Abstract
BackgroundChildren from racial and ethnic minority groups, low-income households, and those with overweight or obesity gain more weight during the summer than the school year. Summer day camps, which offer routine opportunities for physical activity and regular meal and snack times, have potential to mitigate excess weight gain. This randomized controlled trial was done to determine the feasibility and preliminary effectiveness of summer camp in preventing excess summer weight gain among youth from low-income households.MethodsChildren, ages 6 to 12 years, were randomized to attend 8-weeks of summer day camp (CAMP) or to experience an unstructured summer as usual (SAU) in 2017–2018. Primary feasibility outcomes included retention, engagement and completion of midsummer measures. Secondary outcomes included changes in BMIz, engagement in moderate to vigorous physical activity (MVPA) and sedentary behavior, and diet quality and energy intake from the school year to summer. Multivariable linear mixed models were used to assess group differences.ResultsNinety-four participants were randomized to CAMP (n = 46) or SAU (n = 48), of whom 93.0 and 91.6% completed end of school and end of summer assessments, respectively. While CAMP participants attended only 50% of camp days offered, on average, they lost − 0.03 BMIz units while those in SAU gained 0.07 BMIz units over the summer (b = 0.10; p = .02). Group differences in change in energy intake from the school year to summer were borderline significant, as energy intake remained relatively unchanged in CAMP participants but increased among participants in SAU (p = 0.07).ConclusionsRandomizing children to attend summer day camp or experience an unstructured summer as usual was effective in this low-income sample. Our findings support the potential for summer camps in mitigating excess summer weight gain. A larger randomized trial is needed explore efficacy, cost-effectiveness and longer-term effects of attending summer camp on weight and weight-related behaviors.Trial registrationClinicalTrials.gov Registration: NCT04085965 (09/2019, retrospective registration).
Highlights
Children from racial and ethnic minority groups, low-income households, and those with overweight or obesity gain more weight during the summer than the school year
This trial was not powered a priori to test for intervention effects on BMI-for-age z-scores (BMIz) and weight-related behaviors; to inform preliminary effectiveness of attending summer day camp, we examined group differences in BMIz, minutes of moderate to vigorous physical activity (MVPA), percent time spent sedentary and diet
Reported total energy intake remained similar at baseline and midsummer in CAMP participants and increased in SAU participants. Findings from this pilot randomized controlled trial suggest that when children from low-income households are randomized to attend summer day camp or to experience an unstructured summer as usual, they adhere to their randomization assignment
Summary
Children from racial and ethnic minority groups, low-income households, and those with overweight or obesity gain more weight during the summer than the school year. Summer day camps, which offer routine opportunities for physical activity and regular meal and snack times, have potential to mitigate excess weight gain. This randomized controlled trial was done to determine the feasibility and preliminary effectiveness of summer camp in preventing excess summer weight gain among youth from low-income households. The prevalence of obesity is nearly twice as high in children from low-income versus higher income households (18.9% vs 10.9%) [1] These disparities often persist through the life course as youth with overweight or obesity are more likely to have adult obesity and are at increased risk for developing diabetes and cardiovascular disease risk factors [2,3,4]. New evidence suggests that this might be because school-based interventions neglect the critical period of summer
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