Process Evaluation of Making HEPA Policy Practice: A Group Randomized Trial.

Area of Science:

• Childhood obesity prevention
• Public health interventions
• After-school program effectiveness

Background:

• After-school programs (ASPs) are crucial settings for promoting children's health.
• Interventions are needed to increase physical activity and improve dietary quality in children.
• The Strategies to Enhance Practice (STEPs) program aimed to improve moderate to vigorous physical activity (MVPA) and snack quality in ASPs.

Purpose of the Study:

• To examine the relationship between the implementation level of STEPs and changes in children's MVPA and snack quality.
• To determine if higher implementation of STEPs leads to better health outcomes in after-school settings.
• To identify factors influencing the successful implementation of health promotion strategies in ASPs.

Main Methods:

• Twenty ASPs participated in the STEPs intervention.
• Outcomes (MVPA and snack quality) were measured using accelerometers and direct observation.
• STEPs implementation was assessed via document review and direct observation, categorizing ASPs as high or low implementers.

Main Results:

• Higher STEPs implementation was associated with increased MVPA for boys, but not for girls.
• Both high and low implementation groups showed improvements in serving fruits, vegetables, and water, and reductions in desserts and sugar-sweetened beverages.
• Effect sizes indicated that increased implementation positively influenced the serving of healthier snacks and MVPA for boys.

Conclusions:

• Higher implementation of STEPs is linked to improved MVPA for boys and healthier snack offerings in ASPs.
• Girls' MVPA benefited from the intervention irrespective of implementation level.
• Program adaptation and local adoption of strategies appear key for successful implementation and maximizing intervention impact.