Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group Randomized Controlled Trial on Children’s Food, Beverage, and Calorie Consumption among Snacks Served

Lee, Rebekka M.; Giles, Catherine M.; Cradock, Angie L.; Emmons, Karen M.; Okechukwu, Cassandra A.; Kenney, Erica L.; Thayer, Julie C.; Gortmaker, Steven L.

doi:10.1016/j.jand.2018.04.011

Cited by 13 publications

(57 citation statements)

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“…OSNAP is an environmental change evidence-based intervention (EBI) designed to promote healthy improvements to afterschool practices and policies [10, 12, 13, 41]. The intervention focuses on the following 10 goals: 1) do not serve sugary drinks, 2) do not allow sugary drinks to be brought in during afterschool time, 3) offer water as a drink at snack every day, 4) offer a fruit or vegetable option every day at snack 5) do not serve foods with trans fats, 6) when offering grains, serve whole grains, 7) offer 30 min of physical activity to all children daily, 8) offer 20 min of vigorous physical activity to all children 3 times per week, 9) eliminate use of commercial broadcast and cable television and movies, 10) limit computer and digital device time to homework or instructional only.…”

Section: Methodsmentioning

confidence: 99%

“…The intervention has demonstrated increases in children’s vigorous physical activity by 36% or an average of 3.2 min [10]. Dietary improvements included increases in consumption of water (1.49 oz./snack) and whole grains (0.10 servings/snack) and decreases in consumption of juice (− 0.61 oz./snack), beverage calories (− 29.1 kcal/snack), foods with trans fats (− 0.12 servings/snack), and total calories (− 47.7 kcal/snack) compared to controls [11, 12]. The intervention also increased servings of water at snack and health-promoting policies [13, 14].…”

Section: Introductionmentioning

confidence: 99%

“…While interventions in out-of-school time, childcare, and school settings have all demonstrated success in promoting healthy behaviors early in life [10, 12, 15–20], little research has rigorously tested strategies for spreading these population-based prevention EBIs for large population reach. In the OST field, experts have established nutrition and physical activity standards [21], but professional development needed for implementation varies widely and no best practices exist for developing this skills of this largely part-time, low-wage workforce [22].…”

Section: Introductionmentioning

confidence: 99%

“…This study is designed to push the field of community-based obesity prevention forward by investigating two implementation strategies for scaling up this EBI [10, 12]: 1) an in-person train-the-trainer approach that develops the capacity of existing YMCA facilitators, and 2) a self-paced online training that can centrally reach a geographically dispersed workforce with greater flexibility. Implementation strategies are considered “methods to enhance the adoption, implementation, sustainment, and scale-up of an innovation” [23].…”

Section: Introductionmentioning

confidence: 99%

“…Implementation strategies are considered “methods to enhance the adoption, implementation, sustainment, and scale-up of an innovation” [23]. In the case of this study, the focus is on strategies intended to accelerate scale-up an obesity prevention intervention [10, 12]. By testing these two training modes, we recognize that different strategies are likely needed for broad population reach.…”

Section: Introductionmentioning

confidence: 99%

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Assessing the effectiveness of training models for national scale-up of an evidence-based nutrition and physical activity intervention: a group randomized trial

et al. 2019

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BackgroundThere is a great need to identify implementation strategies to successfully scale-up public health interventions in order to achieve their intended population impact. The Out-of-school Nutrition and Physical Activity group-randomized trial previously demonstrated improvements in children’s vigorous physical activity and the healthfulness of foods and beverages consumed. This implementation study aimed to assess the effects and costs of two training models to scale-up this evidence-based intervention.MethodsA 3-arm group-randomized trial was conducted to compare effectiveness of in-person and online training models for scaling up the intervention compared to controls. One-third of sites were randomized to the in-person train-the-trainer model: local YMCA facilitators attended a training session and then conducted three learning collaborative meetings and technical assistance. One-third were assigned to the online model, consisting of self-paced monthly learning modules, videos, quizzes, and facilitated discussion boards. Remaining sites served as controls. Fifty-three afterschool sites from three YMCA Associations in different regions of the country completed baseline and follow-up observations using a validated tool of afterschool nutrition and physical activity practices. We used multivariable regression models, accounting for clustering of observations, to assess intervention effects on an aggregate afterschool practice primary outcome, and conducted secondary analyses of nine intervention goals (e.g. serving water). Cost data were collected to determine the resources to implement each training model.ResultsChanges in the primary outcome indicate that, on average, sites in the in-person arm achieved 0.44 additional goals compared to controls (95%CI 0.02, 0.86, p = 0.04). Increases in the number of additional goals achieved in sites in the online arm were not significantly greater than control sites (+ 0.28, 95% CI -0.18, 0.73, p = 0.24). Goal-specific improvements were observed for increasing water offered in the in-person arm and fruits and vegetables offered in the online arm. The cost per person trained was $678 for the in-person training model and $336 for the on-line training model.ConclusionsThis pilot trial presents promising findings on implementation strategies for scale-up. It validated the in-person training model as an effective approach. The less expensive online training may be a useful option for geographically disbursed sites where in-person training is challenging.Trial registrationAlthough this study does not report the results of a health care intervention on human subjects, it is a randomized trial and was therefore retrospectively registered in ClinicalTrials.gov on July 4, 2019 in accordance with the BMC guidelines to ensure the complete publication of all results (NCT04009304).

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