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 - Funding Information:
We express our appreciation to our collaborators at Public School/Middle School-95, the Mosholu Montefiore Community Center, the Montefiore School Health Program, and Wellness in the Schools.
Funding Information:
We express our appreciation for funding supported by a Human Resources and Services Administration (HRSA) Healthy Tomorrows Partnership for Children Program grant (Grant Numbers H17MC29435 and H17MC33892) and the Life Course Methodology Core (LCMC) of the New York Regional Center for Diabetes Translation Research via a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (grant numbers DK111022–8786 and P30 DK111022). The funding sources have provided salary support for JR, JYM, and VS related to study design, analysis and interpretation of the data as well as writing the manuscript and have provided salary support to EJK related to data collection.
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
VL - 21
JO - BMC Public Health
JF - BMC Public Health
SN - 1471-2458
IS - 1
M1 - 672
ER -