Club Fit: Development of a Physical Activity and Healthy Eating Intervention at a Boys & Girls Club After School Program
Journal of Primary Prevention. 2020 Apr;41(2):153-170
Background: The childhood obesity epidemic includes well documented health and psychosocial comorbidities that affect 17% of children in the United States (Ogden, Carroll, Kit, & Flegal, 2012). Previous research has demonstrated that children and adolescents from minority and low income backgrounds face substantially greater social and environmental challenges to engage in physical activity and healthy eating to maintain a healthy weight (Miech et al., 2006). Low levels of physical activity, high levels of sedentary behavior and poor dietary quality are the primary drivers of childhood obesity, and these behaviors are more prevalent among youth from low income and underserved families.
Methods: The study was part of Club Fit, a collaboration of Boys & Girls Club of Rochester, MN, (BGCR) and the Rochester Healthy Community Partnership (RHCP). BGCR is a community organization that offers after-school programs for youth. Its health promotion programs are designed to demonstrate and promote healthy eating and physical activity among youth. BGCR is particularly well-positioned to address health disparities in the community related to nutrition, physical activity, and risk for childhood obesity, as it serves a diverse population of children with large representation of youth from low-income backgrounds; 73% of BGCR members receive free or reduced meals at school, and 41% live in single-parent homes. The mission of RHCP is ‘to promote health and wellbeing among the Rochester community through CBPR, education, and civic engagement to achieve health for all’ (www.roche sterh ealth y.org). RHCP has 12 years of experience implementing and evaluating theorydriven community-based interventions, including work aimed at obesity prevention (Wieland et al., 2016).
Results: The mean age of participants was 10.4 years, and the majority of participants were female (69%), not White (66%), and overweight or obese (52%). Of the 61 participants, only 9 were older than 12 years, and their attendance at Club Fit Huddles was considerably lower than for participants ages 8–12 (mean 5.3 ± 1.8 vs. 9 ± 5.2; p = 0.08). There were statistically significant improvements in self-efficacy and motivation for physical activity from baseline to 6 months and nonsignificant improvements for fruit and vegetable consumption, sugary beverage consumption, and screen time. There were no improvements in social support, physical activity, dietary quality, or BMI z score. Results of univariate analyses did not find significant differences by age, ethnicity, or sex. The mean (SD) attendance at Club Fit Huddles was 8.1 (4.9) sessions out of 32 total Huddles. The mean attendance at Club Fit Huddles and Fitness Challenge was 12.8 (7.5) sessions out of 46 total opportunities. There was a statistically significant correlation between increased Huddle attendance and decreased BMI z score.
Conclusion: Club Fit is a childhood obesity prevention initiative that promotes physical activity and healthy eating at a Boys & Girls Club after-school program. Results of this pilot study indicated that while there were no differences in nutrition outcomes, the intervention was associated with improved self-efficacy and motivational level for physical activity and that increased attendance in Club Fit programming was correlated with decreased BMI z scores. According to these promising preliminary data and the revisions to the intervention components that were informed by the pilot, this intervention warrants testing through a controlled experiment with other after-school programs. Processes and products from this study may be helpful to other communities aiming to address childhood obesity prevention through after-school programs.