title: Process Evaluation of Making HEPA Policy Practice: A Group Randomized Trial.
abstract: This study examines the link between implementation of Strategies to Enhance Practice (STEPs) and outcomes. Twenty after-school programs (ASPs) participated in an intervention to increase children's accumulation of 30 minutes/day of moderate to vigorous physical activity (MVPA) and quality of snacks served during program time. Outcomes were measured via accelerometer (MVPA) and direct observation (snacks). STEPs implementation data were collected via document review and direct observation. Based on implementation data, ASPs were divided into high/low implementers. Differences between high/low implementers' change in percentage of boys accumulating 30 minutes/day of MVPA were observed. There was no difference between high/low implementers for girls. Days fruits and/or vegetables and water were served increased in the high/low implementation groups, while desserts and sugar-sweetened beverages decreased. Effect sizes (ES) for the difference in changes between the high and low group ranged from low (ES = 0.16) to high (ES = 0.97). Higher levels of implementation led to increased MVPA for boys, whereas girls MVPA benefited from the intervention regardless of high/low implementation. ESs of the difference between high/low implementers indicate that increased implementation of STEPs increases days healthier snacks are served. Programs in the high-implementation group implemented a variety of STEPs strategies, suggesting local adoption/adaptation is key to implementation.
authors.affiliation: University of South Carolina, Columbia, SC, USA weaverrg@mailbox.sc.edu.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Weaver
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Moore
authors.affiliation: Arizona State University, Phoenix, AZ, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Huberty
authors.affiliation: Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Darcy
authors.initials: D
authors.lastname: Freedman
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Brie
authors.initials: B
authors.lastname: Turner-McGrievy
authors.affiliation: University of Kentucky, Lexington, KY, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Beighle
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Ward
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Russell
authors.initials: R
authors.lastname: Pate
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Saunders
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Brazendale
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Chandler
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Rahma
authors.initials: R
authors.lastname: Ajja
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Becky
authors.initials: B
authors.lastname: Kyryliuk
authors.affiliation: University of South Carolina, Columbia, SC, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Beets
mesh_terms: D061725:Accelerometry; D060766:Drinking Water; D015444:Exercise; D005260:Female; D005638:Fruit; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D011050:Policy Making; D015397:Program Evaluation; D012574:Schools / Q000458:organization & administration*; D012737:Sex Factors; D062410:Snacks; D014675:Vegetables
chemical_list: D060766:Drinking Water
keywords: intervention; obesity; policy; youth