Effects of the Active Kids voucher program on children and adolescents’ physical activity: a natural experiment evaluating a state-wide intervention

Abstract

Background There is an urgent need for scaled-up effective interventions which overcome barriers to health-enhancing physical activity for children and adolescents. In New South Wales (NSW), Australia, the state government implemented a universal voucher program, ‘Active Kids’ to support the cost of structured physical activity registration for school-enrolled children aged 4.5–18 years old. The objective of this study was to understand the effects a financial incentive intervention delivered in a real-world setting has on children and adolescent’s physical activity participation. Method In 2018, all children and adolescents registered for an Active Kids voucher provided sociodemographic characteristics, physical activity and research consent. This prospective cohort study used an online survey with validated items to measure physical activity and other personal and social factors in children and adolescents who used an Active Kids voucher. Generalized linear mixed models were used to examine changes from registration to after voucher use at ≤8 weeks, 9–26 weeks and ≥ 6 months. Results Study participants reported increasing their days achieving physical activity guidelines from 4.0 days per week (95%CI 3.8, 4.2) at registration (n = 37,626 children) to 4.9 days per week (95%CI 4.7, 5.1) after 6 months (n = 14,118 children). Increased physical activity was observed for all sociodemographic population groups. The voucher-specific activity contributed 42.4% (95%CI 39.3, 45.5) to the total time children participated in structured physical activities outside of school. Children and adolescents who increased to, or maintained, high levels of activity were socially supported to be active, had active parent/caregivers, had better concentration and were overall happier than their low-active counterparts. Conclusion The Active Kids program significantly increased children’s physical activity levels and these increases continued over a six-month period. The Active Kids voucher program shows promise as a scaled-up intervention to increase children and adolescents’ physical activity participation. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12618000897268, approved May 29th, 2018 - Retrospectively registered.

Fair play? Participation equity in organised sport and physical activity among children and adolescents in high income countries: a systematic review and meta-analysis

“…Sport has several additional costs such as registration, uniform, travel, and equipment, which can present greater barriers for children and adolescents from disadvantaged backgrounds. This cost barrier to sport has been addressed through financial incentive programs across the world [ 50 ] which have shown some promising findings (e.g., [ 51 ]). However, there are socioeconomic disparities in awareness and engagement in these programs and further targeted work is needed [ 52 ].…”

Community support for policy interventions targeting unhealthy food environments in public institutions

“…Community acceptance has proven greater for interventions representing the status quo 18,19 and we found greater support for existing interventions compared to speculative ones, illustrated through consistently higher support for food environment policies for schools, 33 hospitals and health facilities, 34 and for information campaigns 35 and children's sports rebates 36 . This may reflect a preference to target children or other vulnerable groups 18,20 or enhanced perceptions of government responsibility within institutions that have historical engagement in health‐promoting activities and are typically responsible for leading by example.…”

Enabling Better Physical Activity and Screen Time Behaviours for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents

“…However, such options only further widen socioeconomic disparities with barriers such as cost, accessibility, and lack of local facilities affecting families from the most disadvantaged backgrounds [ 76 , 77 ], something that was also identified by the parents in this research. A recent analysis has also shown that SES is inversely linked with sports expenditure, with an AUD 311 difference in median expenditure between the most and least disadvantaged populations [ 78 ]. However, the implementation of the Active Kids Voucher program in NSW is a clear demonstration of the power of upstream policies and programs to support physical activity participation.…”