School-Community Partnerships A Cluster-Randomized Trial of an After-School Soccer Program

Importance: Identifying community-based programs that increase physical activity among diverse youth could yield sustainable tools to reduce obesity and obesity disparities. Objective: To evaluate the impact of a community-based after-school soccer and youth development program, America SCORES, on students' physical activity, weight status, and fitness. Design: Cluster-randomized trial. Study measures were collected in the fall (baseline), winter (midpoint), and spring (end point) of the 2009-2010 school year. Setting: After-school programs in 6 schools within a large urban school district. Participants: All 4th and 5th grade students in after-school programs at the study schools were eligible. Intervention: Three schools were randomized to receive the SCORES after-school program, delivered via the train-the-trainer model. Main Outcome Measures: Change in minutes of after-school moderate-to-vigorous physical activity (MVPA), fitness (maximal oxygen consumption), and body mass index over 1 school year. Results: Participants (n = 156) were diverse (42% Latino, 32% Asian, and 12% African American) and 76 (49%) had a body mass index at or above the 85th percentile. There were no significant group differences in the change in physical activity, fitness, or weight status among all students. However, among students with a body mass index at or above the 85th percentile, SCORES significantly increased MVPA after school (3.4 min/d; 95% CI, 0.3-6.5) and on Saturdays (18.5 minutes; 95% CI, 3.4-33.6). Conclusions and Relevance: Existing community-based programs such as SCORES can increase physical activity among low-income youth, particularly those most at risk for weight-related comorbidities. While evaluating existing programs presents special challenges, partnerships between communities, schools, and researchers are an important component of translational research to address obesity.