Care Providers' Perceptions in Promoting Healthy Eating and Physical Activity in the After-School Setting

• Author / Creator

  Elias, Pierrette H.

• Comprehensive school health (CSH) is an evidence-based and internationally recognized framework which has been effective in school-based health promotion interventions. Given its effectiveness in the school setting, there is a need to expand this approach into other community settings, such as the after-school setting. The after-school time period is an important time for children to engage in healthy behaviours. The critical hours of 3:00 – 6:00 p.m. provide an opportunity to promote healthy eating (HE) and physical activity (PA) among children attending after-school care (ASC). As a holistic approach, CSH recognizes the significant impact the social and physical environments have on children’s health behaviours. Care providers are major influencers within the ASC setting, impacting HE and PA opportunities for children. However, little is known regarding the role care providers play in health promotion interventions in the ASC setting, specifically those using comprehensive approaches. The after-school health promotion intervention School’s Out…Let’s Move (SOLMo) provided this opportunity. Thus, the purpose of this research was to explore care providers’ perceptions and experiences implementing the health promotion intervention SOLMo. This research utilized multiple methods to address two objectives: 1) to examine changes to care providers’ perceived awareness, knowledge, confidence, behavioural control and, attitudes towards promoting HE and PA for children in comparison to usual practice care providers; 2) to explore care providers’ role and their perceptions in promoting HE and PA.
  The quantitative component of this research examined the changes to care providers’ perceptions in their ability to promote HE and PA within the ASC setting during the SOLMo intervention in comparison to usual practice (i.e., control) sites. Previously validated surveys, from preschool and school-based health promotion intervention projects, were modified to reflect the ASC setting. Surveys were distributed and collected from all care providers (n=57) from SOLMo intervention sites (n=4) and control sites (n=4) at pre- (September 2016) and post-intervention (March 2017). Linear regression analyses of survey questions examined changes in care providers (n=17) perceived awareness, knowledge, confidence, behavioural control, and attitude towards promoting HE and PA within the ASC setting. Results confirmed care providers’ attitudes towards promoting both HE and PA were significantly higher (p<0.05) in the intervention (n=10) compared to the control group (n=7) after six months delivering the intervention. Focused ethnography informed the qualitative component of this research. Semi-structured interviews with care providers (n=13) from the SOLMo intervention sites (n=4) were conducted following the intervention (May 2017). Through latent content analysis five themes emerged: 1) enhanced awareness; 2) improved programming; 3) strong relationships; 4) collaborative approach; and 5) role tension.
  The close examination of the care providers’ role in this research provided insight into their perspectives on promoting HE and PA within the after-school health promotion intervention SOLMo. Overall, this research confirms the critical role care providers’ play in health promotion strategies within the ASC environment. Findings and recommendations from this research will aid future health promotion strategies to improve healthy lifestyles of school-age children within the ASC and other community settings.

• Subjects / Keywords

  • physical activity
  • health promotion
  • school-age children
  • Care provider perceptions
  • out-of-school
  • healthy eating
  • after-school

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R3X05XV3Z

• License

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