title: Snacks, beverages, and physical activity during volunteer-led out-of-school-time programs: a cross-sectional analysis.
abstract: Tens of millions of children regularly participate in out-of-school-time (OST) programs, providing an opportunity for child health promotion. Most research on OST has focused on structured, staff-led after-school programs, as opposed to volunteer-led programs such as enrichment programs and youth sports. The aim of this study was to describe snacks, beverages, and physical activity (PA) practices in volunteer-led OST programs across five organizations in three states.
  
  
  
  An online survey including the Out-of-School-Time Snacks, Beverages, and Physical Activity Questionnaire was distributed to 1,695 adult leaders of enrichment and youth sports programs serving 5-12 year-old children in Maine, Massachusetts, and New Hampshire, USA. The response rate was 57.8%, with 980 leaders participating and 698 (136 youth sports, 562 enrichment) remaining after data cleaning procedures. Frequencies were calculated to describe snack, beverage, and PA offerings during typical meetings and whether healthy snack, beverage, and PA criteria were met. Criteria were developed a priori with the intent to capture co-occurring practices that together indicate healthy snack (fruits and vegetables or no snack over salty/sweet snacks); beverage (water over sugar-sweetened beverages); and PA environments (regular opportunities for >15 or 45 min of PA in enrichment and sports programs, respectively).
  
  
  
  About half of enrichment leaders reported that snacks and beverages were provided during typical meetings vs. one-fifth of sports leaders. In 28.4% of enrichment programs, PA was offered at every meeting vs. 98.5% of sports programs. Among enrichment programs, 50.4 and 25.8% met healthy snack and beverage criteria, respectively, and 29.4% met PA criteria, with 27.6% meeting criteria in two or more areas, and 5.0% in all three. Among sports programs, 72.8 and 78.7% met healthy snack and beverage criteria, respectively, and 71.3% met PA criteria. Eighty-two percent met criteria in two or more areas, and 46.3% met criteria in all three.
  
  
  
  Most programs did not meet criteria for healthier snacks and beverages and opportunities for PA during typical meetings, indicating room for improvement in encouraging widespread adoption of these practices. Efforts to improve the healthfulness of snacks and beverages and increase opportunities for PA during volunteer-led OST programs are warranted.
authors.affiliation: ChildObesity180, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, 02111, MA, USA. christina.economos@tufts.edu.|Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA. christina.economos@tufts.edu.
authors.forename: Christina D
authors.initials: CD
authors.lastname: Economos
authors.affiliation: Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, G56 Farber Hall, South Campus, Buffalo, NY, 14214, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Anzman-Frasca
authors.affiliation: ChildObesity180, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, 02111, MA, USA.
authors.forename: Alyssa H
authors.initials: AH
authors.lastname: Koomas
authors.affiliation: ChildObesity180, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, 02111, MA, USA.
authors.forename: Grace
authors.initials: G
authors.lastname: Chan
authors.affiliation: Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Folta
authors.affiliation: ChildObesity180, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, 02111, MA, USA.
authors.forename: Julianne
authors.initials: J
authors.lastname: Heck
authors.affiliation: ChildObesity180, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, 02111, MA, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Newman
authors.affiliation: Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Sacheck
mesh_terms: D001628:Beverages; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008281:Maine; D008297:Male; D008404:Massachusetts; D009513:New Hampshire; D062410:Snacks; D011795:Surveys and Questionnaires; D014675:Vegetables; D014838:Volunteers
keywords: After-school programs; Beverages; Children; Enrichment; Nutrition; Out-of-school time; Physical activity; Snacks; Youth sports