Physical Activity Behaviors of Children Who Register for the Universal, State-Wide Active Kids Voucher: Who Did the Voucher Program Reach?

Abstract

Active Kids is a government-led, universal voucher program that aims to reduce the cost of participation in structured physical activity for all school-enrolled children in New South Wales (NSW), Australia. As part of the Active Kids program evaluation, this cross-sectional study examined the Active Kids’ program’s reach to children in NSW and their physical activity behaviors, before voucher use. Demographic registration data from all children (4.5–18 years old) who registered for an Active Kids voucher in 2018 (n = 671,375) were compared with Census data. Binary and multinomial regression models assessed which correlates were associated with meeting physical activity guidelines and participation in the sessions of structured physical activity. The Active Kids program attracted more than half (53%) of all eligible children in NSW. Children who spoke a primary language other than English at home, were aged 15–18 years old, lived in the most disadvantaged areas, and girls, were less likely to register. Of the registered children, 70% had attended structured physical activity sessions at least once a week during the previous 12 months, whilst 19% achieved physical activity guidelines. Active Kids achieved substantial population reach and has the potential to improve children’s physical activity behaviors.

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

“…Participants reported higher annual expenditure on structured physical activity than population estimates [32], with the Active Kids voucher universally supporting 20% of the structured activity costs. This reflects the underrepresentation of children from low socio-economic areas registered in the Active Kids program [26]. The contribution of the Active Kids voucher to annual expenditure achieved was similar to previous estimates [15].…”

“…Notably though, the Active Kids vouchers could not be used for school holiday programs (duration < 8 weeks) or programs held during school time or delivered by schools [29]. The definition of structured physical activities, the duration of program, and point of sale financial support provided by the Active Kids voucher were central to the high community reach [26], and improvements in physical activity behaviours. The ACTIVE trial has highlighted the importance of ensuring incentivised activities align with adolescents personal preferences [18].…”

“…The prospective cohort study design which explored outcomes in using natural experimentation suggest that these results are may be generalisable to similar populations. The Active Kids program includes a substantial sample of NSW children, compared to Census data, which allows us to provide confident estimates of the outcomes achieved through the program [26]. Although the study sample was generally representative of all children who used an Active Kids voucher (Table 1), limitations exist.…”

“…A complex yet pragmatic quasi-experimental, mixed-methods evaluation was integrated into the design of Active Kids and involves a series of studies [25]. We have previously reported the population awareness and reach of the Active Kids program [26,27]. The objective of this study was to fill the gap in understanding of the impact of a universal, statewide financial incentive intervention (Active Kids voucher) on children's physical activity participation, and the contribution of the voucher to support structured physical activity participation.…”

Body mass Index of children and adolescent participants in a voucher program designed to incentivise participation in sport and physical activity: A cross-sectional study

“…The Active Kids Program has been implemented state-wide for one calendar year. The reach of the program has been previously reported however data was not available to understand the reach of the Active Kids program to children who are overweight or obese ( Foley et al, 2020 ). This information will inform policy makers and program deliverers and assist in improving this and future policy interventions on a national and international level aiming to address childhood overweight and obesity.…”