Two-Year Healthy Eating Outcomes: An RCT in Afterschool Programs

Michael W. Beets, R. Glenn Weaver, Gabrielle Turner-McGrievy, Jennifer Huberty, Justin B. Moore, Dianne S. Ward, Darcy A. Freedman, Aaron Beighle

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Introduction Across the U.S., afterschool programs (ASPs, 3:00PM–6:00PM) are trying to achieve nationally endorsed nutrition standards (Healthy Eating Standards) calling for fruits/vegetables and water to be served every day, while eliminating sugar-sweetened beverages and foods. The purpose of this study was to evaluate the 2-year changes in the types of foods and beverages served during a community-based intervention designed to achieve the Healthy Eating Standards. Study design Randomized delayed treatment trial with an immediate (1-year baseline and 2-year intervention) or delayed (2-year baseline and 1-year intervention) group. Setting/participants Twenty ASPs serving 1,700 children (aged 5–12 years) were recruited, with baseline occurring spring 2013, and outcome assessment occurring spring 2014 and 2015. Intervention The multistep intervention, Strategies To Enhance Practice for Healthy Eating, assisted ASP leaders/staff to serve foods/beverages that meet the nutrition standards. Main outcome measures The foods and beverages served for snack were observed directly. Results Compared with non-intervention years, both the immediate and delayed groups increased the number of days/week that fruits/vegetables (0.6 vs 1.7 days/week and 0.6 vs 4.4 days/week, OR=3.80, 95% CI=1.45, 9.95) and water (2.3 vs 3.7 days/week and 2.7 vs 4.8 days/week, OR=4.65, 95% CI=1.69, 12.79) were served. Sugar-sweetened beverages were almost eliminated by post-assessment (1.2 vs 0.2 days/week and 3.2 vs 0.0 days/week, OR=0.05, 95% CI=0.02, 0.13). Only the immediate group decreased the number of days/week desserts were served (2.9 vs 0.6 days/week, OR=0.10, 95% CI=0.03, 0.33). Implementation barriers for the delayed group included once/month delivery schedules for fruits/vegetables and limited storage space for foods meeting the Healthy Eating Standards. Conclusions Improvements in the foods/beverages served in ASPs can be made, yet were hindered by structural barriers related to procurement and storage of perishable foods. Additional efforts are needed to support ASPs as they work toward fully achieving the Healthy Eating Standards.

Original languageEnglish
Pages (from-to)316-326
Number of pages11
JournalAmerican Journal of Preventive Medicine
Issue number3
StatePublished - Sep 1 2017

Bibliographical note

Publisher Copyright:
© 2017 American Journal of Preventive Medicine

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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