The application of mHealth to monitor implementation of best practices to support healthy eating and physical activity in afterschool programs.
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BACKGROUND Childhood obesity continues to be a global epidemic and many child based settings e g school afterschool programs have great potential to make a positive impact on children s health behaviors Innovative and time sensitive methods of gathering health behavior information for the purpose of evaluation and strategically deploying support are needed in these settings PURPOSE The aim is to 1 demonstrate the feasibility of mobile health mHealth for monitoring implementation of healthy eating and physical activity HEPA standards and 2 illustrate the utility of mHealth for identifying areas where support is needed within the afterschool setting METHODS Site leaders N 175 of afterschool programs ASPs were invited to complete an online observation checklist via a mobile web app Healthy Eating and Physical Activity Mobile HEPA m once per week during ASP operating hours Auto generated weekly text reminders were sent to site leaders mobile devices during spring and fall 2015 and 2016 and spring 2017 school semesters Data from HEPA m was separated into HEPA variables and expressed as a percent of checklists where an item was present A higher percentage for a given item would indicate an afterschool has higher compliance with current HEPA standards RESULTS A total of 141 site leaders of ASPs completed 13 960 HEPA m checklists The average number of checklists completed per ASP was 43 range 1 220 for healthy eating and 50 range 1 230 for physical activity For healthy eating the most common challenge for ASPs was Staff educating children about healthy eating and for physical activity checklists Girls only physical activity is provided at ASP CONCLUSION HEPA m was widely used and provided valuable information that can be used to strategically deploy HEPA support to ASPs This study gives confidence to the adoption of mHealth strategies as a means for public health practitioners to monitor compliance of an initiative or intervention