Please select the eligibility criteria that correspond to the clinical trial below.
Title: Nutrition and Physical Activity Policies, Obesogenic Behaviors and Weight Outcomes
Brief Summary: The investigators long-term goal is to advance the adoption and successful implementation of policies that promote PA and nutrition in after school programs (ASP) nationwide. The investigators objective here is two fold. First, the investigators will test the effectiveness of two promising strategies designed to 1) increase the amount of PA children accumulate while attending an ASP and 2) promote changes in the nutritional quality of the snacks served. This represents a fundamental step in establishing practice-based guidelines (best practices) for the uptake and achievement of public health policy goals (CA and Harvard). Second, the investigators will examine the barriers and facilitators to implementing these strategies. The expected outcome of this study is evidence supporting best practices for ASPs to employ to meet policy goals.


Options:
A: Inclusion Criteria

* Enrolled in participating after-school program
* Live in Massachusetts or Rhode Island
B: Inclusion Criteria:

* In 4th or 5th grade of a participating school at time of enrollment
* BMI greater than or equal to the 85th percentile on the 2000 CDC growth charts
* Medical clearance obtained from primary care provider

Exclusion Criteria:

Our goal is to be inclusive as possible, however, children will not be eligible to participate if they:

* have a condition that limits their participation in physical activity enough that they are not able to participate in Physical Education at school (e.g. significant structural heart disease)
* are pregnant
* have been diagnosed with a chronic illness that affects their growth and/or weight (e.g., type 1 diabetes, hypothyroidism, inflammatory bowel disease)
* have taken systemic steroids (oral, intravenous, or intramuscular) for a period of more than 21 days in the past year
* are taking other medications potentially affecting their growth and/or weight (e.g. methylphenidate HCL)
* are unable to complete the informed consent process
C: Inclusion Criteria:

Programs that:

* Operate immediately after the school day
* Operate every day of the school year for a minimum of 2 hours
* Serve a minimum of 30 children of elementary age (6-12 years)
* Operate in a school, community or faith Setting
* Provide a snack
* Provide homework assistance/completion time
* Provide enrichment
* Provide opportunities for physical activity
* All children enrolled, staff, and afterschool program (ASP) leaders in the ASPs were eligible to participate in the study.

Exclusion Criteria:

* Programs that:
* Were singularly focused
* Programs that were physical activity focused

Children that:

* Have any physical and/or orthopedic impairment that would limit a child's ability to participate in regular physical activity.
D: Inclusion Criteria:

* after-school program participant in fourth grade group
* informed parental consent
* assent to participate in Body Mass Index assessment

Exclusion Criteria:

* third or fourth grade student
* participant in study in previous year

Answer: C