Are Sports The Catalyst For MVPA Benefits In Out Of School Programs? A Moderation Analysis In Elementary-aged Children

PURPOSE: The structured days hypothesis (SDH) suggests when children are in structured environments, they have healthier movement behaviors, including more moderate-to-vigorous physical activity (MVPA). Out of school programs (OSPs) are a popular form of structured environments, and there is evidence that participation in these OSPs is associated with higher MVPA in elementary-aged children; however, it is not clear if sports are the primary driver of the association between OSPs and MVPA. Therefore, the purpose of this study was to examine whether attending sports programs moderates the effect between OSPs and MVPA in elementary-aged children. METHODS: Children (N = 685; 48.7% female; 52.7% White; K-5th grade) participated in a 14-day observational protocol in Spring 2022. Each night, parents completed texted surveys about their child’s participation in OSPs. Children wore an Actigraph GT9X accelerometer on their non-dominant wrist to measure MVPA. Accelerometer data were processed using GGIR (v 2.8-2). Linear mixed-effects models predicted day-level MVPA from time spent in OSPs. Moderation effects were examined with sports by OSP time interaction. Only weekdays were included for this analysis. Sex, income, grade, time spent in school, and accelerometer non-wear time were included as covariates. RESULTS: Of the 421 children that attended OSPs, 53% attended sports programs. On average, on days when children went to an OSP, they attended for 117.2 ± 55.0 minutes, specifically, children spent 96.8 ± 53.7 minutes at sports, 156.2 ± 54.7 minutes at after-school programs, and 103.0 ± 57.6 minutes in other programs. Mixed-effects models suggested that time spent in OSPs on a given day were linked with higher MVPA for that day, such that children engaged in 0.1 more minutes of MVPA for every additional minute attending OSPs (95CI = 0.1, 0.2). Attending sports programs was not associated with additional MVPA beyond participating in other OSPs (B = -0.1 ± 0.1; 95CI = -0.2, 0.0). CONCLUSIONS: On days when children spend more time in OSPs, they have higher MVPA, but there are not additional MVPA benefits when children attend sports versus other OSPs. Our data supports the SDH suggesting that filling children’s time with structure, despite what type of structure it is, is associated with healthier movement behaviors. Research reported in this publication was supported by the National Institute Of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number 5R01DK116665 and the US Department of Health and Human Services Health Resources and Services Administration (1T1CMC3536