Impact of Free Summer Day Camp on Physical Activity Behaviors and Screentime of Elementary-age Children from Low-Income Households: A Randomized Clinical Trial.

Background: To examine the efficacy of providing free summer day camp (SDC) to children from low-income families on changes in physical activity, time spent sedentary, and screentime. Methods: Across three summers (2021-2023), we randomized 422 children (8.2±1.5yrs, 48% female, 51% Black, 69% at or below 200% Federal Poverty Level, 30% food insecure) from seven elementary schools to one of two conditions: summer as usual (control, n=199) or free SDC for 8-10wks (intervention, n=223). Accelerometry measured activity (moderate-to-vigorous PA [MVPA] and time spent sedentary) and parent daily report of screentime were measured using a 14-day in April/May (school) and July (summer). Intent-to-treat analysis examined changes in behaviors between school and summer. Exposure models examined differences in behaviors during summer on days when children attended vs. did not attend a SDC in both intervention and control children. Results: Intent-to-treat models indicated in the summer children in the intervention group accumulated +15.0mins/day (95CI 12.0 to 18.0) more MVPA and spent -29.7mins/day (-37.7 to -21.8) less time sedentary and -14.1 mins/day (-23.9 to -4.3) on screens, compared to children in the control group. Exposure models indicated, on days children attended SDCs, they accumulated more MVPA (+26.1mins/day, 22.5 to 29.7), and spent less time sedentary (-63.5mins/day, -72.9 to -54.1) and on screens (-9.5mins/day, -20.1 to 1.2), compared to days when children did not attend SDC. Conclusions: Policies targeting upstream structural factors, such as universal access to existing community SDCs during summer, could lead to improvements in health behaviors among children from low-income households. Clinical Trialsgov: NCT04072549.