TY - JOUR
T1 - Trends in health behavior and weight outcomes following enhanced afterschool programming participation
AU - Rieder, Jessica
AU - Moon, Jee Young
AU - Joels, Joanna
AU - Shankar, Viswanathan
AU - Meissner, Paul
AU - Johnson-Knox, Elicia
AU - Frohlich, Bailey
AU - Davies, Shelby
AU - Wylie-Rosett, Judy
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: The United States needs to increase access to effective obesity prevention and treatment programming for impoverished youth at risk for health disparities. Although recommended, schools have difficulty consistently implement evidence-based obesity programing. We report on the effectiveness of adding structured nutrition education and minimum physical activity (PA) requirements to standard middle school after-school programming. Methods: Using a longitudinal pre-post study design, we evaluated program effectiveness at one year on target behaviors on students recruited during three consecutive school years (2016–2018). We used generalized linear (or logistic) mixed-effects modeling to determine: 1) impact on healthy weight and target healthy behavior attainment, and 2) whether target behavior improvement and weight change were associated with after-school program attendance. The seven target behaviors relate to eating healthy, physical activity, and sleep. Results: Over the three years, a total of 76 students enrolled and completed one year of programming (62% Hispanic, 46% girls, 72% with BMI > 85th %ile, 49% with BMI > 95th %ile). Of students with BMI > 85th %ile, 44% maintained or decreased BMI Z-score. There were improvements (non-significant) in BMI Z-score and the adoption of four healthy eating behaviors: fruit, vegetables, sugar-free beverages, and unhealthy snack food. Students with higher after-school attendance (> 75%) had greater improvements (non-significant) in composite behavior scores, BMI Z-score, and in most target behaviors (5/7) than students with lower after-school attendance (< 75%). Sleep improvements were significantly associated with BMI Z-score decrease (Beta = − 0.05, 95% CI (− 0.1,-0.003), p = 0.038.) Conclusions: Enhancement of existing after-school programming with structured nutrition education and minimum physical activity requirements demonstrates positive improvements in several health behaviors and weight outcomes. Adopting enhanced after-school programming increases access to health activities and may bring us closer to solving obesity in at-risk youth in impoverished communities. Trial registration: ClinicalTrials.govidentifier (NCT number):NCT03565744. Registered 21 June 2018 – Retrospectively registered.
AB - Background: The United States needs to increase access to effective obesity prevention and treatment programming for impoverished youth at risk for health disparities. Although recommended, schools have difficulty consistently implement evidence-based obesity programing. We report on the effectiveness of adding structured nutrition education and minimum physical activity (PA) requirements to standard middle school after-school programming. Methods: Using a longitudinal pre-post study design, we evaluated program effectiveness at one year on target behaviors on students recruited during three consecutive school years (2016–2018). We used generalized linear (or logistic) mixed-effects modeling to determine: 1) impact on healthy weight and target healthy behavior attainment, and 2) whether target behavior improvement and weight change were associated with after-school program attendance. The seven target behaviors relate to eating healthy, physical activity, and sleep. Results: Over the three years, a total of 76 students enrolled and completed one year of programming (62% Hispanic, 46% girls, 72% with BMI > 85th %ile, 49% with BMI > 95th %ile). Of students with BMI > 85th %ile, 44% maintained or decreased BMI Z-score. There were improvements (non-significant) in BMI Z-score and the adoption of four healthy eating behaviors: fruit, vegetables, sugar-free beverages, and unhealthy snack food. Students with higher after-school attendance (> 75%) had greater improvements (non-significant) in composite behavior scores, BMI Z-score, and in most target behaviors (5/7) than students with lower after-school attendance (< 75%). Sleep improvements were significantly associated with BMI Z-score decrease (Beta = − 0.05, 95% CI (− 0.1,-0.003), p = 0.038.) Conclusions: Enhancement of existing after-school programming with structured nutrition education and minimum physical activity requirements demonstrates positive improvements in several health behaviors and weight outcomes. Adopting enhanced after-school programming increases access to health activities and may bring us closer to solving obesity in at-risk youth in impoverished communities. Trial registration: ClinicalTrials.govidentifier (NCT number):NCT03565744. Registered 21 June 2018 – Retrospectively registered.
KW - Adolescent obesity
KW - Afterschool programming
KW - Healthy eating
KW - Physical activity
KW - School health
KW - Sleep
KW - Target behaviors
KW - Wellness Cascade
UR - http://www.scopus.com/inward/record.url?scp=85103998668&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103998668&partnerID=8YFLogxK
U2 - 10.1186/s12889-021-10700-4
DO - 10.1186/s12889-021-10700-4
M3 - Article
C2 - 33827501
AN - SCOPUS:85103998668
SN - 1471-2458
VL - 21
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 672
ER -