Physical Activity and After School Programs

Physical Activity and After School Programs

Exercise and Health

Physical Activity in an Organized After School Program: A Pilot Study

MARIETTA ORLOWSKI1, JEFFERY HALLAM2, KAREN WONDERS1

1Wright State University, Department of Health, Physical Education and Recreation, Dayton, OH 45435 USA,2Univeristy of Mississippi, Center for Health Behavior Research, University, MS, 38677 USA

ABSTRACT

Orlowski M, Hallam JS, Wonders KY.Physical Activity in an Organized After School Program: A Pilot Study.JEPonline 2010;(3):12-21. After school programs offer significant opportunity to increase the physical activity levels of children. The purpose of this mixed methods investigation was to describe the fitness and physical activity levels of children enrolled in a multi-site after school program, and to, explore environmental and psychosocial variables related to after school physical activity levels. A total of 91 students (average age 7.43 + 0.57 years) completed fitness testing. On average, the students scored in the 40th percentile or below for each of the fitness components. Participants also spent an average of 155+9.57 minutes of the total 180 minutes in the after school program participating in light, sitting activities. The most common light activities were homework, snack, arts and crafts, cards, and socializing with friends. There was a moderate relationship (r = 0.32, p = 0.06) between minutes spent in light/sedentary activity and BMI; however, low variability in physical activity minutes may have influenced the relationship. Descriptively, 60% of the overweight or obese participants spent the entire 180 minutes at the after school program in light activity. Semi-structured focus groups revealed that the social context of activities was also an important theme in after school programs. Reporting whom they were doing an activity with was the most commonly reported aspect of any activity.

Key Words: Physical Activity, Children

INTRODUCTION

After school programs offer significant opportunity to increase the physical activity levels of children and account for 25% of the activity opportunities for youth. Only recess and physical education, because of their inclusive enrollment, account for more opportunity (1). Currently, 6.5 million school-aged children are enrolled in an after school program, while 14 million children take care of themselves after school (1). Furthermore, enrollment in after school programs could increase, given an increase in the numbers of single and employed mothers and intensified efforts to promote positive youth development (15).

Traditional youth activity barriers of transportation, cost, and time are reduced by after school programs. Children are already enrolled in the program and spend an average of eight hours per week in attendance (1). The potential for after school program physical activity lies not only in barrier removal, but also in the presence of established activity facilitators including peers, adult supervision, equipment, and facilities (10, 12).

The study of after school programs is in its infancy. What is known is that most after school programs report homework and snack time as consistent components of the after school schedule.Physical activity levels and activity typesappear to vary among after school programs. In one study of seven elementary schools, 4th graders spent anaverage of 47 minutes per after school session in active recreation (3). About half (49%) of the active recreation time was in organized activities such as game playing, and the remaining active recreation time was in free play. By comparison, students spent an average of 28 minutes in academic time and 15 minutes in snack time. In another study, elementary age students in after school programs spent an average of 42.6, 40.8, 13.4, and 5.3 minutes in sedentary, light, moderate, and vigorous physical activity, respectively (14).

Recent policy-oriented reports acknowledge the potential of after school programs for improving the health of children (2, 8, 13). However, information gapslimit the ability for policy development and advocacy regarding after school programming, space, staffing, and training (3, 14). The primary aim of this studywas to describe the fitness level and after school activity levels of children enrolled in an after school program. A secondary aim was to explore environmental and psychosocial variables related to after school physical activity levels. Findings from this study will aid in the creation of policy and programs that enhance the health of children, as well as provide direction for additional research topics and methods.

METHODS

Setting and Participants

After school sites were selected from a single provider organization that supervises 27 afterschool sites from 10 different school districts. The organization was a recreational membership organization that provides recreation, childcare, and summer camp programs to all individuals and families regardless of income, race, or ethnicity in a four-county area of the Midwest. The afterschool sites included students of varying academic performance, socioeconomic status, levels of urbanization, and ethnicities. They include 675 students of which 27% are minorities and 37% come from a low-income family. There is a similar percentage of boys and girls, 48% to 52% respectively, with a mean age of 8.2 (+1.6) years. Testing methods were approved by the after school provider, and parental consent was obtained by the provider.

Phase I of this mixed methods design consisted of fitness testing and after school physical activity reporting.Fitness testing was completed at five after-school sites from four school districts that were diverse in terms of location and student body characteristics. In addition, physical activity recall questionnaires were administered to eight after-school sites, four of which were sites where fitness testing was also conducted.Fitness testing and activity recalls were completed during a 30-day period in the spring of 2007.

