The Adoption of the Healthy Eating Standards in Local Afterschool Programs Does Not Improve Quality of Snacks

J Sch Health. 2019 Oct;89(10):809-817. doi: 10.1111/josh.12822. Epub 2019 Aug 9.


Objectives: In 2011, the National Afterschool Association adopted the Healthy Eating and Physical Activity (HEPA) standards to address snack quality and physical activity in afterschool programs. Although research has indicated promise in the adoption of these policies by national organizations, less is known about local adoption, implementation, and effectiveness. In this study, we aimed to compare the quality of snacks served at program sites pre- and post-adoption and to determine the quality of non-program snacks compared to program snacks.

Methods: An interrupted time series design was used to measure snack quality and consumption at 3 policy adopting sites and 2 non-policy adopting sites that served as a comparison control. Trained research staff collected snack type, brand, and amount consumed using a modified quarter-waste method. Analysis on nutrient content of snacks was completed using Nutrition Data System for Research software.

Results: Adoption of the HEPA standards among policy adopting sites did not result in significantly better snack quality. Across all sites, program snacks were healthier than non-program snacks.

Conclusion: Pursuing additional components of the HEPA standards related to implementation may be necessary to significantly improve snack quality. Environmental supports such as limiting the amount of non-program snacks available onsite may improve snack quality.

Keywords: afterschool programs; child and adolescent health; health policy; nutrition and diet; school snacks.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community-Institutional Relations
  • Diet, Healthy / statistics & numerical data*
  • Food / statistics & numerical data
  • Health Promotion / methods*
  • Humans
  • Interrupted Time Series Analysis
  • Nutrition Policy*
  • Nutritive Value
  • Program Evaluation
  • Schools
  • Snacks*