Childcare services that completed an Australian physical-activity program had seven times the odds of meeting activity and screen-time targets. Across all services enrolled, including those that dropped out, nothing changed.

More than 500,000 Australian children spend part of each week in outside school hours care, the before- and after-school services that bridge the gap between the school day and the working one. Previous research by the same group found that children spent around 60 per cent of their after-school care time inactive, and that the variation between services was enormous.

A study published in JAMA Network Open tested a program designed to change that, and returned two results that point in opposite directions.

Where it was completed, it worked

Among services that completed the Activated OSHC program — training staff and embedding new practices in their written policies — the effects were substantial. Those services had more than seven times the odds of meeting recommended physical activity and screen time targets before and after school. Children in before-school care at those services showed a significantly greater increase in moderate-to-vigorous physical activity, 23 per cent. Staff were three times as likely to demonstrate behaviours that promote physical activity.

The program’s design deliberately avoids putting the onus on families. “Rather than placing the responsibility entirely on children and parents, Activated OSHC focuses on the environment around children — how staff are trained, the activities on offer and the policies services have in place,” said Professor Carol Maher of Adelaide University, the study’s lead researcher.

“Every week, more than 500,000 Australian children spend time in outside school hours care, so there’s a real opportunity for children to be more active,” she said. The scale of the opportunity is set by how far short the national picture falls: roughly one in four Australian children meets recommended moderate-to-vigorous activity levels, and one in three meets screen time guidelines.

Across every service enrolled, nothing moved

The second result is the one that complicates the first, and the release states it plainly. Across all intervention services, including those that did not complete the program, there was no significant improvement in overall guideline adherence or in children’s physical activity.

The arithmetic behind that is in the uptake figures. Of the roughly 200 intervention services involved, covering about 10,000 children, 80 per cent registered for the program — but fewer than half completed all the training and policy requirements. A program that produces large effects in the half that finishes it and no effect overall is a program whose main obstacle is not its content.

This distinction matters more than it might appear, and it is worth being precise about what each number can support. The headline figures — sevenfold odds, a 23 per cent increase — describe services that completed the program. Those services selected themselves. A service with enough staff, enough stability and enough management attention to push a training-and-policy program through to accreditation is plausibly a service that was already better placed to get children moving. Some of the measured effect is the program; some of it may be whatever made completion possible.

The null result across all services is the more conservative reading, and in trial terms it is the more defensible one: it compares everyone who was offered the program against those who were not, and finds no difference. That is the figure a government deciding whether to fund a national rollout should be looking at.

Maher’s own reading

To her credit, Maher does not oversell the completers. “Making a program available is only part of the solution,” she said. “Services need the time and practical support to put those changes into practice and sustain them.”

“While fewer than half of the services completed accreditation, those that did showed meaningful improvements in staff practices, their environment and children’s activity,” she said. “The challenge now is helping more services get there.”

That framing locates the problem correctly. Outside school hours care in Australia, as in most countries, runs on thin margins with casual staff, high turnover and limited non-contact time. Asking such a service to complete staff training and rewrite its policies is asking for hours that may not exist. The finding is less about whether children can be made more active in after-school care — they evidently can — than about what it costs a service to get there.

Why the setting is a sensible target

The logic of intervening in outside school hours care is strong. Children are present for a sustained block of time, several days a week, under supervision, in a setting with equipment and space. The hours involved are ones that would otherwise often be sedentary, and the service already has a duty of care and a program of activities. Changing what that program contains is a lighter lift than changing a family’s routine.

It is also a setting where the relevant decisions are made by a small number of adults rather than by thousands of parents. That is why an environmental approach — staff training, activity offerings, written policy — is the right instrument. The study’s own uptake figures are evidence that the instrument is harder to apply than it looks.

“Our previous research showed enormous variation between services in how active children were, with children spending around 60% of their time in after-school care inactive,” Maher said. “What this study shows is that when services complete the program — by training staff and embedding healthier practices into their policies — we can create environments that better support children to be active.”

What the release does not settle

Several things are missing that would sharpen the picture. The release gives no comparison figures for the control services, no confidence intervals on the sevenfold odds ratio, and no indication of what the 23 per cent increase in moderate-to-vigorous activity means in minutes per child per session. It does not report whether the completing services differed measurably from the non-completers at baseline, which is the analysis that would test the self-selection concern directly.

There is also an oddity in the metadata: the journal listing categorises the work as a case study, which does not match a design comparing some 200 intervention services against controls across roughly 10,000 children. That is likely a classification error rather than a description of the method.

Funding came from the Australian Government’s Medical Research Future Fund and the National Health and Medical Research Council, and the authors report no conflicts of interest — a complete disclosure, which is less common than it should be. The release names only Maher, with no first or corresponding author identified, so the endnote below carries the paper title alone.

What remains is a useful and honestly reported finding: the intervention does what it claims where it is carried through, and getting it carried through is the unsolved part.

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Notes

1. “Boosting Children’s Physical Activity in Outside School Hours Care.” JAMA Network Open, 5 October 2026. DOI: 10.1001/jamanetworkopen.2026.36701.
2. Adelaide University. “Keeping kids moving beyond the school bell.” EurekAlert!, 5 October 2026. https://www.eurekalert.org/news-releases/1146594.