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Journal of Obesity
Volume 2013 (2013), Article ID 576821, 8 pages
http://dx.doi.org/10.1155/2013/576821
Research Article

Comparative Effectiveness of After-School Programs to Increase Physical Activity

1Department of Social Sciences and Health Policy, and the Maya Angleou Center for Health Equity, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
2Department of Psychology and Human Development, Vanderbilt University, Nashville, TN 37240, USA
3Kennedy Center, Vanderbilt University, Nashville, TN 37203, USA
4Department of Economics, Center for Evaluation and Program Improvement, Peabody College, Vanderbilt University, Nashville, TN 37203, USA
5Clinical Research Center, Vanderbilt University, Nashville, TN 37232, USA
6Center for Evaluation and Program Improvement, Peabody College, Vanderbilt University, Nashville, TN 37203, USA
7Departments of Family Medicine and Pediatrics, Office of Rural Health and Health Disparities, University of Mississippi Medical Center, Jackson, MS 39216, USA
8Center for Translational Science, Children’s National Medical Center, Washington, DC 20010, USA
9Vanderbilt University School of Medicine, Nashville, TN 37232, USA
10Nashville Metropolitan Board of Parks and Recreation, Nashville, TN 37215, USA
11Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA

Received 10 January 2013; Accepted 6 July 2013

Academic Editor: Reza Majdzadeh

Copyright © 2013 Sabina B. Gesell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 based in a community recreation center versus a standard school-based after-school program. 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, 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 ( ). 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 moderate-vigorous physical activity by a model-implied 14.7 percentage points. Conclusions. A low-cost, alternative after-school program featuring adult-led physical activities in a community recreation center was associated with increased physical activity compared to standard-of-care school-based after-school program.