Effect of an after-school physical activity and nutrition education intervention on elementary school attendance

Background: We studied the effect of an after-school physical activity (PA) and nutrition education (NE) program on attendance in overweight children (Body Mass Index (BMI) ≥85th percentile). Methods: Based on Fall 2008 BMI, students at three elementary schools (W, H, and A) participated in three interventions: 1) high intensity (HI): twice weekly after-school program (W); 2) medium (MI): in-school PA, NE, and non-food reward program (W, H); and 3) no intervention (A). Schools were socioeconomically similar with >80% of children qualifying for free or reduced lunch. Primary outcome was mean days absent. Results: 556 students (A=212, H=166, W=178) were included in the analysis. 46% at A, 48% at H, and 44% at W were overweight (p=0.78). 37 students at W enrolled in HI; 34 were overweight. Overall, students at A missed 9.0 days during the school year, compared to 7.7 at H, and 7.6 at W (p=0.08). Excluding students in HI, there was no significant difference in absences by BMI percentile at each school (overweight versus not: A=9.5 versus 8.5, p=0.31; H=7.3 versus 8.1, p=0.35; and W=7.3 versus 8.5, p=0.33). Among overweight students, those in HI missed significantly fewer days than students not in HI (HI=5.73, W=7.3, H=7.3, A=9.5, p=0.01). Conclusions: Overweight students in HI missed significantly fewer days than those not enrolled. Students receiving MI missed significantly fewer days than students not enrolled. This suggests that school-based programs promoting PA and NE contribute to improved attendance in elementary students. Future goals include identification of reasons for this difference.