Health Promotion in After-School Programs: Two-Year Outcomes of an Intervention

Thursday, April 3, 2014
Exhibit Hall Poster Area 2 (Convention Center)
Robert G. Weaver1, Michael W. Beets1, Collin A. Webster1, Aaron Beighle2, Jennifer Huberty3, Falon Tilley1, Rahma Ajja1, Daria Winnicka1, Jessica Chandler1 and Becky Kyryliuk1, (1)University of South Carolina, Columbia, SC, (2)University of Kentucky, Lexington, KY, (3)Arizona State University, Phoenix, AZ
Background/Purpose:

Afterschool programs provide an opportunity to increase children’s healthy eating and physical activity (HEPA). Current standards documents highlight the important role that afterschool program staff can play in HEPA by calling for staff to display HEPA promotion behaviors and refrain from HEPA discouraging behaviors during the program time. However, few studies have evaluated strategies to change staff HEPA promotion/discouraging behaviors. The purpose of this study was to evaluate a comprehensive training program targeting afterschool program staff HEPA promoting/discouraging behaviors identified in afterschool program standards.

Method:

Four large-scale YMCA afterschool programs serving ~500 children participated in this pre- (Fall 2011) multiple-post (Spring 2012, Fall 2012, Spring 2013), no control group, pilot study. Site leaders and staff at the participant sites received professional development training founded in the 5Ms (i.e. Mission, Model, Manage, Monitor, Maximize) and LET US Play principles (i.e. lines, elimination, team size, uninvolved staff/kids, and space, equipment and rules), on-site booster training sessions, workshops, and ongoing technical support from January to May 2013. Staff promotion behaviors were measured using the System for Observing Staff Promotion of Activity and Nutrition (SOSPAN). 

Analysis/Results:

Random effects models accounting for the clustering of scans within sites within days were used to estimate changes in staff behaviors across measurement periods. Staff behaviors were expressed as a percentage of the number of scans observed during scheduled snack or physical activity. Standards call for staff to display certain behaviors on a daily or weekly basis. For these behaviors the outcomes are expressed as the percentage of days a behavior was observed. A total of 8949 SOSPAN scans were completed over 87 program days across the four measurement periods. All 19 measured staff behaviors trended in the desired direction. For example, “staff engaged in physical activity with children” increased from 26.7% to 40.1% of scans, while staff eating and drinking unhealthy foods or beverages decreased from 55.6% to 14.5% and 73% to 8% of days observed. However, at measurement period three, several behaviors regressed towards baseline.

Conclusions:

Comprehensive professional development training and ongoing technical assistance can have a sizable impact on key staff behaviors identified by afterschool program HEPA Standards. The fluctuation of staff behaviors in the undesired direction at the third measurement period may be explained by staff turnover at the site leader and staff level and highlights the need for ongoing training and technical assistance.