Survey of Afterschool Programs Suggests Most Offer Fruit and Vegetables Daily.

Introduction: Most children underconsume fruit and vegetables. This study estimated the frequency and quality of fruit and vegetables offered during snack in US afterschool programs and examined program-level factors associated with offering them, including awareness and use of the National AfterSchool Association Healthy Eating and Physical Activity standards.

Methods: We conducted descriptive analyses and regression modeling by using data collected from 684 National AfterSchool Association members and their colleagues via a 2015 online survey.

School health implementation tools: a mixed methods evaluation of factors influencing their use.

Background: The U.S. Centers for Disease Control and Prevention (CDC) develops tools to support implementation of evidence-based interventions for school health.

Developing a Tool to Assess the Capacity of Out-of-School Time Program Providers to Implement Policy, Systems, and Environmental Change.

Background: Little is known about public health practitioners' capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program providers to improve students' level of nutrition and physical activity through changes in PSEs.

Community Context: The measure was developed and tested through an engaged partnership with staff working on the Alliance's Healthy Out-of-School Time (HOST) Initiative.

Promoting physical activity in Out-of-School-Time programs: we built the bridge--can we walk over it?

This commentary describes physical activity standards for Out-of-School Time programs and argues that their widespread adoption presents important opportunities for research on their implementation and impact.

Uptake of National AfterSchool Association physical activity standards among US after-school sites.

Objective: In 2011, the National AfterSchool Association (NAA) adopted standards to guide delivery of physical activity (PA). We assessed after school sites' uptake of the five PA standards.

Method: We conducted a descriptive study in fall 2013.

Utilization of a free fitness center-based exercise referral program among women with chronic disease risk factors.

Physical activity (PA) reduces the risk for a number of chronic diseases including heart disease, hypertension, hyperlipidemia, and diabetes mellitus type 2. However, most Americans do not meet expert recommendations for exercise, and minorities and low-income persons are the most inactive. Community-based approaches to promoting PA include primary care exercise referral programs.

Development of healthy eating and physical activity quality standards for out-of-school time programs.

Background: Out-of-school time (OST) programs serve over 8 million children per year and have ample opportunity to promote health through menu and physical activity choices. Until recently, however, the field has lacked a comprehensive set of operationalizable standards for healthy eating and physical activity. The National AfterSchool Association adopted voluntary healthy eating and physical activity quality standards (HEPAQS) in April, 2011.

A toolkit to promote fidelity to health promotion interventions in afterschool programs.

Community-based obesity prevention efforts are an essential component of a public health approach to obesity and chronic disease risk reduction. Afterschool programs can participate by providing healthy snacks and regular physical activity. Although efficacious obesity prevention strategies have been identified, they have not been widely implemented.

Price and healthfulness of snacks in 32 YMCA after-school programs in 4 US metropolitan areas, 2006-2008.

Introduction: A common perception is that healthful foods are more expensive than less healthful foods. We assessed the cost of beverages and foods served at YMCA after-school programs, determined whether healthful snacks were more expensive, and identified inexpensive, healthful options.

Methods: We collected daily snack menus from 32 YMCAs nationwide from 2006 to 2008 and derived prices of beverages and foods from the US Department of Agriculture price database.

Effect of an after-school intervention on increases in children's physical activity.

Purpose: Evaluate the effect of an after-school intervention on physical activity program changes and individual behaviors among children.

Methods: A quasi-experimental evaluation of a YMCA-driven environmental change intervention with 16 intervention and 16 control sites in four metropolitan areas in the United States. Intervention sites participated in learning collaboratives designed to promote physical activity and nutrition through environmental change, educational activities, and parent engagement.

Informal training in staff networks to support dissemination of health promotion programs.

Purpose: To study informal skill transfer via staff networks as a complement to formal training among afterschool childcare providers implementing a health promotion program.

Design: Cross-sectional, sociometric network analysis.

Setting: Boston Young Men's Christian Association (YMCA) afterschool programs implementing the iPLAY program.

Disseminating health promotion practices in after-school programs through YMCA learning collaboratives.

Purpose: We describe the perceived usefulness of a learning collaborative for translating obesity prevention science into practice at YMCA after-school programs.

Approach: We conducted mixed-methods research to identify beneficial aspects of the collaborative and to assess perceived effect of the collaborative on ability to meet goals.

Setting: Sixty-one YMCA after-school programs serving roughly 2500 children in 21 states.

Impact of an organizational intervention designed to improve snack and beverage quality in YMCA after-school programs.

