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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Physical Activity.

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Strategy. Extracurricular Activities for Physical Activity

Approach. Provide students with opportunities to participate in sports or other athletic activities before or after school

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Overview. Studies indicate that an intervention where students are offered opportunities to participate in sports or athletic activities after school increases time in physical activity for children and adolescents. Activities include sports such as soccer, tennis, basketball, volleyball, etc. at the beginner, intermediate, or competitive levels. Before or after-school activities can also include dance, fitness breaks, and physically active games.[1,2]

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • School/program participation data
  • School/program coordinator reports and feedback
  • Funding allocation and expenditure reports

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Community Organizing (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of before and after-school sports and athletic activities offered to students. (Measures the variety and options of extracurricular physical activity programming)
  • Number of students who enroll for sign up to participate in before for after-school sports and athletic activities. (Quantifies the reach and initial engagement of the focus population)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of before and after-school sports and athletic activities that are evidence-based, developmentally appropriate, and align with quality standards for physical activity programming. (Assesses the quality and appropriateness of the activity offerings)
  • Percent of before and after-school sports and athletic activities that are adaptable for students of all ability levels. (Measures the usability and accommodation for various participant needs)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of partnerships established between schools and community organizations to expand access to before and after-school sports and athletic activities. (Measures the collaboration and shared resources to support programming)
  • Number of policies or practices adopted by schools to institutionalize and sustain before and after-school physical activity opportunities. (Measures the systemic integration and prioritization of extracurricular physical activity)
  • Number of schools that demonstrate increased overall student physical activity levels and improved school health indicators after implementing before and after-school sports and athletic activities. (Measures the school-level impact and shift towards valuing physical activity)
  • Number of community physical activity programs for initiatives that are strengthened for expanded as a result of student participation and interest developed through before and after-school activities. (Assesses the ripple effect and community-level impact of school-based programming)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of before and after-school sports and athletic activities that specifically engage students from a variety of communities. (Measures the intentional focus on increasing access and reach)
  • Percent of program funding and resources allocated to support the participation of students facing challenges to physical activity access. (Measures the distribution of investment to support the use of multiple perspectives)
  • Percent reduction in gaps in physical activity levels and fitness outcomes between student subgroups participating in before and after-school sports and athletic activities. (Measures the impact on health outcomes)
  • Percent of students who report a sense of belonging and a socially welcoming environment in the before for after-school sports and athletic activities they participate in. (Assesses the experience of participants from various backgrounds)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Carlin A, Murphy MH, Nevill A, Gallagher AM. Effects of a peer-led Walking In Schools intervention (the WISH study) on physical activity levels of adolescent girls: A cluster randomised pilot study. Trials. 2018 Jan 11;19(1):31.

2 Robbins LB, Wen F, Ling J. Mediators of physical activity behavior change in the "Girls on the Move" intervention. Nursing Research. 2019 Jul/Aug;68(4):257-266.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.