Turn up the healthy eating and activity time (HEAT): Physical activity outcomes from a 4-year non-randomized controlled trial in summer day camps

Summer day camps (SDCs) serve over 14 million children in the U.S. and are well-positioned to help children accumulate the guideline of 60 min per day (60 min/d) of moderate-to-vigorous physical activity (MVPA). The purpose of this study was to evaluate a multi-component intervention to increase the percentage of children meeting 60 min/d of MVPA. Twenty SDCs serving 3524 children (7.9 yrs., 46.2% girls, 66.1% non-Hispanic Black) participated in a 4-summer non-randomized two-group intervention. Children's accelerometer-derived MVPA was collected using accelerometers worn on the non-dominant wrist. SDCs were assigned to either 2 summers of intervention (n = 10, no intervention summer 2015, intervention summer 2016 and 2017) or 1 summer of intervention (n = 10, no intervention summer 2015 and 2016, intervention summer 2017). The final summer (July 2018) was a no intervention follow-up. Multilevel mixed effects regression models estimated changes in percent of children meeting 60 min/d of MVPA. Across all summers and SDCs, children accumulated an average of 89.2 min/day (±22.5) of MVPA. The likelihood of meeting the 60 min/d MVPA guideline was not different during intervention versus baseline summers for boys or girls (p > 0.05). Girls and boys were 3.5 (95CI = 1.5, 8.1) and 3.7 (95CI = 1.6, 8.4) times more likely to meet the 60 min/d guideline during intervention summers versus follow-up, respectively. The intervention was not successful at increasing the percentage of children meeting the 60 min/d MVPA guideline. However, children attending SDCs accumulated substantial amounts of MVPA thus efforts should focus on making SDCs an accessible setting for all children.