After-School Program More Than Triples Odds Kids Meet Activity Targets

For more than half a million Australian children each week, the final school bell does not mark the end of structured care. Outside school hours care services, known as OSHC, look after children before classes begin and after they finish, and for many working families these services shape a substantial portion of a child’s weekday. A major new study from Adelaide University, published in JAMA Network Open, suggests that these settings can be transformed into genuine engines of physical activity, provided the adults who run them are given the right training, tools and policy scaffolding. The research evaluated Activated OSHC, a free online training and accreditation program, and found that services which completed it achieved dramatic improvements in how active children were and how much time they spent in front of screens.

The scale of the problem the program addresses is considerable. According to the Australian Institute of Health and Welfare data cited by the research team, only one in four Australian children currently achieve the recommended amount of moderate-to-vigorous physical activity, and only one in three meet screen time guidelines. These shortfalls matter because regular vigorous movement in childhood is linked to healthier cardiovascular and metabolic profiles, better bone development, improved mental wellbeing and stronger academic engagement. Conversely, excessive recreational screen time is associated with poorer sleep, higher sedentary behaviour and reduced opportunities for social and motor skill development. With so few children meeting national recommendations, researchers have increasingly looked beyond the traditional targets of school physical education and family routines toward the environments where children actually spend their time.

Outside school hours care represents one of the largest of those environments. Professor Carol Maher of Adelaide University’s School of Allied Health and Human Performance, the study’s lead researcher, noted that more than 500,000 Australian children spend time in OSHC every week, creating what she described as a real opportunity for children to be more active. Earlier work by her team had revealed enormous variation between services in how active children were during care, with children spending around 60 percent of their time in after-school care inactive. That variation was itself a clue: if some services managed to keep children moving while others did not, then the difference likely lay in modifiable factors such as staff behaviour, the activities on offer and the policies governing the service, rather than in the children themselves.

Activated OSHC was designed around precisely that insight. The program is an evidence-based initiative codesigned by Adelaide University together with the OSHC sector, in collaboration with government and child health experts. Rather than placing responsibility entirely on children and parents, it targets the environment surrounding the child: how staff are trained, what activities are available and what policies the service has in place. Delivered as self-paced online training leading to formal accreditation, the program provides practical tips for creating an active environment, concrete strategies for reducing screen time, and techniques for encouraging participation from all children regardless of age or ability. A central component helps each service develop a physical activity and screen time policy aligned with the Australian guidelines for outside school hours care, embedding healthy practice into institutional structure rather than leaving it to individual staff initiative.

The trial involved almost 200 OSHC services collectively caring for approximately 10,000 children across Australia, making it one of the largest evaluations of its kind in this setting. The results among services that completed the full program were striking. Those services had more than seven times the odds of meeting recommended physical activity and screen time targets before and after school compared with services that had not completed accreditation. Children attending accredited services showed significantly greater increases, of 23 percent, in moderate-to-vigorous physical activity during before-school care. Staff at these services were three times as likely to demonstrate behaviours that actively promote physical activity, indicating that the program changed adult practice as well as child outcomes.

From a technical standpoint, these effect sizes are notable for a relatively light-touch, scalable intervention. Online, self-paced training can be disseminated nationally at low marginal cost, and the accreditation model gives services a clear benchmark aligned with existing Australian guidelines. The finding that before-school care showed measurable gains in moderate-to-vigorous activity is particularly interesting, since morning sessions are shorter and often dominated by quiet supervision, yet they appear highly amenable to change when staff are equipped with appropriate strategies. The tripling of positive staff behaviours suggests a mechanism: trained educators model and prompt activity more consistently, and children respond to the environment they are offered. In intervention science, this pattern of environmental change preceding behavioural change in children is exactly what theory would predict.

However, the study also delivers a sobering counterpoint about implementation. While 80 percent of intervention services registered for the program, fewer than half completed all the training and policy requirements needed for accreditation. Across all intervention services, including those that did not finish, there was no significant improvement in overall guideline adherence or in children’s physical activity. In other words, simply making a program available was not enough to shift outcomes. This null result for the intervention-as-offered is arguably as important as the positive results for completers, because it quantifies the gap between reach and effectiveness. Busy OSHC services juggle staffing constraints, variable educator qualifications and demanding operational schedules, and accreditation demands sustained effort across training modules and policy development.

Professor Maher framed this contrast as one of the biggest challenges facing health programs generally: turning good intentions into lasting change. She emphasised that making a program available is only part of the solution, and that services need time and practical support to put changes into practice and sustain them. Yet she also pointed to the promise in the completers’ results, noting that although fewer than half of the services finished accreditation, those that did showed meaningful improvements in staff practices, their environment and children’s activity. The challenge now, she said, is helping more services get there. This reframing of the problem, from designing an effective intervention to designing effective implementation support, reflects a broader shift in implementation science toward studying how evidence-based programs are adopted, adapted and maintained in real-world conditions.

The research team’s next steps follow directly from that logic. Future work will explore different ways of helping more services successfully implement the program, including additional implementation support and peer learning approaches, in which services that have completed accreditation mentor those still working through it. The team also plans to investigate whether the program can be successfully replicated internationally, a question with significant implications given that outside school hours care and similar before- and after-school models exist in many countries facing the same childhood inactivity trends. If the Australian results translate, the OSHC setting could become a globally relevant lever for population-level physical activity promotion.

The study was funded by the Australian Government’s Medical Research Future Fund and the National Health and Medical Research Council, and the authors reported no conflicts of interest. Its publication in JAMA Network Open places a rigorous evaluation of a practical, policy-aligned intervention before an international clinical and public health audience. For parents, educators and policymakers, the central message is twofold. The hours around the school day, long treated as logistical filler, are a genuine opportunity to close the gap between the one in four children who move enough and the national guidelines designed for all of them. And closing that gap depends less on exhorting individual children to be active than on training staff, shaping environments and embedding policies that make movement the easy, default choice in the places children already are.

Subject of Research: Evaluating an online training and accreditation program to increase physical activity and reduce screen time in Australian outside school hours care services

Article Title: Keeping kids moving beyond the school bell

Article References: Keeping kids moving beyond the school bell. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: physical activity, outside school hours care, children's health, screen time, Activated OSHC, Adelaide University, JAMA Network Open, implementation science, accreditation, public health, Australia, childhood obesity prevention