title: Making healthy eating and physical activity policy practice: the design and overview of a group randomized controlled trial in afterschool programs.
abstract: National and state organizations have developed policies calling upon afterschool programs (ASPs, 3-6 pm) to serve a fruit or vegetable (FV) each day for snack, while eliminating foods and beverages high in added-sugars, and to ensure children accumulate a minimum of 30 min/d of moderate-to-vigorous physical activity (MVPA). Few efficacious and cost-effective strategies exist to assist ASP providers in achieving these important public health goals. This paper reports on the design and conceptual framework of Making Healthy Eating and Physical Activity (HEPA) Policy Practice in ASPs, a 3-year group randomized controlled trial testing the effectiveness of strategies designed to improve snacks served and increase MVPA in children attending community-based ASPs. Twenty ASPs, serving over 1800 children (6-12 years) will be enrolled and match-paired based on enrollment size, average daily min/d MVPA, and days/week FV served, with ASPs randomized after baseline data collection to immediate intervention or a 1-year delayed group. The framework employed, STEPs (Strategies To Enhance Practice), focuses on intentional programming of HEPA in each ASPs' daily schedule, and includes a grocery store partnership to reduce price barriers to purchasing FV, professional development training to promote physical activity to develop core physical activity competencies, as well as ongoing technical support/assistance. Primary outcome measures include children's accelerometry-derived MVPA and time spend sedentary while attending an ASP, direct observation of staff HEPA promoting and inhibiting behaviors, types of snacks served, and child consumption of snacks, as well as, cost of snacks via receipts and detailed accounting of intervention delivery costs to estimate cost-effectiveness.
authors.affiliation: University of South Carolina. Electronic address: beets@mailbox.sc.edu.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Beets
authors.affiliation: University of South Carolina.
authors.forename: R
authors.initials: R
authors.lastname: Glenn Weaver
authors.affiliation: University of South Carolina.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Turner-McGrievy
authors.affiliation: Arizona State University.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Huberty
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Dianne S
authors.initials: DS
authors.lastname: Ward
authors.affiliation: Case Western University.
authors.forename: Darcy A
authors.initials: DA
authors.lastname: Freedman
authors.affiliation: University of South Carolina.
authors.forename: Ruth
authors.initials: R
authors.lastname: Saunders
authors.affiliation: University of South Carolina.
authors.forename: Russell R
authors.initials: RR
authors.lastname: Pate
authors.affiliation: University of Kentucky.
authors.forename: Aaron
authors.initials: A
authors.lastname: Beighle
authors.affiliation: University of South Carolina.
authors.forename: Brent
authors.initials: B
authors.lastname: Hutto
authors.affiliation: University of South Carolina.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Moore
mesh_terms: D061725:Accelerometry; D002648:Child; D004032:Diet; D015444:Exercise; D005260:Female; D005638:Fruit; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D012107:Research Design; D012574:Schools / Q000458:organization & administration*; D057185:Sedentary Behavior; D062410:Snacks; D014675:Vegetables
keywords: Children; Community; Fruit; Moderate-to-Vigorous; Obesity; Policy