title: Development of healthy eating and physical activity quality standards for out-of-school time programs.
abstract: BACKGROUND
  Out-of-school time (OST) programs serve over 8 million children per year and have ample opportunity to promote health through menu and physical activity choices. Until recently, however, the field has lacked a comprehensive set of operationalizable standards for healthy eating and physical activity. The National AfterSchool Association adopted voluntary healthy eating and physical activity quality standards (HEPAQS) in April, 2011.
  
  
  METHODS
  We describe the development of HEPAQS. This work reflects a social ecological model for changing children's eating and activity behaviors through program-level interventions. The standards were developed using a national, mixed-methods needs assessment, review of existing standards and expert recommendations, and a participatory process of discussion, review, and consensus engaging 19 influential service and policy organizations and agencies in the Healthy Out-of-School Time (HOST) coalition, which we convened in 2009.
  
  
  RESULTS
  The HOST coalition approved a final version of the HEPAQS in January, 2011. The 11 standards address content, curriculum selection, staff training, program support, and environmental support for healthy eating and physical activity. In April, 2011, the HEPAQS were adopted by the National AfterSchool Association, and have subsequently been widely disseminated. Extensive adoption and implementation efforts are underway.
  
  
  CONCLUSIONS
  The availability of a comprehensive set of standards for healthy eating and physical activity in OST provides practical information to help community-based youth-serving organizations participate in obesity and chronic disease prevention. A working awareness of their content will be useful to scientists undertaking health promotion studies in the out-of-school time setting.
authors.affiliation: Department of Exercise and Health Sciences, University of Massachusetts Boston, MA 02125, USA. jwiecha@rti.org
authors.forename: Jean L
authors.initials: JL
authors.lastname: Wiecha
authors.forename: Georgia
authors.initials: G
authors.lastname: Hall
authors.forename: Ellen
authors.initials: E
authors.lastname: Gannett
authors.forename: Barbara
authors.initials: B
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D002648:Child; D002656:Child Day Care Centers / Q000592:standards*; D002664:Child Nutritional Physiological Phenomena; D004032:Diet; D015444:Exercise; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D009765:Obesity / Q000517:prevention & control