Table 1.

Summary of primary prevention interventions targeting obesity prevention in the after school setting.

#	Intervention	Theory	Intervention Duration & Description	Study	Design & sample	Salient findings
1.	Youth Fit For Life	Social Cognitive Theory	-Delivered in three 45-minute sessions over 12 weeks. -Program consisted of 4 components, targeting: (1) Cardiovascular exercise by noncompetitive games (2) Resistance exercise using resistance bands (3) Nutrition/health information (4) Behavioral skills training	Annesi, 2006 [18]	Quasi-Experimental TX: n = 84 (2005) TX: n = 41 (2003) CNT: n = 40 x age = 10.8	-Significant improvements for PA (p < 0.001), physical self-concept (p < 0.013) and self-efficacy for exercise barriers (p < 0.001) in the treatment group and no changes in the control.
				Annesi, Faigenbaum, et al. 2008 [19]	Quasi-Experimental TX: n = 146 CNT: n = 123 age = 10.6	-Significant improvements for all self-appraisal factors (ex. general self (p < 0.003)), mood factors (ex. Tension (p < 0.001)) and PA (p < 0.001) within the treatment group. -Measures also significantly different between the TX and CNT groups at the time of posttest (p < 0.001).
				Annesi, Moore, et al. 2008 [20]	Quasi-Experimental TX: n = 217 Overall age = 9.7	-Significant improvement for PA (p < 0.001) from baseline to the end of the program. -Significant negative predictors of PA post-intervention included frequency of PA at baseline (p < 0.001) and age (p < 0.007)
				Annesi, et al. 2009 [21]	Pilot Study Total n = 43 age = 9.0 years	-Significant improvements found for BMI (p < 0.03), strength (p < 0.001), endurance (p < 0.04), engagement in PA (p < 0.01), vegetable intake (p < 0.02), self-efficacy for PA (p < 0.002) and physical self-concept (p < 0.05), but not flexibility, or fruit intake.
				Annesi, et al. 2011 [22]	Quasi-Experimental TX :n = 121 TX plus HopSports® video-system: n = 171 age = 7.3 years	-Significant improvements for BMI-percentile (p < 0.001), muscular strength (p < 0.001), and cardio-respiratory endurance (p < 0.007) within both groups, but no difference between groups.
2.	Nutrition & Media Intervention	Social Cognitive Theory	-Delivered in 12 two-hour sessions over 6 weeks. -Program included education for nutrition, media literacy and health communication.	Evans, et al. 2006 [23]	Pilot Study TX: n = 18 CNT: n = 21 4th and 5th grade children	-Significant improvements for motivation (p < 0.013), home nutrition environment (p < 0.02), and perceived parental support (p < 0.04), but not fruit/vegetable intake, self-support or self-efficacy.
3.	Pilates Program	None stated	-Delivered every day for 4 weeks. -Program included basic training in Pilates.	Jago, et al. 2006 [24]	Pilot Study TX: n = 16 CNT: n = 14 age = 11.2 years	-Significant improvements for BMI-percentile (p < 0.039), but no other measure (ex. blood pressure)
4.	10-Month Physical Activity Intervention	None stated	-Delivered everyday school day for 110 minutes for a total of 10-months -For each session: 30 min. for homework; 25 min. PA skills development; 35 min. PA; and 20 min. toning/stretching	Barbeau, et al. 2007 [25]	RCT TX: n = 118 CNT: n = 83 age = 9.5 years	-Average attendance was 54% (2.5 days/week). -Significant improvements for BMI-percentile (p < 0.008), body composition (p < 0.0001), cardiovascular fitness (p < 0.047) and overall PA (p < 0.0006) were found for the treatment group, compared with the control group.
				Howe, et al. 2011 [26]	RCT TX: n = 62 CNT: n = 44 age = ~9.8 years	-Average attendance was 57.7% (2.5 days/week). -Significant improvements for children attending ≥60% of intervention for MVPA (p < 0.04), BMI (p < 0.0034), and body composition (p < 0.019) compared to the control group.
