Making healthy eating and physical activity policy practice: process evaluation of a group randomized controlled intervention in afterschool programs.

Authors:
Michael W Beets
Michael W Beets
University of South Carolina
United States
Brent Hutto
Brent Hutto
University of South Carolina
United States
Ruth P Saunders
Ruth P Saunders
University of South Carolina
United States
Dr. Justin B Moore, PhD, MS
Dr. Justin B Moore, PhD, MS
Wake Forest School of Medicine
Associate Professor
Implementation Science, Epidemiology
Winston-Salem, NC | United States
Gabrielle Turner-McGrievy
Gabrielle Turner-McGrievy
University of South Carolina
United States
Jennifer L Huberty
Jennifer L Huberty
University of Nebraska Omaha
United States
Dianne S Ward
Dianne S Ward
University of North Carolina at Chapel Hill
United States

Health Educ Res 2015 Dec;30(6):849-65

Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA.

This study describes the link between level of implementation and outcomes from an intervention to increase afterschool programs' (ASPs) achievement of healthy eating and physical activity (HE-PA) Standards. Ten intervention ASPs implemented the Strategies-To-Enhance-Practice (STEPs), a multi-component, adaptive intervention framework identifying factors essential to meeting HE-PA Standards, while 10 control ASPs continued routine practice. All programs, intervention and control, were assigned a STEPs for HE-PA index score based on implementation. Mixed-effects linear regressions showed high implementation ASPs had the greatest percentage of boys and girls achieving 30 min of moderate-to-vigorous physical activity (47.3 and 29.3%), followed by low implementation ASPs (41.3 and 25.0%), and control ASPs (34.8 and 18.5%). For healthy eating, high/low implementation programs served fruits and vegetables an equivalent number of days, but more days than control programs (74.0 and 79.1% of days versus 14.2%). A similar pattern emerged for the percent of days sugar-sweetened foods and beverages were served, with high and low implementation programs serving sugar-sweetened foods (8.0 and 8.4% of days versus 52.2%), and beverages (8.7 and 2.9% of days versus 34.7%) equivalently, but less often than control programs. Differences in characteristics and implementation of STEPs for HE-PA between high/low implementers were also identified.

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http://dx.doi.org/10.1093/her/cyv052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836399PMC

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December 2015
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