Do physical activity interventions in outside‐school hours care services help increase children's overall daily physical activity?

Key messages

To date, physical activity programmes in outside‐school hours childcare services may marginally increase moderate‐to‐vigorous physical activity. However, the increase may be too small to have a meaningful impact on children's overall daily activity level. 

Why is it important to increase children's physical activity in this setting?

Only 20% of children aged 5 to 17 years engage in enough physical activity to reduce the risk of non‐infectious diseases (such as heart disease and diabetes). The time outside‐school hours is a good opportunity for children to get more exercise to improve their health and well‐being.  Given the millions of children who attend outside‐school hours childcare services across the world, using this setting may be a good way to increase these children's overall daily physical activity.

We wanted to know whether physical activity programmes made a difference to overall daily physical activity in children aged 4 to 12 years in outside‐school hours childcare settings.

What did we do?

We searched electronic databases and relevant journals to find studies. We included any randomised study (in which people have the same chance of being given the intervention or not) that looked at programmes to increase physical activity in outside‐school hours care settings. We compared and summarised the results of the studies and rated our confidence in the evidence, based on factors such as study methods and sizes.

What did we find?

We included nine studies with 4458 children taking part. Five studies focussed on staff‐based programmes to change practice in the outside‐school hours childcare setting (for example, change in programming, activities offered, staff facilitation). Two studies used staff and parent strategies (for example, newsletters sent home with parent information, parent tool‐kits added to the staff strategies), one study used staff and child‐based programmes (for example, children had home activities to emphasise physical activity education added to the staff strategies) and one study used child‐only intervention strategies. Taken together, the results suggest that staff‐and‐parent‐ and staff‐and‐child‐based interventions may lead to a small or no increase in overall daily physical activity. They may also cause a small or no reduction in body mass index (a measure of body fat based on height and weight) and improve cardiovascular fitness. Only one study looked at whether the benefits and use of the programme were at least worth what was paid for them. This study found online training of staff for physical activity programmes is more affordable than in‐person training. None of the studies reported on unwanted effects or how the intervention affected children's well‐being.

What were the limitations of the evidence?

All studies included in this review were from high‐income countries (the USA and Norway), so we do not know if the results would be similar in low‐ and middle‐income countries. More research from a bigger range of countries and including other strategies not typically studied using random methods would broaden and strengthen the evidence available.

How up‐to‐date is this evidence?

The evidence is current to August 2020.

View full review here