Opportunities in the Extended Day: Approaches for Promoting Physical Activity and Healthy Eating During Out‐of‐School Time

Abstract

BackgroundThis systematic review aims to identify out‐of‐school time (OST) interventions (eg, programming, policies) that increased opportunities for physical activity (PA) and healthy eating and/or improved youth PA and dietary behaviors.MethodsWe searched for articles within systematic reviews that met our criteria (2010‐2018) and for individual articles (2010‐2020). Reviewer pairs screened articles, double‐extracted data, assessed risk of bias (RoB), and achieved consensus. We included 71 articles (55 studies, 60 intervention arms).ResultsHealth (n = 3) and nutrition education (n = 7) interventions showed promising results, but most used weak designs and had high RoB. PA‐focused interventions (n = 23) were largely consistent in improving fitness and moderate to vigorous PA during programming. Programmatic interventions that improved both PA and nutrition outcomes engaged family or community members (n = 4/13). Most organizational policy interventions improved the nutrition environment and student PA during OST.ConclusionsOrganization‐level policy and programmatic interventions can improve environmental supports and youth behaviors during OST programming, complementing school‐day efforts to address student PA and dietary intake. To maximize their potential impact, OST programs need to be accessible to families. Administrators can consider actions to reduce participation barriers.

Transforming Evidence Into Action: A Commentary on School‐Based Physical Activity and Nutrition Intervention Research

“…Out-of-school time (OST) programs using PA and nutrition standards and supportive programming practices paired with professional development and technical assistance. 22 …”

“…We found evidence supporting existing recommendations for comprehensive school PA programs that include school-level PA policies, PE and recess during the school day, and focused PA interventions offered multiple times a week before or after school to increase student PA and, in some cases, reduce sedentary behavior. 9 , 14 , 17 , 22 …”

“… 27 Other opportunities for skill-based nutrition education in OST, such as afterschool cooking clubs and nutrition curricula, showed some evidence of effectiveness but need additional evaluation. 22 …”

“…Many interventions that reported positive results for at least 1 PA or nutrition outcome provided implementation-focused professional development or technical assistance and/or engaged family or community members frequently as part of a coordinated approach. 16 – 18 , 22 , 32 Family and community engagement strategies to support and promote PA and nutrition in school and OST settings included communicating with families and community members; providing classes and support for families; offering volunteer opportunities for family and community members; involving families and community members in decision making; reinforcing health knowledge and practices in the home and community; and promoting collaborations among school and community to support students and their families. 32 …”

“…Whether reviewing school or OST policies and practices, teams may benefit from focused technical assistance, 46 facilitation, 47 or learning collaboratives to conduct self-assessments and action planning. 48 Involving students through teen/peer mentoring models and participation in school wellness councils showed promise but was neither evaluated widely nor in high quality studies, 16 , 20 , 22 suggesting more research may be needed.…”