title: Comparative effectiveness of after-school programs to increase physical activity.
abstract: BACKGROUND
  We conducted a comparative effectiveness analysis to evaluate the difference in the amount of physical activity children engaged in when enrolled in a physical activity-enhanced after-school program based in a community recreation center versus a standard school-based after-school program.
  
  
  METHODS
  The study was a natural experiment with 54 elementary school children attending the community ASP and 37 attending the school-based ASP. Accelerometry was used to measure physical activity. Data were collected at baseline, 6 weeks, and 12 weeks, with 91% retention.
  
  
  RESULTS
  At baseline, 43% of the multiethnic sample was overweight/obese, and the mean age was 7.9 years (SD = 1.7). Linear latent growth models suggested that the average difference between the two groups of children at Week 12 was 14.7 percentage points in moderate-vigorous physical activity (P < .001). Cost analysis suggested that children attending traditional school-based ASPs-at an average cost of $17.67 per day-would need an additional daily investment of $1.59 per child for 12 weeks to increase their moderate-vigorous physical activity by a model-implied 14.7 percentage points.
  
  
  CONCLUSIONS
  A low-cost, alternative after-school program featuring adult-led physical activities in a community recreation center was associated with increased physical activity compared to standard-of-care school-based after-school program.
authors: Department of Social Sciences and Health Policy, and the Maya Angleou Center for Health Equity, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. sgesell@wakehealth.edu
authors: Sabina B
authors: SB
authors: Gesell
authors: Evan C
authors: EC
authors: Sommer
authors: E Warren
authors: EW
authors: Lambert
authors: Ana Regina
authors: AR
authors: Vides de Andrade
authors: Lauren
authors: L
authors: Whitaker
authors: Lauren
authors: L
authors: Davis
authors: Bettina M
authors: BM
authors: Beech
authors: Stephanie J
authors: SJ
authors: Mitchell
authors: Nkiruka
authors: N
authors: Arinze
authors: Stevon
authors: S
authors: Neloms
authors: Colleen K
authors: CK
authors: Ryan
authors: Shari L
authors: SL
authors: Barkin
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D057186:Comparative Effectiveness Research; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D009043:Motor Activity; D063766:Pediatric Obesity / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D011998:Recreation; D040242:Risk Reduction Behavior; D012574:Schools; D013714:Tennessee / Q000453:epidemiology; D013997:Time Factors
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