standards

Compiled by: Jean Wiecha 1/12/09

 

This documents contains:

1. Recent References on Healthy Eating and Physical Activity in Out of School Time 2. CDC Recommendations for Child Obesity Prevention 3. YMCA of the USA Environmental Standards for Out of School Time


A separate document contains

 

# Institute of Medicine Recommendations for School Nutrition **********************************************************


Here are abstracts and/or citations from some recent publications. This is not a complete list; we were looking for research on policy and environmental interventions and these are examples of the limited literature available.


Annesi, J. J., J. C. Moore, et al. (2008). "Correlates of changes in voluntary physical activity associated with the Youth Fit For Life intervention during after-school care." Psychol Rep 102(3): 911-9.


Overweight in youth is increasing and physical inactivity has been implicated as a causal factor. An after-school care intervention, Youth Fit For Life, has been associated with significant improvements in physiological factors and frequency of moderate-to-vigorous physical activity voluntarily completed outside of structured settings. Correlates of the observed changes in physical activity amounts were, however, unknown. A multiple regression equation with simultaneous entry of sex, age, race, initial Body Mass Index, and initial frequency of voluntary physical activity as predictor variables for changes in physical activity was calculated on Euro-American and African-American participants ages 8 to 12 years (N=217). A statistically significant 16% of the variance in changes in frequency of voluntary physical activity over 12 wk. was accounted for, with only voluntary physical activity at baseline and age making significant, unique contributions. For participants either overweight or at risk for overweight (n=72), the changes in physical activity significantly correlated with changes in Body Mass Index. Implications of findings to maximize treatment effects on voluntary physical activity were suggested.


Coleman, K. J., K. S. Geller, et al. (2008). "Physical activity and healthy eating in the after-school environment." J Sch Health 78(12): 633-40.


BACKGROUND: No research to date has extensively described moderate and vigorous physical activity (MVPA) and healthful eating (HE) opportunities in the after-school environment. The current study described the quality of the after-school environment for its impact on children's MVPA and HE. METHODS: An alliance of 7 elementary schools and Boys and Girls Clubs who worked with the Cooperative Extension Service in Lawrence, KS, was selected to participate in a larger intervention study. After-school settings were observed for information regarding session type, session context, leader behavior, physical activity, and snack quality using validated instruments such as the System for Observing Fitness Instruction Time. Data presented are baseline measures for all sites. RESULTS: Participating children (n = 144) were primarily non-Hispanic white (60%) and in fourth grade (69%). After-school sites offered 4 different sessions per day (active recreation, academic time, nonactive recreation, and enrichment activities). Children were provided with a daily snack. On 36% of the days observed, this snack included fruit, fruit juice, or vegetables. There was significantly more time spent in MVPA during free play sessions (69%) compared to organized adult-led sessions (51%). There was also significantly more discouragement of physical activity during organized adult-led sessions (29%) as compared to the free play sessions (6%). CONCLUSIONS: The quality of after-school programs can be improved by providing fruits and vegetables as snacks; offering more free play activities; training the after-school staff in simple, structured games for use in a variety of indoor and outdoor settings; and training after-school staff to promote and model MVPA and HE in and out of the after-school setting.


Kelder, S., D. M. Hoelscher, et al. (2005). "The CATCH Kids Club: a pilot after-school study for improving elementary students' nutrition and physical activity." Public Health Nutr 8(2): 133-40.


BACKGROUND: Although many school-based diet and physical activity interventions have been designed and evaluated, relatively few have been tested for the after-school setting. After-school day-care programmes at either elementary schools or private locations provide a ready-made opportunity for health programmes that may be difficult to incorporate into an already-full school day. The purpose of this paper is to report on a pilot study of an after-school adaptation of the CATCH (Coordinated Approach To Child Health) elementary school programme called the CATCH Kids Club (CKC). METHODS: The CKC was pilot-tested and formatively evaluated in 16 Texas after-school programmes: eight in El Paso and eight in Austin (four intervention and four reference sites each). Evaluation consisted of direct observation of moderate to vigorous physical activity during play time, self-reported food intake and physical activity, and focus group interviews with after-school programme staff. RESULTS: Students responded well to the physical activity and snack components and were less interested in the five-module education component. Routine staff training was a key variable in achieving proper implementation; the ideal would be a full day with repeated follow-up model teaching visits. Staff turnover was a logistic issue, as was programme leader readiness and interest in conducting the programme. Strong and significant effects were observed for the physical activity but not for the education component. The results of the physical education component suggest it is feasible, effective and ready for larger-scale evaluation or dissemination.


