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Improving Programs, Policies and Services to Promote Healthy Development in Middle Childhood in Afterschool Settings

Publication Date

This project was a collaborative effort by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Office of Women’s Health (OWH). This work examines how investments by the U.S. Department of Health and Human Services (HHS) support local efforts to promote healthy development in middle childhood in afterschool settings to support social-emotional, behavioral, and physical health. Given the significant federal investment in and the large number of school-aged children participating in afterschool programs, as well as the potential benefits for children’s health and development, this study focused on:

  1. the extent to which evidence-based tools or interventions are implemented in afterschool programs;
  2. the promising practices for administering, improving, and sustaining these interventions at the local level; and
  3. how afterschool programs can better address the needs of boys and girls.

This webpage includes links to materials ASPE and OWH have developed with James Bell Associates as part of an effort to identify interventions and practices implemented in afterschool settings that improve children’s social-emotional, behavioral and physical health. Project findings are based on a literature review and case studies of five afterschool program sites serving economically disadvantaged families in diverse geographic regions. These findings may be helpful to policymakers and program administrators working to allocate resources targeting children from low-income working families.

A Policymaker’s Guide to School-Age Child Care: Challenges and Opportunities to Support and Scale Federally Subsidized Programs
This brief provides an overview of issues associated with school-age child care for federal and state policymakers. The brief synthesizes and extends the findings from ASPE’s Middle Childhood Afterschool Project (MCASP), and focuses on the need to 1) support working families; 2) strengthen the quality of child care settings for school-age students; 3) scale supports for social-emotional and behavioral health; 4) address tremendous unmet need; and 5) pursue sustainable cross-sector strategies to finance school-age child care.

Providing an Essential Service: An Overview of Afterschool Programs’ Support of Children’s Social-Emotional, Behavioral, and Physical Health During Middle Childhood
This overview brief details the approach to the literature review and case study methodology for five afterschool study sites associated with ASPE/OWH’s Middle Childhood Afterschool Project (MCASP). Key findings from the literature review and interviews and observations at sites are articulated in the overview brief.

Afterschool Programs’ Support of Children’s Social-Emotional, Behavioral, and Physical Health During Middle Childhood: A Summary of Findings from the Literature
This document provides an overview of the comprehensive literature review developed as part of ASPE/OWH’s Middle Childhood Afterschool Project (MCASP). This graphical summary includes key insights from the literature review to identify afterschool programs serving children aged 6 to 12 that report positive outcomes in social-emotional, behavioral and physical health, and summarizes findings by gender.

Afterschool Programs’ Support of Children’s Social-Emotional, Behavioral, and Physical Health During Middle Childhood: A Targeted Review of the Literature
The literature review for the MCASP study was conducted to determine what: (1) afterschool programs report positive outcomes in social-emotional, behavioral, or physical health during middle childhood; (2) evidence is for differential impacts by gender; (3) characteristics of programs, participants, and families are associated with afterschool programs that report positive outcomes in social-emotional, behavioral, or physical health; and (4) routines, content, and activities are included in programs reporting positive outcomes.

Afterschool Programs’ Support of Children’s Social-Emotional and Behavioral Health
Case study research conducted for MCASP indicated that afterschool programs view children’s social skills and self-confidence as important program goals. Staff-child relationships and peer relationships are viewed as central in helping children develop social skills, understand and regulate their emotions, and build self-confidence. Program observations revealed positive peer and staff-child interactions, and that children were engaged in afterschool program activities and content. Overall, only a few programs use an evidence-informed curriculum and provide formal training to staff on how to promote SEBH. More training is needed to appropriately address child trauma and secondary trauma in staff.

Promoting the Physical Health of Boys and Girls: Examples from Five Afterschool Programs
Observations and interviews at afterschool sites revealed that programs used a variety of strategies to encourage physical health including targeted activities, a wide range of activities to appeal to kids’ interests, and healthy snacks and nutritional education. Staff encouraged boys and girls to participate in activities they enjoy, regardless of gender expectations. This was especially true for encouraging girls to participate in sports or physical activities. Overall, programs did not include sufficiently vigorous physical activities to meet the recommended standards.

Gender Informed Programming: Examples of Current Practices at Five Afterschool Programs
In afterschool programs studied for MCASP, staff primarily endorse a “gender blind” approach, providing the same activities to boys and girls. A majority of staff at programs are female. Only one program observed had a balance of male and female staff. During site visits, staff commented on gendered cultural norms expressed by some parents. In some instances, gender influenced how staff interacted with children or considered themselves models for children.

Sources, Use, and Adequacy of Funding for Five Afterschool Programs
Afterschool programs in the MCASP study received funding from multiple sources to provide program services. Among the sources, In-kind support from school districts and volunteers was often crucial to support program operations. Program administrators reported spending considerable time fundraising and anxiety about maintaining funding levels. Staff describe their funding as adequate to provide their current programming, but all noted a desire for additional funding to expand programming to better meet the needs of school-age children and improve staff training.