Report No. 021-12

TO: Chair and Members of the Board of Health
FROM: Graham L. Pollett, MD, FRCPC, Medical Officer of Health
DATE: 2012 February 16

Physical Activity and Healthy Eating Resources for After-School Program and Day Care Providers

Recommendation

It is recommended that Report No. 021-12 re Physical Activity and Healthy Eating Resources for After-School Program and Daycare Providers be received for information.

Background Information

Overweight and obesity rates are at epidemic proportions in Canada and around the globe. In a recent study, researchers found that 25% of sampled children aged 6 to 13 years of age from London were overweight or obese, a finding consistent with national data from the Canadian Community Health Survey. This rate has nearly doubled in the last 30 years, strengthening the need for effective public health interventions to quell the rising rates of obesity and corresponding risks for chronic disease.

After-school programs provide excellent opportunities for children to participate in fun, safe, unstructured, and structured physical activities and nutrition education sessions. Such programs provide a window of opportunity to assist children in the development of healthy lifestyle behaviours without competing with the school-based curricula related to health and physical activity.

The Healthy Eating Active Living (HEAL) Working Group, an internal Health Unit committee, partnered with London Children’s Connection, the YMCA of Western Ontario, and Western University (WU) to conduct qualitative research with After-School Program (ASP) providers in London and Middlesex County. Currently there are nearly 100 ASPs in London and Middlesex. The purpose of the research was to gather ASP providers’ perspectives on the use of afterschool programs and resources to provide nutrition education and engage children in physical activity.

Results

In-depth interviews and demographic survey results with nine ASP providers in Middlesex-London resulted in the following key observations: 1) there is a need to provide nutrition programming in an engaging and fun format for children, 2) gymnasiums are not always available; some ASPs take place in a classroom, 3) although physical activity resources are available, many activities require significant preparation time and equipment that is not always available, 4) activities and games need to meet the developmental stage and ability of participants, and should be easy to implement with little preparation time, and 5) training for ASP providers is important to build confidence using resources. 

Phase One – Healthy Bodies Happy Kids

The Healthy Bodies Happy Kids Toolkit was created to meet the needs of ASP providers and address the issues brought forward in the in-depth interviews and questionnaire. The Toolkit, designed to be used with children between 6 and 12 years of age, consists of more than 100 games and activities that include healthy eating messages and nutrition information, as well as a section on how to modify activities to meet space constraints and the variable ages of the children. The content for the activities was developed in partnership with students from Brescia University College and WU and includes a nutrition question bank, physical activity and movement ideas, a document to assist ASP providers in adapting activities for children with a disability, and helpful tips for using the Toolkit. Funding for the creation of the toolkit was provided in part by the Ministry of HealthPromotion and Sport’s Healthy Communities Fund.

Draft copies of the Toolkit were tested with seven ASPs in London, and feedback from evaluations was incorporated into the final product. One-hundred fifty (150) toolkits were created and each ASP in London andMiddlesex County received one. A distribution plan to expand the reach of the Toolkit to recreational facilities, camps and other organizations (including other health units) was created and implemented. In addition to the development of the Toolkit, a manuscript was written and is currently in print with the Child Health and Education: An Interdisciplinary Journal. The manuscript focuses on the results from the qualitative study and recommendations for future after-school programming highlighting healthy eating and active living.

Eighty (80) ASP providers received training using the Toolkit in October 2010 and another 200 received training in February 2011. An evaluation of the kit was conducted with ASP providers between June and November 2011, after the kit had been implemented with ASP providers for a reasonable period of time. A second qualitative study will use focus groups with ASP providers to determine the extent to which the Toolkit is being implemented as intended as well as to determine the utility of the Toolkit in ASP planning.

Phase Two – Hop Skip Munch 

In 2011, the HEAL Working Group implemented phase two of this project which was the development of a healthy eating and physical activity resource, the Hop Skip Munch Toolkit, for Early Years Centre staff and daycare providers. This toolkit targets children aged two to five years of age in the daycare setting. One thousand (1000) copies of the resource have been printed, and a plan for distribution and training of the Early Years staff and daycare providers is underway in 2012.

Conclusion

After-School Programs enhanced by strong nutrition and physical activity programming materials and supports create supportive environments for learning. As such, this programming should foster lifelong behaviours for healthy eating and active living. The evidence-informed interactive toolkits for both after-school and early years program providers facilitates the engagement of children in physical activities and nutrition education opportunities.

This report was prepared by Ms. Lori Fellner, Health Promoter and Dr. Heather Thomas, Public Health Dietitian, Chronic Disease Prevention and Tobacco Control Team.

Graham L. Pollett, MD, FRCPC
Medical Officer of Health

This report addresses the following requirement(s) of the Ontario Public Health Standards:
Foundations: Principles-1, 2, 4 (Need, Impact, Partnership and Collaboration); Foundational Standard: 3, 4, 8, 9, 10, 11, 12, 13; Chronic Disease Prevention: 1, 3, 7, 11; Child Health: 4, 7.