title: Making healthy eating and physical activity policy practice: process evaluation of a group randomized controlled intervention in afterschool programs.
abstract: This study describes the link between level of implementation and outcomes from an intervention to increase afterschool programs' (ASPs) achievement of healthy eating and physical activity (HE-PA) Standards. Ten intervention ASPs implemented the Strategies-To-Enhance-Practice (STEPs), a multi-component, adaptive intervention framework identifying factors essential to meeting HE-PA Standards, while 10 control ASPs continued routine practice. All programs, intervention and control, were assigned a STEPs for HE-PA index score based on implementation. Mixed-effects linear regressions showed high implementation ASPs had the greatest percentage of boys and girls achieving 30 min of moderate-to-vigorous physical activity (47.3 and 29.3%), followed by low implementation ASPs (41.3 and 25.0%), and control ASPs (34.8 and 18.5%). For healthy eating, high/low implementation programs served fruits and vegetables an equivalent number of days, but more days than control programs (74.0 and 79.1% of days versus 14.2%). A similar pattern emerged for the percent of days sugar-sweetened foods and beverages were served, with high and low implementation programs serving sugar-sweetened foods (8.0 and 8.4% of days versus 52.2%), and beverages (8.7 and 2.9% of days versus 34.7%) equivalently, but less often than control programs. Differences in characteristics and implementation of STEPs for HE-PA between high/low implementers were also identified.
authors.affiliation: Department of Exercise Science, weaverrg@mailbox.sc.edu.
authors.forename: R Glenn
authors.initials: RG
authors.lastname: Weaver
authors.affiliation: Department of Exercise Science.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Beets
authors.affiliation: Department of Exercise Science.
authors.forename: Brent
authors.initials: B
authors.lastname: Hutto
authors.affiliation: Department of Health Promotion, Education, and Behavior.
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Saunders
authors.affiliation: Department of Health Promotion, Education, and Behavior, Office of Practice and Community Engagement, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Moore
authors.affiliation: Department of Health Promotion, Education, and Behavior.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Turner-McGrievy
authors.affiliation: School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Huberty
authors.affiliation: Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Dianne S
authors.initials: DS
authors.lastname: Ward
authors.affiliation: Department of Exercise Science.
authors.forename: Russell R
authors.initials: RR
authors.lastname: Pate
authors.affiliation: Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA and.
authors.forename: Aaron
authors.initials: A
authors.lastname: Beighle
authors.affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Darcy
authors.initials: D
authors.lastname: Freedman
mesh_terms: D002648:Child; D000072001:Diet, Healthy; D019422:Dietary Sucrose; D015444:Exercise; D005260:Female; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D044469:Racial Groups; D012574:Schools / Q000458:organization & administration*; D013022:South Carolina
chemical_list: D019422:Dietary Sucrose