5.	Kids Living Fit	Social Cognitive Theory	-Delivered once per week for 12 weeks. -Sessions included various exercise and dietary components	Speroni, et al. 2007 [27]	Quasi-Experimental TX: n = 80 CNT: n = 105 age ≈ 9.3 years	-Average attendance was 82%. -Children in TX group experienced a significant decrease in BMI-% (p < 0.01), while those in CNT group had a significant increase (p < 0.01).
6.	Georgia Fitkid	None stated	-Delivered for 2 hours every school day for three-years. -For each session, 40 min. for eating a healthy snack and 80 min. for PA.	Gutin, et al. 2008 [28]	RCT TX: n = 148 CNT: n = 168 age = 8.5 years	-Significant improvements for bone density (p < 0.01), fat-free soft tissue (p < 0.01), weight (p < 0.01), height (p < 0.01), and body mass index (p < 0.05) were found for TX group. -Also a group x time interaction for fitness (p < 0.01) and body fat % (p < 0.05) but benefits were not sustained during the summer.
7.	Be a Fit Kid	Precede/ Proceed model	Delivered 3 times each week in 2 hours sessions for 12 weeks. -Program consisted of a PA, diet and parent component	Slawta, et al. 2008 [29]	Pilot Study TX: n = 75 6 to 12 years	-Significant improvements for body composition (p < 0.001), fitness (p < 0.001), nutrition knowledge (p < 0.001), some dietary habits (ex. Total fat intake (p < 0.001), and for those who participated in at least 75% of the program, near significant reductions in total cholesterol (p < 0.059) and triglyceride levels (p < 0.099).
8.	Food Fit	Social Cognitive Theory	-Delivered six 45-minute sessions over 6 weeks. -Program consisted of skills training to identify healthier foods.	Branscum, et al. 2009 [30]	Pilot Study TX: n = 58 3rd, 4th and 5th grade children	-Significant improvements for overall dietary behaviors (p < 0.001), and behavior antecedents for some lessons.
9.	Club Possible	Social Cognitive Theory	-Implementation varied by site. -Program consisted of education and behavior change activities for increasing PA, and improving healthy eating.	Huberty, et al. 2009 [31]	Quasi-Experimental TX: n = 670 Age range: 5 to 11	-BMI-percentile significantly decreased among children (p < 0.0001). -There were no changes in PA self-efficacy, or social support among children ages 7−9 or 10−12, and only 7−9 age group significantly increased PA enjoyment (p < 0.002).
10.	SCORES	None stated	-Delivered three 60-minute sessions weekly for 18 weeks. -A program that uses soccer to teach literacy in low-income areas.	Madsen, et al. 2009 [32]	Pilot Study TX: n = 178 age = 9.7 years	Overall physical fitness scores significantly increased (p < 0.001). No significant change was reported for overall BMI-percentile, except there was a significant decrease among Asian children (p < 0.001).
11.	Ready. Set. ACTION!	Social Cognitive Theory	-Delivered fourteen 2-hour sessions and eight weekly booster session. -Incorporated theater activities with health promotion activities	Neumark-Sztainer, et al. 2009 [33]	Pilot Study TX: n = 51 CNT: n = 45 age = 10.3 years	-No significant differences in changes for BMI-%, diet, PA, family/home environment or SCT constructs (except for self-efficacy for PA (p < 0.028))
12.	Tommie Smith Youth Athletic Initiative (TSYAI)	Trans-theoretical Model	-Delivered three 90-minute sessions/week for 14-weeks. -Included track & field and other PA games with various health promotion activities.	Topp, et al. 2009 [34]	Pilot Study TX: n = 63 K-5th grade children	-Overall significant improvement for cardiovascular fitness (p < 0.01), but no change for BMI-% and percentage body fat. -Children also consumed significantly more green vegetables (p < 0.02) and less fruit juice (p < 0.02), but there were no other changes in diet.
