Author Archives: Brett Otis

STUDY: Children eat more junk food and nearly twice as many calories when bringing their own snacks to after-school programs.

An HPRC study found that children consumed more salty and sugary foods and nearly twice as many calories when they brought their own after-school snack, as compared to when they consumed only program-provided snacks.

Little is known about how after-school settings may affect children’s dietary intake. Evidence suggests that snacks provided directly by afterschool programs rarely include sugary drinks, and afterschool programs receiving federal reimbursement for snacks must adhere to basic nutrition standards, but virtually nothing is known about the quality of snacks brought into after-school programs by children, whether from vending machines, local stores, or packed from home.

By recording snacks served to and brought in by nearly 300 children in 18 Boston after-school programs on five separate days, researchers found that nonprogram snacks contained more sugary beverages and candy than program provided snacks.   Having a non-program snack was associated with significantly higher consumption of total calories compared to when a child only had a program snack to eat.

Snacking accounts for nearly 30 percent of total calorie intake for most US children aged 2 to 18 years, which makes it an important target area for improving children’s diets and potentially reducing childhood obesity. These findings suggest that after-school programs are a key setting for improving children’s snacks, and that policy strategies limiting nonprogram snacks or setting nutritional standards should be explored further as a way to promote child health.

If you represent or are interested in making your child’s after school environment healthier, check out these resources for healthy snacks and beverages, including sample menus, family newsletters, policy writing guides for a better snack time, and a fast map for eliminating sugary drinks.

Kenney EL, Austin SB, Cradock AL, Giles CM, Lee RM, Davison KK, Gortmaker SL. Identifying Sources of Children’s Consumption of Junk Food in Boston After-School Programs, April-May 2011. Prev Chronic Dis. 2014 Nov 20;11:E205.

OSNAP Launches New Interactive Online Learning Community

The OSNAP Online Learning Community brings together afterschool staff to work through the process of making practice, policy, and environmental changes in their programs.osnap online learning community

Join afterschool and out-of-school time programs from across the country to improve children’s physical activity, nutrition, and screen time habits in your program!

The interactive platform features forums for participation in online discussions, lessons, tips, and resources for making improvments to your program, as well as access to research-tested tools to evaluate your progress.

osnap online media splashTo sign up and start learning how to promote nutrition and physical activity in your out of school time program, contact OSNAP Project Manager Katie Giles at



The OSNAP Online Learning Community works best on Google Chrome or Mozilla Firefox browsers. Don’t have either of them? Download here:

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HPRC at APHA’s 2014 Meeting

APHA_2014_Annual_MeetingThis year’s November APHA meeting, “Healthography,” explores how health challenges are dictated by place.

Be sure to look for HPRC researchers at the following presentations on Monday, November 17th and Tuesday, November 18th.

Monday, 11/17: 8:30AM -10:00 AM
Effective ways of promoting healthy eating in school.

Increasing student water consumption during school meals: A group-randomized, controlled trial
Erica Kenney, ScD, MPH, Steven L. Gortmaker, PhD, Jill Carter, EdM, MA, Jennifer Reiner, BA, Caitlin Howe, MPH and Angie L. Cradock, ScD
8:50 AM – 9:10 AM

Monday, 11/17: 12:30 PM – 2:00 PM
Implementation of national nutrition standards

Evaluating the Impact of the Healthy Beverage Executive Order for City Agencies in Boston, MA
Angie L. Cradock, ScD, Erica Kenney, ScD, MPH, Anne McHugh, MS, Lisa Conley, Esq., Rebecca Mozaffarian, MS MPH, Jennifer Reiner, BA and Steven L. Gortmaker, PhD
1:30 PM – 2:00 PM

Monday, 11/17: 2:30pm – 4:00pm
Mapping Local Obesity Prevalance in the United State: Challenges and Opportunities for Surveillance and Prediction in the 21st Century

Moderator: Steven Gortmaker
Organizer: Steven Gortmaker
Discussant: Bill Dietz

Improving state childhood obesity surveillance: A review of current practice and recommendations for change
Kelly Blondin, SM, Steven Gortmaker, PhD, Angie Cradock, ScD, Stephen Resch, Ph.D., Y. Claire Wang, MD, MSc, ScD, Zachary J. Ward, MPH, Amber Hsiao, MPH and Michael W. Long, ScD

Filling in the Gaps: State-specific childhood obesity prevalence corrected for self-report bias
Michael W. Long, ScD, Zachary J. Ward, MPH, Kelly Blondin, SM, Stephen Resch, Ph.D., Angie L. Cradock, ScD, Y. Claire Wang, MD, MSc, ScD, Amber Hsiao, MPH and Steven L. Gortmaker, PhD

Redrawing the US Obesity Landscape: Bias-corrected estimates of state-specific adult obesity prevalence
Zachary J. Ward, MPH, Michael W. Long, ScD, Stephen Resch, Ph.D., Steven L. Gortmaker, PhD, Angie L. Cradock, ScD, Amber Hsiao, MPH and Y. Claire Wang, MD, MSc, ScD

Using synthetic growth trajectories to predict childhood obesity trends at the individual and population level
Stephen Resch, Ph.D., Zachary J. Ward, MPH, Michael W. Long, ScD, Jeremy Goldhaber-Fiebert, PhD, Y. Claire Wang, MD, MSc, ScD and Steven L. Gortmaker, PhD
3:30 PM – 3:50 PM