Robinson, T. N., Kraemer, H.C., Matheson, D.M. et al. (2003). "Dance and Reducing Television Viewing to Prevent Weight gain in African-American Girls: The Stanford GEMS Pilot Study." Ethnicity and Disease 13(Winter): S1-65 - S1 77.


Story, M., Sherwood, N.E. , Himes, J.H., Davis, M., Jacobs, D.R., Cartwright, Y., Smyth, M., Rochon, J. (2003). "An After-School Obesity Prevention Program for African-American Girls: The Minnesota GEMS Pilot Study." Ethnicity and Disease 13(Winter): S1-54-S1-64.


Childhood Obesity Prevention Recommendations for Families from the CDC


http://www.cdc.gov/nccdphp/dnpa/healthyweight/children/index.htm#prevention Accessed 1/12/09.


Balancing Calories: Help Kids Develop Healthy Eating Habits

One part of balancing calories is to eat foods that provide adequate nutrition and an appropriate number of calories. You can help children learn to be aware of what they eat by developing healthy eating habits, looking for ways to make favorite dishes healthier, and reducing calorie-rich temptations. Encourage healthy eating habits. There's no great secret to healthy eating. To help your children and family develop healthy eating habits: * Provide plenty of vegetables, fruits, and whole-grain products. * Include low-fat or non-fat milk or dairy products. * Choose lean meats, poultry, fish, lentils, and beans for protein. * Serve reasonably-sized portions. * Encourage your family to drink lots of water. * Limit sugar-sweetened beverages. * Limit consumption of sugar and saturated fat. Remember that small changes every day can lead to a recipe for success!


For more information about nutrition, visit Finding Your Way to a Healthier You: Based on the Dietary Guidelines for Americans. [image](PDF-255K)


Look for ways to make favorite dishes healthier.

The recipes that you may prepare regularly, and that your family enjoys, with just a few changes can be healthier and just as satisfying. For new ideas about how to add more fruits and vegetables to your daily diet check out the recipe database from the FruitsandVeggiesMatter.gov. This database enables you to find tasty fruit and vegetable recipes that fit your needs. Remove calorie-rich temptations! Although everything can be enjoyed in moderation, reducing the calorie-rich temptations of high-fat and high-sugar, or salty snacks can also help your children develop healthy eating habits. Instead only allow your children to eat them sometimes, so that they truly will be treats! Here are examples of easy-to-prepare, low-fat and low-sugar treats that are 100 calories or less: * A medium-size apple * A medium-size banana * 1 cup blueberries * 1 cup grapes * 1 cup carrots, broccoli, or bell peppers with 2 tbsp. hummus


Balancing Calories: Help Kids Stay Active

Another part of balancing calories is to engage in an appropriate amount of physical activity and avoid too much sedentary time. In addition to being fun for children and teens, regular physical activity has many health benefits, including: * Strengthening bones * Decreasing blood pressure * Reducing stress and anxiety * Increasing self-esteem * Helping with weight management


Help kids stay active.

Children and teens should participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily.49 Remember that children imitate adults. Start adding physical activity to your own daily routine and encourage your child to join you. Some examples of moderate intensity physical activity include: * Brisk walking * Playing tag * Jumping rope * Playing soccer * Swimming * Dancing


Reduce sedentary time.

In addition to encouraging physical activity, help children avoid too much sedentary time. Although quiet time for reading and homework is fine, limit the time your children watch television, play video games, or surf the web to no more than 2 hours per day. Additionally, the American Academy of Pediatrics (AAP) does not recommend television viewing for children age 2 or younger.50 Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity.


Environmental Standards for Out of School Time Programs from the YMCA of the USA Healthy Eating

Offer a fresh fruit or vegetable option every day in programs that are after school, three-a-day in all day holiday and vacation programs # Do not serve foods with trans fats # Involve kids in snack or meal preparation and clean up # Offer water as the primary drink every day # Do not serve sugar sweetened drinks # Highly encourage staff to participate in all of these healthy eating outcomes with the children Physical Activity # Include moderate, fun, physical activity for every kid every day (30 minutes afterschool programs; 60 minutes holiday and vacation programs) and include out of doors activity whenever possible # Offer vigorous, fun, physical activity as an option three times a week (20 minutes each time) # Highly encourage staff to participate in physical activities with the kids Advertising and Screen Time # Do not include commercial broadcast TV or commercial movies in YMCA programs for children # If included at all, limit computer time to less than one hour per day within YMCA programs for children # Review all posters, handouts and other materials used in YMCA programs for children for advertising that may be incongruent with healthy eating and physical activity