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435. The Healthy Afterschool Activity and Nutrition Documentation Instrument

Research Article
Rahma Ajja, Michael W. Beets, Jennifer Huberty, Andrew T. Kaczynski, Dianne S. Ward
September 2012

Commentary: Rona Macniven, Prevention Research Collaboration, University of Sydney

Programs in the after-school time period with a focus on improving physical activity and nutrition have been increasing in recent years in both Australia and in countries like the U.S., particularly at a time where many families are working longer hours and school facilities are being used outside of traditional school hours. Despite the existence of numerous programs, however, their evaluation in relation to healthy policies and activities is rare and their real impact therefore unknown. This study reports on the development and piloting of a Healthy Afterschool Activity and Nutrition Documentation Instrument (HAANDI), demonstrating a reliable and valid measurement tool in this setting. 

The tool was developed through a review of existing physical activity and nutrition environmental-quality rating scales in child care and afterschool program settings and of standards and policies from state and national physical activity and nutrition, as well as expert opinion. Two separate subscales were generated; the Healthy Afterschool Program Index for Physical Activity (HAPI-PA) and the HAPI-Nutrition (HAPI-N), the HAPI-PA containing scores of factors such as time allocated to physical activity, quality of staff training for physical activity, child feedback and parent workshops. Assessment of the usefulness of the tool involved 39 live programs; inter-rater reliability observations, interviews and written policy and document reviews were undertaken at 20 afterschool programs with validity of the HAPI-PA was established by comparing HAPI-PA scores to pedometer steps of 934 children attending 25 of the afterschool programs.

Strong inter-rater agreement at 85%–100% and kappa statistics high at 0.70 to 1.00 (where reliability scores are measured from 0.00 to 1.00) were evident, highlighting its practicality as an audit tool. Validity findings were also promising with increased pedometer steps associated with physical activity policies, amount and quality of staff training, use of a physical activity curriculum, and offering activities for both boys and girls. Nutrition policies were also related to higher weekly servings of fruit and vegetables and whole grains through programs.

This tool will be relevant both for researchers in childhood physical activity and nutrition as well as teachers and others involved in delivery of programs to young people in the afterschool time period. It will assist evaluation of such programs to determine their future applicability and effectiveness and determine whether funding for these types of programs is warranted.

Source: American Journal of Preventative Medicine, 2012, 43: 263-271. Access to this article may depend on your institutional rights.  Click here to access the full article.