Pedometer-determined step-count guidelines for afterschool programs

Background: Policies to require afterschool programs (ASPs, 3 PM to 6 PM) to provide children a minimum of 30 minutes of moderate-to-vigorous physical activity (MVPA) exist. With few low-cost, easy-to-use measures of MVPA available to the general public, ASP providers are limited in their ability to track progress toward achieving this policy-goal. Pedometers may fill this gap, yet there are no step-count guidelines for ASPs linked to 30 minutes of MVPA. Methods: Steps and accelerometer estimates of MVPA were collected concurrently over multiple days on 245 children (8.2 years, 48% boys, BMI-percentile 68.2) attending 3 community-based ASPs. Random intercept logit models and receiver operating characteristic (ROC) analyses were used to identify a threshold of steps that corresponded with attaining 30 minutes of MVPA. Results: Children accumulated an average of 2876 steps (standard error [SE] 79) and 16.1 minutes (SE0.5) of MVPA over 111 minutes (SE1.3) during the ASP. A threshold of 4600 steps provided high specificity (0.967) and adequate sensitivity (0.646) for discriminating children who achieved the 30 minutes of MVPA; 93% of the children were correctly classified. The total area under the curve was 0.919. Children accumulating 4600 steps were 25times more likely to accumulate 30 minutes of MVPA. Conclusions: This step threshold will provide ASP leaders with an objective, low-cost, easy-to-use tool to monitor progress toward policy-related goals.