Free summer programming on elementary-aged children’s food and beverage consumption: a randomized clinical trial

During summer vacation, many children in households with low income lose access to federally-funded, healthful school meals. Summer day camps (SDCs) provide access to healthful meals and a structured environment; yet low-income families often cannot afford SDCs which may influence food/beverage consumption. This study examined the impact of receiving a free SDC versus experiencing summer as usual (SAU) on dietary intake during summer among children from low-income families. Parent-child dyads (N = 422; child age: 8.2 ± 1.5 yrs; 48% female; 51% Black) were recruited over 3 years (2021–2023) from schools serving families with low-income. Children were randomized to receive 8–10 weeks of free SDC (intervention) or SAU (control). Parents completed daily diaries for 14 days during school (April/May) and summer (July) which captured child consumption of healthful (e.g., fruit, vegetables, milk) and unhealthful (e.g., soda, fast food, snacks/chips) foods/beverages. Mixed-effects intent-to-treat (ITT) models examined the odds of consuming different foods/beverages during summer, controlling for school year consumption, in the SDC group compared to SAU. Secondary as-treated analyses examined the impact of attending structured summer programming versus not attending on the odds of consuming different food/beverages, regardless of randomization. A total of 2,931 daily diaries were completed for intervention (n = 232) and control (n = 201) children. ITT analyses showed the SDC group had decreased odds of consuming frozen desserts (OR 0.68, 95%CI 0.49–0.94), compared to SAU, during summer weekdays. No other differences were observed. As-treated analyses showed children had increased odds of consuming fruit (1.77, 1.30–2.41), milk (1.97, 1.44–2.69), and chips/snacks (1.49, 1.17–1.90), and decreased odds of consuming soda (0.53, 0.34–0.84), fast food (0.57, 0.45–0.73), and frozen desserts (0.58, 0.45–0.74) on weekdays when they attended structured summer programming, compared to days they did not attend. Providing free SDC alone did not promote more healthful food/beverage consumption during summer vacation compared to SAU. However, on days children attended a structured program, children experienced more dietary benefits compared to days they did not. Thus, structured environments may positively impact children’s diet during summer; yet, identifying strategies to address barriers beyond cost to improve attendance and enrollment may enhance the impact of summer programming.