New Standards Aim to Integrate Healthy Eating, Physical Activity into After-School Care Programs

RESEARCH TRIANGLE PARK, N.C. – Efforts to combat childhood obesity and chronic diseases have primarily focused on schools and early child care settings, but a new set of standards written for programs that provide out-of-school care can help community-based organizations make an impact as well, according to a paper by researchers from RTI International, Wellesley College and the YMCA of the USA.  

The comprehensive, science-based standards were developed to help address the absence of a broad-based statement on healthy eating and physical activity in programs that provide care for children and youth in kindergarten through 12th grade before and after school, on holidays, and during vacations. 

The standards’ development process was outlined in a paper published in the December 2012 issue of Childhood Obesity. 

According to the authors, the standards reflect a social ecological model for changing children’s eating and activity behaviors through program-level interventions.

“Out-of-school time programs are a potentially important setting for health promotion,” said Jean Wiecha, Ph.D., a public health nutritionist at RTI International and lead author of the study. “Having consensus on healthy eating and physical activity standards among leaders in the field will help local programs build healthy environments for their kids.” The research was performed while Wiecha was at the University of Massachusetts Boston. 

Since their development, the standards have been adopted by the National AfterSchool Association and are being implemented in many out-of-school time programs nationwide.

The standards were developed using a national, mixed-methods needs assessment, a review of existing standards and expert recommendations, and a participatory process of discussion, review, and consensus engaging 19 service and policy organizations and agencies in the Healthy Out-of-School Time (HOST) coalition.

The coalition established 11 standards for healthy eating and physical activity that address content, staff training, program infrastructure, curriculum selection, and creating a supportive social and physical environment. The recommendations also include best practices for implementing each standard. 

The standards reflect suggestions made by dietary and physical activity experts, such as limiting sugar-sweetened beverages; avoiding foods high in trans fats, saturated fats, and sugars; eating at least five fruits and vegetables daily; and participating in at least 60 minutes of physical activity daily.

These individual-level recommendations are incorporated into program recommendations that include serving a fruit or vegetable daily and providing each child with at least 30 minutes of organized, inclusive physical activity for every three hours of program time. The standards also set targets for organizational practices that can support and sustain healthy snack and physical activity efforts.

In addition to practical information for community-based youth-serving organizations, the authors hope the standards will be useful to scientists undertaking health promotion studies in settings outside of traditional school environments. 

“These recommendations have implications for both practice and policy,” Wiecha said. “We urge scientists interested in health promotion in out-of-school time to consider these standards in developing their research and intervention frameworks.”

The authors also note that future research focused on effective adoption, training and implementation of the standards are warranted, as are studies of impact and behavioral outcomes.