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Mennonite College of Nursing
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Teresa Finegan

Partnering with After-school Programs for Physical Activity and Nutrition Promotion

Introduction/Problem

According to the Centers for Disease Control and Prevention (CDC) (2021a), 19.7 % of children and adolescents in the United States are impacted by obesity. The county of the project location also declared healthy eating and active living as a top three health priority for 2023-2025 as one way to address obesity. Their 2023-2025 Health Improvement Plan identified promoting vegetable and fruit intake, increasing physical activity, and reducing screen time and sugary beverage intake through programming for elementary-aged students as a needed intervention (McLean County, 2023). The purpose of this project was to address pediatric obesity and evaluate if a programming change during the Boys and Girls Club (BGC) after-school program to include the “Healthy Kids Out of School” curriculum was effective in increasing students’ perceived benefit of and readiness to eat fruit and vegetables, physical activity levels during the after-school time, and decreasing body mass index (BMI) percentile.

Methods

It was done as a prospective quality improvement (QI). The sample was a convenience sample of kindergarten through fifth graders attending “The Clubhouse” BGC in a suburban Midwest community and the programming was implemented by the nurse practitioner project investigator, undergraduate nursing students, and clinical nursing faculty. Outcome measures included BMI percentile, step-count, perceived benefit of fruit and vegetables, and readiness to eat fruits and vegetables. A one-tailed paired t-test was used to evaluate BMI and step count between pre- and post-intervention. Wilcoxon Signed Ranks Test was conducted to evaluate pre and post Fruit and Vegetable Inventory responses. Results with a p value <.05 were considered significant.

Findings

Twenty-four participants were included in the final sample. Data analysis showed significant increases in students’ perceived benefit of fruits and vegetables (p = .02), an increase in readiness to eat fruit (p = .54) and vegetables (p = .09) that was not significant, a significant decrease in physical activity during the after-school time (p <.001), and decreased BMI percentile after the programming change (p = .02).

Practice Implications

Although more evaluation needs to be done to determine the long-term benefit of such programming in after-school programs, we recommend continued healthy lifestyle programming at the BGC club and other after school programs to promote fruit and vegetable intake, healthy beverage intake, and physical activity. There is little potential for harm and the programming did show significant improvement in the perceived benefit of eating fruits and vegetables among elementary-aged students. After-school programs can seek partnerships with nursing schools and have health promotion programming led by student nurses and school of nursing clinical faculty. This would allow nursing students to gain valuable clinical experience in public health and pediatrics. School nurses are also in the position to advocate for the implementation of health programs during BGC or similar after-school programs in the community with an emphasis on health promotion and student health outcomes.

References