HW499 Unit 3 Evidence Review Example

Four Questions and the One That Limits the Project: A Unit 3 Literature and Evidence Review on Activity in After-School Programs

[Student Name]

Purdue University Global

HW499: Bachelor's Capstone in Health and Wellness

Unit 3 Literature and Evidence Review

[Instructor Name]

[Date]

The Cotter Bend project is composite; every study cited is real and described from its published report.

The Benchmark

The federal Physical Activity Guidelines for Americans recommend that children and adolescents aged six to seventeen get 60 minutes or more of moderate-to-vigorous physical activity each day (U.S. Department of Health and Human Services, 2018). After-school programs cover only part of a child's day, so standards for these programs set a share of that hour as a target for the program afternoon. This review uses the guideline as the benchmark against which program activity is judged.

Question 1: How Active Are Children in After-School Programs?

Children in after-school programs accumulate some activity, but less than programs could provide. Children wearing accelerometers in a set of after-school programs logged around twenty minutes of brisk activity across the session, and spent more than 40 minutes sedentary (Trost et al., 2008). Activity was higher during free play than during organized or structured sessions, and boys were more active than girls.

Direct observation tells a similar story. Observation tools developed for physical education and after-school settings, such as the System for Observing Fitness Instruction Time (McKenzie et al., 1992) and the System for Observing Staff Promotion of Activity and Nutrition (Weaver et al., 2014), record what children are doing at set intervals and what staff are doing at the same time. These tools allow a program to estimate minutes of activity without fitting devices on children.

Strength: moderate. The studies are consistent, but they come from a limited number of program types and regions.

For Cotter Bend: an informal count of eleven active minutes at one site is below what studies of other programs have found and suggests room for improvement.

How the Evidence Was Weighed

Each question is answered from the strongest sources available and given a strength rating. Group-randomized trials, in which whole programs are assigned to intervention or control, are treated as the strongest evidence for interventions, since they compare similar programs under the same conditions. Observational studies and accelerometer surveys are treated as strong evidence for describing activity levels but weaker for explaining causes. Meta-analyses are weighed by the quality and number of the studies they include. Strength ratings are deliberately conservative, since a capstone that overstates its evidence will make claims its evaluation cannot support.

Question 2: What in the Setting Predicts Activity?

The studies point to three features of the program setting. The first is time: activity cannot happen if no time is scheduled for it, and programs that schedule activity late may lose children who are picked up early. The second is the kind of game: the format of games matters as much as their length. A study comparing games played with traditional rules to the same games modified to avoid elimination, reduce waiting in lines and keep all children involved found that the modified games produced more moderate-to-vigorous activity for both boys and girls, with the largest gain in tag games (Brazendale et al., 2015). The third is staff behavior: observation studies record whether staff join in, encourage or simply supervise, and staff promotion is one of the main features the SOSPAN tool was designed to capture (Weaver et al., 2014).

Strength: moderate for game format, limited for staff behavior as an independent predictor.

For Cotter Bend: the gym period's position at 5:00 and the use of knockout, an elimination game, are both features the evidence links to lower activity.

Question 3: Which Interventions Have Changed Activity?

An early meta-analysis of after-school interventions found positive effects on physical activity and fitness, but only eight of eleven interventions had measured activity at all, and study quality varied (Beets et al., 2009). More recent group-randomized trials have tested interventions focused on staff practice and program policy. In one, programs that received training and support to meet physical activity standards had children who were more than twice as likely to meet the activity policy after the intervention as children in control programs, with gains for both girls and boys (Beets et al., 2015). A related trial in the same program network reported changes in children's activity measured by accelerometer during program time (Beets et al., 2016).

These interventions shared common features: changes to the program schedule to protect activity time, staff training in games that keep children moving and ongoing support for staff.

The interventions that worked did not add new programs; they changed how existing time was scheduled, which games were played and how staff ran them, which are exactly the features Cotter Bend controls.

Strength: moderate to strong for staff-focused interventions in after-school settings, from group-randomized trials.

Question 4: What None of the Studies Can Show

This question limits the project. The studies measured activity during the program afternoon. None of them can show that more activity during the program leads to more total daily activity, since children may compensate by being less active at home. None measured long-term health outcomes such as weight or fitness over years. And most were conducted in a small number of states, with research teams supporting the programs, conditions a parks department without a research partner will not have.

Strength of evidence for effects beyond program time: little to none.

How the Studies Fit Together

The four questions build on one another. The first shows that children in after-school programs are less active than they could be. The second shows that the reasons lie largely in the program itself: when activity is scheduled, which games are played and what staff do. The third shows that changing those features has worked elsewhere. The fourth sets a boundary around what any such change can be shown to achieve. Read together, the studies support a project that changes schedule, games and staff practice, and that judges itself by activity during the program afternoon, not by children's overall health.

What Cotter Bend May Claim

Based on this review, the Cotter Bend project may claim, if its evaluation succeeds, that children at its sites were more active during the program afternoon. It may not claim that children became more active overall, that their health improved or that the change will last beyond the evaluation period without continued support.

Search and Limits of the Review

Sources were found through the university library's databases and by following references in the studies above. Sixteen sources were reviewed; eight are cited here as the most relevant. The review did not include gray literature such as program reports, and most included studies came from the same research network, which may limit the range of program types represented.

References

Beets, M. W., Beighle, A., Erwin, H. E., & Huberty, J. L. (2009). After-school program impact on physical activity and fitness: A meta-analysis. American Journal of Preventive Medicine, 36(6), 527-537. https://doi.org/10.1016/j.amepre.2009.01.033

Beets, M. W., Weaver, R. G., Turner-McGrievy, G., Huberty, J., Ward, D. S., Pate, R. R., Freedman, D., Hutto, B., Moore, J. B., & Beighle, A. (2015). Making policy practice in afterschool programs: A randomized controlled trial on physical activity changes. American Journal of Preventive Medicine, 48(6), 694-706. https://doi.org/10.1016/j.amepre.2015.01.012

Beets, M. W., Weaver, R. G., Turner-McGrievy, G., Huberty, J., Ward, D. S., Pate, R. R., Freedman, D., Hutto, B., Moore, J. B., Bottai, M., Chandler, J., Brazendale, K., & Beighle, A. (2016). Physical activity outcomes in afterschool programs: A group randomized controlled trial. Preventive Medicine, 90, 207-215. https://doi.org/10.1016/j.ypmed.2016.07.002

Brazendale, K., Chandler, J. L., Beets, M. W., Weaver, R. G., Beighle, A., Huberty, J. L., & Moore, J. B. (2015). Maximizing children's physical activity using the LET US Play principles. Preventive Medicine, 76, 14-19. https://doi.org/10.1016/j.ypmed.2015.03.012

McKenzie, T. L., Sallis, J. F., & Nader, P. R. (1992). SOFIT: System for Observing Fitness Instruction Time. Journal of Teaching in Physical Education, 11(2), 195-205. https://doi.org/10.1123/jtpe.11.2.195

Trost, S. G., Rosenkranz, R. R., & Dzewaltowski, D. (2008). Physical activity levels among children attending after-school programs. Medicine & Science in Sports & Exercise, 40(4), 622-629. https://doi.org/10.1249/MSS.0b013e318161eaa5

U.S. Department of Health and Human Services. (2018). Physical activity guidelines for Americans (2nd ed.). https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines

Weaver, R. G., Beets, M. W., Webster, C., & Huberty, J. (2014). System for Observing Staff Promotion of Activity and Nutrition (SOSPAN). Journal of Physical Activity and Health, 11(1), 173-185. https://doi.org/10.1123/jpah.2012-0007