Evaluation of policies to promote physical activity in afterschool programs: Are we meeting current benchmarks?

Background: Policies now recommend afterschool programs (ASP, 3-6 pm) provide children a minimum amount of physical activity daily. We examined the extent to which children attending ASPs meet existing national and state-level policies that specify expected levels of physical activity (PA). Methods: Accelerometer-derived physical activity (light and moderate-to-vigorous, MVPA) of 253 children (5-13 years) was compared to policies that recommend varying amounts of PA children should achieve during an ASP. Results: The proportion of children achieving a policy ranged from 0.0% (California 60 min MVPA and North Carolina 20% of daily program time devoted to MVPA), 1.2% (California 30 min MVPA), to 48.2% (National Afterschool Association 30 min light plus MVPA). Random effects logistic models indicated boys (odds ratio [OR] range 2.0 to 6.27) and children from a minority background (Black/Hispanic, OR range 1.87 to 3.98) were more likely to achieve a recommended level of physical activity, in comparison to girls and White children. Neither age nor BMI were related to achieving a policy. Conclusions: The PA of children attending ASP falls below policy recommended levels; however, these policies were developed in absence of data on expected PA levels during ASPs. Thus, concerted effort towards building a stronger ASP evidence-base for policy refinement is required.