13.	HOP’N	Social Cognitive Theory	-Delivered over three years. -Contained daily PA (30-min.), healthy snacks, and weekly nutrition or PA educational experience.	Dzewaltoski, et al. 2010 [35]	RCT Tx: n = 134 Cnt: n = 112 age = ~ 9.2 years	-No changes in BMI z-score observed. -Significant improvements found PA (p < 0.04) and sedentary behaviors (p < 0.01), especially among overweight/obese children.
14.	Smart Snack	Social Cognitive Theory	-Program included three-90 min workshops implemented weekly. -Various program activities (ex. games) implemented to teach children healthy eating habits.	Freedman, et al. 2010 [36]	Pilot Study TX: n = 63 Age range: 9−14 years	-Of various dietary measures milk (p < 0.05), vegetables (p < 0.05), and water intake (p < 0.05) significantly increased at posttest, but only water (p < 0.01) remained significant at the 3-month follow-up.
15.	NutriActive	None stated	-Delivered everyday for 90-min, for 4-weeks. -Program included PA, snack and supervised non-structured play.	Matvienko, et al. 2010 [37]	Quasi-Experimental TX: n = 42 CNT: n = 28 K and 1st grade children	-Significant improvements for some fitness (ex. Push-ups (p < 0.001)) and all motor skill tests at 4 weeks (p < 0.001), however at the 4-month follow-up these improvements were no longer different between the TX and CNT group.
16.	GEMS (Girls’ health Enrichment Multi-site Studies)	Social Cognitive Theory	-Delivered everyday for two hours, for 2-years. -Program consisted of teaching traditional and current dance, and strategies for reducing screen time.	Robinson, et al. 2010 [38]	RCT TX: n = 134 CNT: n = 127 age = 9.4 years	-No change for BMI in TX group, but reported significant improvements in cholesterol (p < 0.001), LDL (p < 0.001), and depressive symptoms (p < 0.02).
17.	SNAP (Scouting Nutrition & Activity Program)	Social Cognitive Theory	-Delivered eight 60-90 minute sessions over four months. -Program consisted of: (1) An educational curriculum delivered by troop leaders; (2) Troop meeting policies; and (3) Badge assignments completed at home.	Rosenkranz, et al. 2010 [39]	RCT TX: n = 33 CNT: n = 39 age = 10.6 years	-Intervention troops significantly increased PA (p < 0.001) but no change for control troops. -No significant intervention effect on girl’s BMI z-scores, PA, fruit and vegetable consumption, or SSB consumption. -No significant intervention effect for parents FV consumption, PA, or SSB consumption.
18.	Food and Fitness Fun Education Program (FFFEP)	None stated	-Delivered weekly for 30−60 minute sessions over sixteen weeks. -Program included lessons on healthy eating and physical activity and daily physical activities were implemented.	Carson, et al. 2011 [40]	Quasi-Experimental TX: n = 1810 K-5th grade children	-Significant improvements in nutrition (p < 0.01) and PA knowledge (p < 0.01) for TX group. -Parent surveys suggested that their child and own diet and PA behaviors changes as a result of the program.
19.	LA Sprouts	None stated	-Delivered weekly for 90 minute sessions over twelve weeks. -Program included gardening, cooking and nutrition education.	Davis, et al. 2011 [41]	Quasi-Experimental TX: n = 34 CNT: n = 70 age = ~ 9.8 years	-Significant improvements for fiber (p < 0.04) and diastolic blood pressure (p < 0.04) for TX group, compared to CNT group. -For the overweight/obese sample, TX group significantly decreased BMI (p < 0.04) compared with CNT group.
20.	Bienestar & CATCH	Social Cognitive Theory	-Delivered twice weekly for 65−90 minute sessions over twelve weeks. -Program included a bi-lingual health education program, and the PA component of CATCH.	de Heer, et al. 2011 [42]	RCT TX: n = 242 CNT: n = 326 Spillover: n = 236 age = 9.2 years	-Significant improvements for BMI-% (p < 0.045), aerobic capacity (p < 0.012) and intentions to eat healthy (p < 0.046) found for ASP’s that reported higher intervention exposure.