A scoping review of physical activity and screen time guidelines for use in Outside School Hours Care

Globally, millions of children attend Outside School Hours Care. Children's activity in this setting is critical to meeting daily physical activity recommendations. Guidelines are evidence-based statements intended to optimise practice. This study aimed to identify guidelines used in Outside School Hours Care for physical activity and screen time and summarise their content and methods of development.

Outside School Hours Care guidelines for children aged 5 to 12 years were identified by systematically searching Medline, Emcare, Embase, Scopus, ERIC, Sportsdiscus, TROVE, ProQuest, UpToDate, NICE, SIGN and Google in accordance with PRISMA-ScR guidelines. The search was conducted in March 2019 and results screened independently by two authors. Data were synthesized narratively.

Nine guideline documents were identified from grey literature only (n = 8 USA, n = 1 Canada). The included guidelines focused predominantly on the after school care period (n = 9 vs n = 2 for the before school period). All had recommendations for physical activity, whilst 7 included screen time recommendations. There was considerable variability across the physical activity and screen time recommendations, though taken together, they recommended 30-60 min of moderate- to- vigorous physical activity and less than 60 min of recreational screen time per session. All guidelines were developed by expert/stakeholder panels, but none followed rigorous guideline development methods.

Limited published guidelines for physical activity and screen time in Outside School Hours Care exist. There is a variation in duration and intensity of physical activity recommended, whilst screen time recommendations are more consistent. Guidelines designed with rigorous tools and for other world regions are warranted.