Comparative Effectiveness of Afterschool Programs to Increase Physical Activity

Background:
We conducted a comparative effectiveness analysis to evaluate the difference in the amount of physical activity children engaged in when enrolled in a physical activity-enhanced after-school program (ASP) based in a community recreation center versus a standard school-based ASP.

Methods:
The study was a natural experiment with 54 elementary school children attending the community ASP and 37 attending the school-based ASP. Accelerometry was used to measure physical activity. Data were collected at baseline, 6 weeks, and 12 weeks, with 91% retention.

Results:
At baseline, 43% of the multiethnic sample was overweight/obese (BMI≥85thpercentile) and the mean age was 7.9 years (SD=1.7). Linear latent growth models suggested that the average difference between the two groups of children at Week 12 was 14.7 percentage points in moderate-vigorous physical activity (MVPA, p<.001). Cost analysis suggested that children attending traditional school-based ASPs – at an average cost of $17.67 per day – would need an additional daily investment of $1.59 per child for 12 weeks to increase their MVPA by a model implied 14.7 percentage points.

Conclusions:
A low-cost, alternative ASP featuring adult-led physical activities in a community recreation center was associated with increased physical activity in a sample of elementary school children compared to standard-of-care school-based aftercare.