after school report final

Submitted to: Strategic Alliance for Health Submitted by: Aasha M. Abdill, September 2010

Table of Contents

I. Executive Summary2 II. Background.4 III. Introduction.............5 IV. Methodology6 V. Findings8 VI. Recommendations..12 VII. Conclusions.14 VIII. References.......16

1After School Programs and Childhood Obesity Strategic Alliance for Health

I. Executive Summary Funded by Centers for Disease Control and Prevention, the Strategic Alliance for Health, NYC (SAfH) aims to improve individual, family, and community health outcomes in East and Central Harlem and the South Bronx. Seeking to enhance knowledge on the potential role of after school programs on the health outcomes of their participants, SAfH commissioned this research study to examine the contributions of after school providers toward the physical and nutritional well-being of neighborhood youth. This report highlights the findings from a comprehensive analysis of interview data gathered from twenty after school providers in East Harlem, Central Harlem and the South Bronx. Key findings are summarized below.

After school programs offer opportunities for structured physical activity. Duration times vary from as little as 30 minutes to 5 hours per week. All interviewed after school providers regularly offer physical activities as part of their program schedules. The number of days and duration of these activities vary greatly among organizations. Total minutes per week of moderate or rigorous physical activity range from 30 minutes to 300 minutes with a mean duration length of 118 minutes per week (approximately 2 hours weekly). Larger organizations with after school enrollments greater than 1000 students are slightly more likely to offer the typical child more physically active programming throughout the week than programs operated by smaller agencies. After school programs offer snacks and meals regulated by the New York State Department of Health and incorporate healthy-eating curricula in programming. 85% (17) of the sampled agencies offer snacks and full meals as part of the Child and Adult Food Care Program (CACFP), a federally funded initiative. One-third of the sample expressed concern about these meals due to their perception of the unhealthiness of the food or their appeal to the children. 90% (18) of the organizations sampled incorporate educational curricula focused on healthy eating behaviors and nutrition during the academic year. Vending machines with healthy and unhealthy food and beverage options are on site at half the agencies, however, many of these 2After School Programs and Childhood Obesity Strategic Alliance for Health

organizations have policies which discourage or ban use of vending machines during after school time.

Inadequate space/facilities, scarce funding and time constraints were identified as the largest barriers to increasing levels of physical activity during after school hours. Inadequate space or facilities was overwhelmingly identified as a major barrier to increasing the amount of scheduled time for physical activity. Scarce funding in general operating support or grants that could be allocated to sports activities greatly limits resources that can be spent to develop and maintain physically-focused initiatives. Other identified barriers included time constraints given other organizational priorities such as homework help and educational enrichment activities and staff not trained to facilitate physical education. After school programs feel youth physical fitness is central to their missions and seek partnerships for maximizing efforts toward youth wellness. 100% of respondents responded that increasing levels of physical activity is beneficial to their overall organizational missions. 11 organizations (55%) listed obesity and matters concerning overweight youth as a major health problem facing their student population. An additional 4 organizations mentioned poor nutrition or malnutrition as major concerns. 80% of sample organizations are currently partnering or planning to partner with other organizations, governmental agencies or businesses to support student wellness. Despite the challenges faced by after school programs in positively influencing youth physical fitness and eating habits, on the whole, agencies have initiated a myriad of programs and policies to impact youth health outcomes. In addition to structural barriers like facilities and time constraints, agencies expressed their attempts in resolving other challenges such as their perceptions of the cultural insensitivity of some food guidelines, the added reluctance toward sports among girls, and the lack of healthy food options (in addition to the surplus of unhealthy food options) in the neighborhoods they serve.


II. Background While it is true that obesity is unhealthy at any age, a startling and disturbing aspect of the growing obesity epidemic in the United States is a rise of obesity among children. Tripling in prevalence since 1980 (Ogden et al., 2010), health experts warn that this generation of children could have a shorter life expectancy than their parents due to increased risks in associated illnesses such as cardiovascular disease, heart disease, type 2 diabetes, stroke, and several types of cancers (Olshansky et al., 2005). Unfortunately the sobering broad stroke of obesity's consequences isnt solely physical. Researchers have shown associations between obesity and poor academic outcomes from as early as kindergarten (Datar et al., 2004). Children who are obese are more likely to earn lower grades and complete less years of schooling including college matriculation. Although direct mechanisms aren't clear, the association of obesity with psychosocial outcomes like low self-esteem and depression may contribute to academic underperformance (Datar 2006 et al; Mellin et al., 2002). While the problem is widespread, childhood obesity runs especially rampant in communities with higher levels of poverty. Children from families of lower socio-economic status and minority children are far more likely to be obese. Even when controlling for race and class, children who grow up in neighborhoods with badly maintained housing are statistically more likely to be obese then children living in more advantaged neighborhoods (Bethell et al., 2010). The communities of East and Central Harlem and the South Bronx are not immune to these regrettable correlations. Published reports by New York City Department of Health and Mental Hygiene (Matte et al, 2007; Matte et al, 2007) show that nearly 4 in 10 elementary students attending public schools are either obese or overweight in the South Bronx and in East and Central Harlem. Although some policymakers consider schools promising institutions in easing the epidemic given the sheer amount of time children spent in school, unfortunately schools have been unable to answer this calling. School district policies on student wellness are often not aligned with national recommendations for nutrition or physical activity (Chriqui et al, 2009). Challenges of limited funding for physical education, heightened pressure to increase standardized test scores, and general overcrowding may offer insights into this misalignment. With few opportunities for physical education or intramural sports during school hours additional strategies during out of school time hours need to be explored. This report examines after school programs and their capacity to tackle two important ways to fight the obesity epidemic in children: healthy eating habits and increased physical activity.


