Girl on a SwingNationwide, more than 8 million children and adolescents participate in afterschool programs.[1] Recognizing the potential of the afterschool setting for engaging children, many stakeholder groups have worked to develop and adopt standards for obesity prevention in afterschool environments. These collective efforts represent an unprecedented attempt to spread healthy eating and physical activity (HEPA) standards throughout large networks and organizations.

The Y, which serves approximately 700,000 children in its early learning and afterschool programs, is committed to spreading these standards throughout the 10,000 communities across the country in which it works. In late 2011, the YMCA of the USA (Y-USA), the national resource office for Ys across the country, pledged its commitment to the Partnership for a Healthier America (PHA), a nonpartisan nonprofit organization founded to work alongside the First Lady’s Let’s Move! campaign to provide healthy environments for children.

Altarum Institute is serving as the third-party evaluator for this work, assessing the extent to which Y-USA fulfills its commitment to PHA. In 2012, Altarum and Y-USA worked together to create a plan for evaluating compliance with the PHA commitment. In doing so, they identified that there was a dearth of feasible and accurate methods for monitoring implementation of HEPA standards in afterschool program networks. Thus, they created a new survey for measuring compliance. Survey results revealed inconsistencies about whether sites were implementing HEPA standards, so Altarum sought to validate survey responses using a combination of methods, including direct observation, key informant interviews, and document review, to assess the validity of survey responses.

Percentage agreement was calculated to assess the accuracy of each data collection method compared to an overall compliance rating assigned to each standard. We found the level of agreement varied by standard, with strong agreement for physical activity standards and limiting juice and poor agreement for limiting screen time, serving fruits and vegetables, serving meals family style, and making drinking water accessible.

This study demonstrated that a survey alone is insufficient and that additional methods are needed to accurately determine whether afterschool programs are implementing HEPA standards. The findings from this report have implications not only for the Y but also for other multisite youth development organizations making similar commitments to create healthy environments for children. Our hope is that our findings will provide relevant information for others in the field who are undertaking similar efforts to monitor the implementation of HEPA standards in large, multisite, out-of-school-time networks.

For the project findings, please read the full report here.


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