Comparative Effectiveness of After-School Programs to Increase Physical Activity

Abstract EN

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.