III. Introduction The purpose of this report is to examine the current priorities and offerings of after school programs in the communities of East and Central Harlem and the South Bronx. Explicit focus on physical and nutritional offerings of after school providers enable the assessment of what role after school programs can potentially play in helping students meet the physical activity guidelines set by the Center for Disease Control (CDC). CDC recommends that children and adolescents do 60 minutes (1 hour) or more of physical activity each day. In the spring of 2010, Strategic Alliance for Health (SAfH) contracted with an independent evaluator to develop a research design that would gauge after school program priorities, outlooks and organizational activities as it directly relates to the physical and nutritional well-being of their youth participants. This report gives an overview of the findings from in-depth interviews of twenty after school providers. In addition to assessing the current offerings of after school programs, the study seeks to draw lessons and best practices while highlighting obstacles providers face in targeting youth physical fitness in their program strategies. It is the hope of SAfH that the data presented in this report can be used to not only increase understanding of current after school offerings in regards to youth physical health, but to also initiate a dialogue on how after school programs can offer moderate to vigorous daily physical activity programming to the children they serve. This report examines the following questions: What are the opportunities for structured physical activities during after school programming? What are the opportunities for healthy eating and developing healthy eating habits during after school programming? What are the biggest barriers to providing more opportunities spent in moderate and rigorous physical activity during after school programming? What are the approaches and experiences of after school providers in the eating and fitness behaviors of their youth participants?


IV. Methodology The findings presented in this report are based largely on data collected from indepth interviews with after school providers. The universe of after school providers for this study was compiled from two organizational sources: the Department of Youth and Community Development (DYCD) and the Partnership for After School Education (PASE). DYCD operates Out of School Time (OST), the largest after school initiative in the nation. DYCD also operates the Beacon and Cornerstone initiatives, after school programs hosted in New York City Housing Authority (NYCHA) community centers and in public schools. PASE is New York Citys largest network of after school practitioners. While these directories include the majority of after school providers in NYC they do not comprise all after school programs. Online directories of PASE and DYCD were searched using the zip codes associated with SAfH targeted communities of East and Central Harlem (10026, 10027,10029, 10030, 10035, 10037, 10039) and the South Bronx (1045, 10452, 10454, 10456, 10459, 10474). Two hundred and thirteen (213) organizations operating approximately 317 after school sites in the South Bronx and East and Central Harlem were catalogued. The studys population was further reduced due to incorrect, outdated and unavailable contact information. After school providers who did not serve elementary age students at the time of the study were also removed from the sample. Fifty-three organizations were initially contacted via email or phone for participation in this study. Follow-up phone calls were made to definitively ascertain whether the organization had received the original solicitation letter or were generally aware of the study. A communication exchange with thirtyseven of the agencies was obtained. Of these organizations, twenty after school providers were successfully recruited into the study yielding a response rate of 54%. Based on the original number of organizations recorded in the online directories the sample represents approximately 9.3% of organizations providing after school programs in the target area. Below are selected demographic indicators of the end sample. Our after school providers are fairly older agencies (minimum years of operation is 24) with sizeable enrollments located in East and Central Harlem and the South Bronx (Figures 1-3). An overwhelming majority host program sites within NYC public schools (Figure 4). All providers in this sample are community or youth nonprofit organizations which offer free services for most, if not all, of their participants. Data presented in this report are gleaned from phone interviews with employees of participating organizations. Interview conversations lasted anywhere from 20 minutes to 57 minutes with a mean length time of 30 minutes. Interviewees held various position titles: 11 were in organizational management positions, 4 were directors at the program level and 5 were site coordinators. 6After School Programs and Childhood Obesity Strategic Alliance for Health

Figure 1 Sample Characteristics: Age of Agency

Figure 2

Sample Characteristic: Community Served

50 yrs 9 (45%)

Serve South Bronx 14 (70%)

Serve East &Central Harlem 11 (55%)

25-49 yrs 8 (40%)

Serve Both 5 (25%)

Figure 3 Sample Characteristics: Youth Enrollment

Figure 4 Sample Characteristics: Site Location Type

> 1000 enrolled 8 (40%)

< 250 enrolled 2 (10%)

Ind Sites (only) 3 (15%)

250-499 enrolled 7 (35%) 500-999 enrolled 3 (15%)

Host Sites in Public Schools 17 (85%)


V. Findings After school programs commonly offer opportunities for structured physical activity, yet duration levels varies. All of the interviewed after school providers offer some sort of structured physical activity during program hours. Structured physical activity was defined as physical activity led by staff which allowed students to participate in moderate to rigorous movement. Activities occur as infrequently as once every two weeks to five days per week, lasting in duration anywhere from 30 to 75 minutes per session. To compare time typically spent by a student in physically active programming across organizations, an average number of minutes per week was calculated from multiplying the number of days where physical activity was offered by the number of minutes each session lasted. For organizations who gave ranges of days or activity duration, midpoints were taken. Fifty percent of after school providers offer 2 or more hours of physical activity per week.Figure 4 Average time per week of physical activity9 8 7 6 5 4 3 2 1 0

after school report final

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