Monday, 11/17: 2:30 PM – 4:00 PM
Improving Population Health in Youth

Dissemination of the OSNAP (Out-of-School Nutrition and Physical Activity) intervention: Evidence-based strategies, low-cost resources, and partnerships for success
Rebekka M. Lee, ScD, Catherine M. Giles, MPH, Madeleine DeBlois, MEd, Erica L. Kenney, ScD, Steven Gortmaker, PhD, Jessica L. Barrett, MPH and Angie Cradock, ScD
3:30 PM – 4: 00 PM

Tuesday, 11/18: 8:30 AM – 10:00 AM
Progress in Physical Activity Policy Research

Driven to support: Individual and county-level factors associated with public support for active transportation policies
Angie L. Cradock, ScD, Jessica L. Barrett, MPH, Jamie F. Chriqui, PhD, MHS, Kelly R. Evenson, PhD, Karin Valentine Goins, MPH, Jeanette Gustat, PhD, Katie M. Heinrich, PhD, Cynthia K. Perry, PhD, FNP, Michele Scanze, MPH, Thomas L. Schmid, PhD, Rachel Tabak, PhD, M. Renée Umstattd Meyer, PhD, MCHES and Cheryl Valko, MPH, RD
9:10 AM – 9:30 AM

Tuesday, 11/18: 4:50 PM – 5:10 PM
Food policy approaches to improve health

Competitive beverage availability in Boston Public Schools after implementation of a comprehensive, district-wide nutrition policy
Rebecca Mozaffarian, MS MPH, Steven L. Gortmaker, PhD, Erica L. Kenney, ScD MPH, Jill E. Carter, EdM MA, M. Caitlin Westfall Howe, MS MPH, Jennifer Reiner, BA and Angie L. Cradock, ScD
4:50 PM – 5:10 PM

Keep it Flowing: A Practical Guide to School Drinking Water Planning, Maintenance & Repair

Keep It Flowing GuideKeep it Flowing: A Practical Guide to School Drinking Water Planning, Maintenance & Repair, addresses the practical side of drinking water in schools by outlining the steps needed to provide adequate numbers of properly maintained drinking fountains and tap water dispensers in school buildings.

It is designed for the people who make our nation’s schools run day-in and day-out, including those within state and tribal agencies and organizations, districts, school boards and local education authorities and schools.

Feedback on the guide is welcome, so please send any suggestions or questions to Angie Cradock (


HPRC study demonstrates sustainable approach to addressing overweight risk among children

Primary care is an opportune setting to contribute to obesity prevention and treatment. However, there is limited evidence for effective and sustainable interventions in primary care. The Maine Youth Overweight Collaborative (MYOC) successfully affected office systems, provider behavior, and patient experience, back in 2009.

This follow-up study by HPRC’s Dr. Steven Gortmaker and Dr. Michele Polacsek found myoc sustainable improvements in clinical decision support and family management of risk behaviors within a primary-care-based approach to addressing overweight risk among children and youth.

Polacsek M, Orr J, O’Brien LM, Rogers VW, Fanburg J, Gortmaker SL. Sustainability of key maine youth overweight collaborative improvements: a follow-up study. Child Obes. 2014 Aug;10(4):326-33.

Creating Healthy Spaces for Kids in Boston

OSNAP Banner

Interested in making your child’s after school environment healthier? See how your after-school program can sign up for OSNAP.

OSNAP works with after-school and summer programs to establish and expand healthy food, beverage physical activity and screen reduction time practices and policies. This support is provided through a series of three Learning Community training sessions. Participating programs apply what they learn in the training, work with OSNAP staff throughout the school year and network with other OST programs on successful strategies being used in Boston through the Learning Community. Additionally, they receive skill-based training on examining their own nutrition and physical activity environments, practices and policies, as well as free evidence-based curriculum and resources to support making healthy changes during their programs.

Getting Kids Excited About Food


Check out Dr. Steve Gortmaker’s Food Revolution Day guest blog on the importance of getting kids excited about healthy eating and living, and the work the HPRC is doing to create tools for change:

Getting kids excited about food and nutrition is going to be crucial to the success of a food revolution. Kids need to be interested in and excited about ways to get healthy if they’re going to maintain those habits in the long term, and they need the environments in which they spend their time to support healthier eating and more exercise.

The home is a key environment for teaching healthy habits, but it is just one of the many spaces in which children spend their time. From preschools and schools to organized sports, after-school programs, and summer camps, healthy eating and physical activity must also be integrated into the places where children learn and play—but unfortunately, this isn’t always the case…continue reading on Food Revolution Day

2014 Leaders in Health Cohort


Congratulations to the 2014 cohort for their successful completion of the Leaders in Health Community Training Program!

Specific details about these participant’s individual projects will be posted soon.

Leaders in Health works to build the capacity of our community partners by providing participants with an introduction to the fundamentals of community-based participatory research (CBPR) and nutrition, physical activity, and obesity prevention among children and youth.

Helping Kids and Communities Be Healthy and Active

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Across Massachusetts, communities are searching for ways to help residents live active and healthy lives.

The Massachusetts Joint Use Toolkit is a how-to guide for community members seeking to access public buildings and spaces afterhours so residents can exercise and engage in other recreational activities. This Toolkit helps communities maximize the use of schools, playgrounds, parks, libraries, and town halls, by offering children and their families a safe, familiar place to get fit. The Toolkit describes the process of sharing space from A to Z; it addresses location, funding, safety, and liability, and provides a Model Joint Use Agreement that communities can use to safely open unused spaces to the public.

More about the toolkit and joint use project.