Phase II consisted of qualitative data collection from four after school sites. All four sites participated in Phase I and represented three school districts. The sampling plan was to interview 6 to 8 participants per site (7, 9).Attendance on the days of the focus groups was 7, 8, 15 and 29 participants, respectively. At sites with single digit attendance, all the participants in attendance were included in the focus groups. A total of 26 children participated in the focus groups, ranging in age from 5 to 11; 58% of the participants were males. A separate focus group was conducted for the site leaders for all Phase I sites (n = 8).All focus groups were completed during a two weeks period in the spring of 2007.

Procedures

Fitness testing assessed participant body mass index (BMI), cardiorespiratory endurance, muscular endurance, and flexibility. All tests followed protocols described in the YMCA Fitness Testing and Assessment Manual (17). Cardiorespiratory endurance was assessed via a 1-mile walk/run, whereby each student ran or walked the distance of 1-mile as fast as he/she was able. The total time it took each student to complete 1-mile was recorded and analyzed. Muscular endurance was measured using the 1-minute sit up test. Each student completed as many sit-ups as he/she could in the time frame of one minute. The total number of sit-ups was recorded and used for analysis. Finally, flexibility was measured via the sit-and-reach test. The test was repeated three times, and the highest score was recorded for analysis.All fitness testing was conducted by the organization’s fitness director and the after school program leader.

Participants reported physical activity via the Physical Activity Questionnaire, which was adapted from the Previous Day Physical Activity Recall (16). Children were asked to report activities from the previous day, in 15-minute time blocks. The Previous Day Physical Activity Recall is a valid and reliable instrument for measuring physical activity. Criterion validity was determined by pedometers (r= 0.88, p = 0.01) and accelerometers (r = 0.77, p = 0.01). Reliability was assessed through test-retest methodology (r = 0.98). The instrument was slightly modified; the shortened version only included the after school hours. The questionnaire was completed on a day that was separate from the fitness testing.

Phase II data collection consisted of semi-structured focus groups with program participants. Prior to the focus group, a moderator guide was developed and reviewed by the organization’s program supervisor. The guide was created from a generated list of possible questions and then organized into four topic themes: favorite activities, physical activity levels, typical day at after school program, and modeling and cues for activity (9). The setting was as naturalistic as possible: each focus group was held at the after school program site and participants sat in a circle on the floor with their peers and the moderator. Because the after school programs are assigned to space by the individual school, the interviews occurred in different location types: a cafeteria, a gymnasium, in a classroom, and on a playground.The groups were facilitated by the same researcher and ranged from 15 to 24 minutes in length.Not all topics were discussed in all focus groups; the moderator completed the interviews when the participants lost interest.

The site leader focus group was completed similarly to the participant focus groups. Interview questions were organized around four themes: goals of after-school program, current site activity levels, beliefs and perceived skills related to after school activity, and programming ideas.The group was facilitated by two researchers and was completed in 60 minutes.

Data Analysis

Descriptive statistics were computed as means and standard deviations for the continuous variables. Relationships between BMI and physical activity minutes were assessed via Pearson’s correlation coefficient. Content analysis was completed via the focus group transcripts and the moderator debriefing notes. The verbatim transcripts were color-coded by after school site; all participant responses were cut into individual pieces. The responses were then sorted into the four question themes and a miscellaneous category. The individual themes were then analyzed for content, specificity, frequency, and extensiveness. Extensiveness refers to how many individuals said something; frequency refers to the number of times a comment was made. Responses with specific details were given more emphasis because these comments are deemed more authentic (7). A third researcher, with experience in physical activity research and focus group analysis, reviewed all the transcripts and data interpretations.

RESULTS

Fitness Levels

A total of 91 students completed fitness testing, of which 51 were female and 40 were male. The students’ average age was 7.43 + 0.57 years. On average, the students scored in the 40th percentile or below for each of the fitness components (Table 1). Specifically, the average time for completing the run walk was 672 +0.58 seconds for males and 696 + 0.57 seconds for females. The cardiorespiratory endurance scores (average) were in the 30-35 percentile and 35-40 percentile, respectively. On average, both males and females completed 16 sit-ups in a minute, indicating a muscular endurance at or below the 5-10 percentile. Flexibility percentile averages were at the 10 and 5 percentile for males and females, respectively (5).

The average BMI for males was 17.1 + 0.3 kg/m2, which corresponds to the 72nd percentile for this age group. The average BMI for the females was 17.8 + 0.61 kg/m2, which corresponds to the 87th percentile for this age group. There was a wide range of BMI values, from a minimum BMI of 9.4 kg/m2 to a maximum BMI of 37.9 kg/m2. Slightly more than half (56%) of the participants had a healthy BMI, between the 5th and 85th percentile. Of the remaining 44% of the participants (n = 40), 21 were classified as overweight and 19 were classified as obese (Table 2).

