The Healthy Afterschool Activity and Nutrition Documentation Instrument

Abstract

Background Policies call on afterschool programs to improve the physical activity and nutrition habits of youth attending. No tool exists to assess the extent to which the afterschool program environment meets physical activity and nutrition policies. Purpose To describe the development of the Healthy Afterschool Activity and Nutrition Documentation (HAAND) instrument, which consists of two subscales: Healthy Afterschool Program Index for Physical Activity (HAPI-PA) and the HAPI-Nutrition (HAPI-N). Methods Thirty-nine afterschool programs took part in the HAAND evaluation during fall/spring 2010–2011. Inter-rater reliability data were collected at 20 afterschool programs during a single site visit via direct observation, personal interview and written document review. Validity of the HAPI-PA was established by comparing HAPI-PA scores to pedometer steps collected in a subsample of 934 children attending 25 of the afterschool programs. Validity of the HAPI-N scores was compared against the mean number of times/week that fruits/vegetables (FV) and whole grains were served in the program. Results Data were analyzed in June/July 2011. Inter-rater percent agreement was 85%–100% across all items. Increased pedometer steps were associated with the presence of a written policy related to physical activity, amount/quality of staff training, use of a physical activity curriculum, and offering activities that appeal to both genders. Higher servings of FV and whole grains per week were associated with the presence of a written policy regarding the nutritional quality of snacks. Conclusions The HAAND instrument is a reliable and valid measurement tool that can be used to assess the physical activity and nutritional environment of afterschool programs.

Intervention leads to improvements in the nutrient profile of snacks served in afterschool programs: a group randomized controlled trial

“…In brief, the STEPs-HE conceptual framework involves a multistep, adaptive approach to incorporating healthy eating strategies into daily routine practice. The framework was informed by the authors' extensive empirical work [12][13][14][17][18][19][20] conducted within this setting, as well as their practical experience working with ASP organizations. The approach consists of identifying essential ASP characteristics that represent fundamental building blocks that function as necessary programmatic components to achieving full integration of healthy eating strategies and eventual achievement of the Healthy Eating (HE) Standards [4,5].…”

“…Additionally, at baseline the Healthy Afterschool Activity and Nutrition Document (HAAND) was collected on all 20 programs. [12,17] The HAAND is collected from a single day site visit by a trained research assistant that includes direct observation of foods and beverages served, a semistructured interview with the program leader, and written document review. Only the nutrition portion of the HAAND is presented in this study.…”

Physical activity and healthy eating environmental audit tools in youth care settings: A systematic review

“…Inter-rater reliability (Table 2) was the most commonly tested type of reliability (n=7) 13, 21, 23-26 followed by test-retest (n=3), 21, 82, 83 and internal consistency (n=1). 25 For reliability assessment, studies reported Pearson correlation, Cronbach's α, kappa coefficient, percent agreement and/or interclass correlation coefficient (ICC) scores.…”

“…25 For reliability assessment, studies reported Pearson correlation, Cronbach's α, kappa coefficient, percent agreement and/or interclass correlation coefficient (ICC) scores. The following tools had the highest reliability coefficients: the Wellness Child Care Assessment Tool (WellCCAT) 25 with an ICC ranging from 0.84-0.99; the Food and Beverage Environment Analysis and Monitoring System (FoodBEAM), 26 with an ICC ranging from 0.97-0.99; the Community Healthy Living Index (CHLI), 23 with percent agreement ranging from 84%-93%; and the Healthy Afterschool Activity and Nutrition Documentation (HAAND) 13 with percent agreement ranging from 85%-100% and kappa coefficients ranging from 0.73-1.00.…”

“…Construct validity (table 2) was the most reported type of validity (n=5), 13, 21, 24, 25, 82 followed by face and/or content validity (n=3), 13, 21, 83 criterion validity (n=2) 21, 84 and convergent validity (n=1). 26 Construct validity comparisons were made: against national expert review, 21 comparison to environmental characteristic scores among sites using groups expected to differ due to known characteristics, 24, 25 and objective measures of child-level physical activity such as pedometers 13 and direct observation.…”