Opportunities in the Extended Day: Approaches for Promoting Physical Activity and Healthy Eating During Out‐of‐School Time

Abstract

ABSTRACTBackgroundThis systematic review aims to identify out‐of‐school time (OST) interventions (eg, programming, policies) that increased opportunities for physical activity (PA) and healthy eating and/or improved youth PA and dietary behaviors.MethodsWe searched for articles within systematic reviews that met our criteria (2010‐2018) and for individual articles (2010‐2020). Reviewer pairs screened articles, double‐extracted data, assessed risk of bias (RoB), and achieved consensus. We included 71 articles (55 studies, 60 intervention arms).ResultsHealth (n = 3) and nutrition education (n = 7) interventions showed promising results, but most used weak designs and had high RoB. PA‐focused interventions (n = 23) were largely consistent in improving fitness and moderate to vigorous PA during programming. Programmatic interventions that improved both PA and nutrition outcomes engaged family or community members (n = 4/13). Most organizational policy interventions improved the nutrition environment and student PA during OST.ConclusionsOrganization‐level policy and programmatic interventions can improve environmental supports and youth behaviors during OST programming, complementing school‐day efforts to address student PA and dietary intake. To maximize their potential impact, OST programs need to be accessible to families. Administrators can consider actions to reduce participation barriers.