Objectives: We evaluated the quality of snacks and beverages served at YMCA after-school programs before and after the programs' participation in a YMCA Learning Collaborative.

Methods: We collected data on the types and brands of snacks and beverages (including fresh fruits and vegetables, whole grains, foods with trans fats, water, and sugar-sweetened beverages) served daily during 3 different time periods spanning 14 months in total, and the components of the healthy eating standards. We compared snack and beverage quality before and after the intervention.

Development of the Community Healthy Living Index: a tool to foster healthy environments for the prevention of obesity and chronic disease.

Objectives: This paper presents a new, comprehensive tool for communities to assess opportunities for active living and healthy eating and to mobilize all sectors of society to conquer obesity and chronic disease.

Method: Relevant existing tools and input from an expert panel were considered to draft the Community Healthy Living Index (CHLI). CHLI covers five major sectors where people live, work, learn, and play: schools, afterschools, work sites, neighborhoods, and the community-at-large.

Extra-team connections for knowledge transfer between staff teams.

As organizations implement novel health promotion programs across multiple sites, they face great challenges related to knowledge management. Staff social networks may be a useful medium for transferring program-related knowledge in multi-site implementation efforts. To study this potential, we focused on the role of extra-team connections (ties between staff members based in different site teams) as potential channels for knowledge sharing.

Reliability and validity of YRBS physical activity items among middle school students.

Purpose: To assess test-retest reliability and validity of the Youth Risk Behavior Survey (YRBS) items for moderate and vigorous physical activity in middle school students.

Methods: Students (N = 125; 12.7 +/- 0.

School-based programs: lessons learned from CATCH, Planet Health, and Not-On-Tobacco.

Establishing healthy habits in youth can help prevent many chronic health problems later in life that are attributable to unhealthy eating, sedentary lifestyle, and overweight. For this reason, many public health professionals are interested in working with school systems to reach children in school settings. However, a lack of familiarity with how schools operate can be a substantial impediment to developing effective partnerships with schools.

School vending machine use and fast-food restaurant use are associated with sugar-sweetened beverage intake in youth.

Objective: To examine associations between use of school vending machines and fast-food restaurants and youth intake of sugar-sweetened beverages.

Design: A cross-sectional observational study.

Subjects/setting: From a group randomized obesity intervention, we analyzed baseline data from 1,474 students in 10 Massachusetts middle schools with vending machines that sold soda and/or other sweetened drinks.

When children eat what they watch: impact of television viewing on dietary intake in youth.

Objectives: To test whether increased television viewing is associated with increased total energy intake and with increased consumption of foods commonly advertised on television, and to test whether increased consumption of these foods mediates the relationship between television viewing and total energy intake.

Design: Prospective observational study with baseline (fall 1995) and follow-up (spring 1997) measures of youth diet, physical activity, and television viewing. We used food advertising data to identify 6 food groups for study (sweet baked snacks, candy, fried potatoes, main courses commonly served as fast food, salty snacks, and sugar-sweetened beverages).

Effects of a school-based obesity-prevention intervention on menarche (United States).

Objective: Early menarche is a risk factor for breast cancer. Since body composition influences age at menarche we decided to estimate the effects of a school-based intervention for the prevention of obesity on the initiation of menses in young girls.

Methods: Ten schools were randomized to a modified curriculum or no curricular changes for 2 school-years.

Playground safety and access in Boston neighborhoods.

Background: Youth physical activity is partly influenced by access to playgrounds and recreational opportunities. Playgrounds in disadvantaged areas may be less safe.

Methods: Investigators assessed safety at 154 playgrounds in Boston between July 2000 and July 2001.

Diffusion of an integrated health education program in an urban school system: planet health.

Objective: Assessed the feasibility, acceptability, and sustainability of Planet Health, an interdisciplinary, integrated health education curriculum implemented in six public middle schools.

Methods: Workshops on Planet Health implementation were attended by 129 teachers (language arts, math, science, and social studies) over three school years (1999-2000, 2000-2001, and 2001-2002). Questionnaires were administered post-implementation and in the fall and spring of each year.

Youth recall and TriTrac accelerometer estimates of physical activity levels.

Purpose: To examine significance of missing data and describe physical activity patterns using recall and accelerometer measures among youth in a nonlaboratory setting.

Methods: Fifty-four middle-school students wore TriTrac-R3D monitors (TTM) and completed an interviewer-prompted 24-h recall during two, 5-d monitoring sessions. We coded 2860 30-min recall intervals to a standard MET compendium.