Physical Activity Levels

Most of the activity time, regardless of site or sex, was spent in light activity. On average, participants (n=168) spent 155.0+9.6 minutes of the total 180 minutes in the after school program participating in light, sitting activities (Table 3). In addition, 100% of the surveyed participants from two after school sites, and 70% of the total participants reported being sedentary the entire time they were in attendance at the after school program (Table 4). Participants reported that they predominantly participated in light activity the entire time they were in attendance at their after school program (Table 5). Only 5 of the total students surveyed reported performing any hard intensity activity at all. The most common reported light activities were homework, snacks, arts and crafts, cards, and socializing with friends (Table 6). There was a moderate relationship (r = 0.32, p = 0.06) between the time spent performing light sitting activity and the participant’s BMI.

Small amounts of time were spent in activities of higher intensities. Participants reported an average of 17.2, 14.2, and 12.4 minutes in physical activity that was easy, moderate, or hard, respectively (see Table 3). The most common reported moderate physical activities were walking or playing kickball. Three sites had group averages of 10 or more minutes of moderate activity. The same groups also reported similar values for hard or vigorous activity.

Participant Focus Groups

When asked about their “favorite activities after school”, responses varied. The activities mentioned in the highest frequency, extensiveness, and specificity were card games and swimming. In all four groups, children talked about playing card games. Furthermore, when talking about card games, children offered details such as what cards they traded, and with whom. Swimming was also mentioned in three of the four groups; again with specific details of what they liked about swimming. For example, one student replied, “I like to go to the deep end and go as far as I can and hold my breath as long as I can and try and touch the bottom.” Going to the park was also a common response. Specific park activities reported were playing on the slides, climbing on the monkey bars, and running around.

Other favorite activities that were mentioned in more than one focus group were video and computer games, television, listening to music, and crafts (see Table 6). Moderate intensity activities that were mentioned in more than one group included playground ball games, such as dodge ball, kickball and poison ball, soccer, basketball and horseback riding. Activities that were mentioned more than once in a single focus group included fishing, cheerleading, jump roping, and “going to the gym.”

Participants had difficulty estimating time spent in physical activity, as well as describing a typical day in the after school program. Children were asked, “How many times in the last week were you physically active for an hour?” Physical activity had been defined as moving your body and breathing hard. Even after several lead up questions and prompts prior to this question, not one child could convert activity to a total number of hours. Children were asked to record responses in a notebook. In both the first and second focus groups, children were able to list activities, but struggled with a time conversion. For example, “I did this at recess and we only have 25 minutes.” Another student reported he played 10 baseball games in the past week. Participants in the third and fourth group were not asked this series of questions.

The last theme explored in the focus groups was about activity cues and modeling, specifically activity with family. The reported activities varied; however, most responses were specific and animated.

We go to the pool and we dive and we get back up and then we run around and then we do flips.
We take walks with the dog.
I would like to run on the track. My mom makes me speed walk.
Go fishing… You know how I cook them? You know how my grandpa cooks them? He cuts them up first and then he lets them stay in the fridge for a bit, he puts them on the stove and cooks them.

An unanticipated, but predominant theme across all questions and focus groups was the social context of the physical activity. Reporting whom they were doing an activity with was the most commonly reported aspect of any activity. In addition to activities with family members, participants reported activities with a friend in the after school program, a neighborhood friend, a dog, grandparents and aunts. Examples of common responses to favorite activities were:

Go to the park and ride my bike with (my friend) S.
I am R and I am 10 years old and I like to play with a friend in the neighborhood at X park…
My name is K and I am 7 years old and I like to play soccer with my dad after school.
Me and my friend N, which is probably not going to be here for the rest of the year… me and him almost everyday bring our Yugioh cards but for a long period time, in the middle of the year, we didn’t bring them for a long, long time.

Leader Focus Group

The site leaders reported safety, consistency, meals, affection, and discipline as the purpose of the after school program.

Obviously I hate to call it a day care, but it’s just to help parents out who have to work and don’t have the opportunity to come home at 3:30 p.m. everyday to get kids off the bus.
We have a schedule so there is time to have table time where there are several sit down activities and we will have a group game and then we try to keep everything structured so they are not just running around like crazy kids because that is usually when your problems happen.

Homework, snacks and “the schedule” were referenced repeatedly and in different parts of the group: “…they come in, they do their homework, they get a snack, as they finish up their homework, groups start to go outside if they are able or go to the gym or whatever keeps them busy.” The after snack time of the schedule appeared to vary by leader, by space, and by group size/dynamics. One leader, with camp experience, reported group games such as capture the flag and various playground ball games. Others leaders reported board games and crafts. Notably, the space access was different by group. The two most “envied” spaces were a designated classroom and a well-equipped playground. One of the sites was based in the designated classroom; one site had access to a well equipped playground. The other groups had access to outdoor space, but commented on the limited equipment and or quality of the equipment: “I wish we had a better jungle gym thing. They get bored with the rope thing and like the swing.” The number of children, and the age ranges were reported as specific challenges: