Join the Collaborative for Advancing Healthy Experiences in Out-of-School Time (CAHE-OST) on May 21 at 2pm Eastern for an interactive training session designed for out-of-school time (OST) professionals to explore how meaningful partnerships can strengthen program capacity, support sustainable programming, and unlock new funding streams. Through a real-world case study, the Illinois Afterschool Network (IAN) and Bright Promises Foundation will share how their collaboration evolved, the distinct roles each organization plays, and how aligning strengths led to expanded impact. Learn how to build partnerships by focusing on alignment, shared purpose, and what works best for your program and the young people you serve! 

Register Today!

Out-of-school time (OST) programs serve over 7 million youth — an estimated 3 million may have chronic health conditions. Join the Collaborative for Health Equity in Out-of-School Time (CAHE-OST) on Thursday, April 30 from 2 to 3 p.m. Eastern for their upcoming webinar, Prepared & Empowered: Action Planning for Chronic Health Conditions in OST. Learn more and register today.

Out-of-school time (OST) programs play a vital role in supporting the health, safety, and belonging of young people. With over 7 million youth enrolled in OST programs it is estimated that 3 million may have a chronic health condition. OST providers are increasingly called upon to ensure that youth with chronic health conditions, including asthma, diabetes, allergies, and seizure disorders, can fully and safely participate in programs.

The Collaborative for Advancing Healthy Experiences in OST’s (CAHE-OST) new resource, Supporting Youth with Chronic Health Conditions in OST Strategy Guide, elevates strategies to support this work — from creating safe environments, to planning for preparedness, and communicating with key partners. CAHE-OST hosted a companion webinar (see recording on YouTube) featuring guest presenter Heidi Milby with the National Association of Chronic Disease Directors to highlight these best practices. Heidi kicked off the discussion sharing 5 key questions to consider when supporting youth with chronic conditions in an OST setting:

• What does the child and family want/need?
• How can staff/providers be involved?
• What information can be collected and regularly shared?
• What do you do in an emergency?
• What policies or protocols are in place (or can be put into place)?

Additional strategies identified in the resource and webinar that make a difference are highlighted below. Be sure to explore the guide and review the webinar to go more in-depth with practical examples with each! 

Create Safe, Healthy, and Responsive OST Environments

• Invest in staff training: Ongoing professional development equips staff with the knowledge and confidence to recognize symptoms, respond to emergencies, and support daily management of chronic conditions.

• Design inclusive, flexible activities: Universal design approaches, such as offering flexible participation options and planning inclusive activities, help normalize accommodations and reduce stigma. Meeting youth “where they are” and ensuring they can safely engage in physical and enrichment activities supports both belonging and well-being.

Build a Network of Care through Collaboration 

• Build strong relationships with families: Trusting relationships are foundational. When families are respected and supported, they are more likely to share important health information and collaborate on care plans. Proactive outreach and strengths-based conversations help normalize discussions about health needs.

• Strengthen coordination across systems: Collaboration with school nurses, wellness councils, special education teams, and medical providers strengthens continuity of care. Establishing communication systems and shared leadership structures helps ensure everyone understands their roles in supporting youth. This begins with proactive relationship building and intentional communication in preferred formats.

Communicate Clearly and Consistently

• Create clear plans and systems: Clear policies, individualized action plans, and established emergency protocols reduce uncertainty and increase staff confidence. Programs benefit from tools such as asthma, allergy, diabetes, and seizure action plans, along with accessible health infographics and guides.

• Protect privacy and respect consent: Balancing information-sharing with confidentiality is essential. Programs that clearly communicate how health information will be used, and obtain appropriate consent, build trust while safeguarding youth dignity and privacy. Tools like dual consent forms and memorandums of understanding can streamline communication between programs and providers.

OST programs are uniquely positioned to promote whole child health and wellness. By creating safe spaces, building strong relationships, and coordinating across home, school, and healthcare settings, programs can ensure that youth with chronic health conditions are healthy, safe, supported, challenged, and engaged. For individualized program support and resources for your OST program, reach out directly to CAHE-OST at healthyOST@edc.org. 

The Collaborative for Advancing Healthy Experiences in OST (CAHE-OST), a partnership between the National AfterSchool Association and the Education Development Center, is spotlighting success stories from the field to uplift the impactful work that out-of-school time professionals are leading across the nation to support the health and wellness for young people and their staff.

Marshelle Watkins-Blackwell is a Family Resource Center Director, serving grades 3-6 in a Kentucky school. Out-of-school time, in addition to being a key component of her work, is her passion.

Marshelle observed that at her school, standardized test scores were trending low while students were experiencing heightened anxiety in the wake of the COVID-19 pandemic. Working primarily in inner-city schools, she was acutely aware of how standardized testing can misrepresent students’ abilities and place additional pressure on young people already navigating significant challenges. Rather than viewing test outcomes as a fixed reality, Marshelle began asking what additional supports could exist beyond the school day.

For Marshelle, it became clear that “everything can’t be done during the school day.” She emphasized that out-of-school time is not supplemental, but essential and “just as pivotal as the school day when it comes to providing the academic supports and interventions that our students need.” In these OST spaces, students have greater flexibility to receive targeted support, build confidence, and engage in learning environments that reduce stress while reinforcing academic growth.

In response, Marshelle developed an engaging out-of-school time program she called Testing Boot Camp, designed to blend physical activity with academic preparation while intentionally weaving in emotional and mental health supports. The program encouraged students to move first — through simple exercises like jumping jacks, push-ups, and running in place — to help “get the wiggles out” and get the blood going before transitioning into academic strategies such as restating questions and using test-taking acronyms.

Marshelle worked alongside teachers and school leaders to bring the program to life, creating an atmosphere fueled by collaboration and enthusiasm. That collective energy translated directly to students, who were excited to participate and felt supported by the adults around them. As Marshelle reflected, “the success was measured in the enthusiasm of the teachers and the staff and the students just coming together,” rather than in metrics alone.

At the core of the Testing Boot Camp was a strengths-based approach that focused on putting energy into the solutions. While students did see measurable gains, Marshelle emphasized that the most meaningful outcome was the confidence and self-efficacy students developed. Instead of approaching tests with dread, students felt prepared, empowered, ready to give their best effort rather than feeling defeated before the test even began.

Marshelle shared that one of the most meaningful impacts of the Testing Boot Camp program was how students’ motivation and self-efficacy extended beyond test preparation and into other areas of their school experience. She observed students carrying that confidence into the classroom to build stronger academic skills, including writing more effective papers and approaching learning with greater persistence and belief in themselves.

When asked to reflect on a lesson learned, Marshelle emphasized the importance of improving school readiness by “starting as young as possible.” She explained that one of the challenges of focusing primarily on academic testing is that students who struggle on assessments are often not ready for school in the first place. In Kentucky, where preschool enrollment rates remain among the lowest, she noted that more than 70 percent of incoming kindergartners in her district were unable to pass standardized readiness assessments, pointing to a deeper, systemic gap.

Drawing from her classroom experience, Marshelle shared how students who are not school-ready are often separated from peers and placed into targeted interventions, which can quietly undermine confidence over time. “Not being ready really chips at the confidence and academic motivation of students,” she explained, noting that these early experiences can follow young people across grade levels. For Marshelle, this reality reinforces the need for greater investment in out-of-school time for preschool-aged children, as well as a shift in how readiness itself is framed. Rather than focusing narrowly on kindergarten readiness, she urged the field to think more broadly about long-term success. “We have to change the language, not kindergarten readiness, but success readiness,” she said, emphasizing that “This is where it starts, and having a good start can propel you, or it can derail you.”

In closing, Marshelle reflected on the importance of understanding one’s identity in the out-of-school time space and how that clarity shapes both practice and impact. For her, knowing what she brings as a professional has guided how she shows up for students and how she designs programs that support their growth.

“What impact do you want to leave as a professional?” she asked. “My identity may be different from someone else’s identity. My identity is really grounded in literacy and helping motivate my students’ confidence, academic behaviors…., and just really healthy habits.” For Marshelle, that self-awareness is essential. “I think it’s important as a professional to know what your identity is in this out-of-school time space,” she shared, “because it really guides your purpose and your direction.”

Marshelle’s Lessons Learned for the Field:

1. Physical activity can help students’ academic testing by increasing their confidence and self-efficacy
2. Start supporting children as early as possible to help build their success readiness
3. Your identity and impact that you want to leave as a professional in out-of-school time navigates your purpose and direction in the field

Each story in this series represents unique cases of how OST professionals enact policy, program, and practice changes in different contexts across the country. We hope you learn new ideas for your work and are inspired as much as we are! If you want your story featured in this series, submit your idea here  or contact the Collaborative at healthyOST@edc.org.

CAHE-OST is working to improve the health and well-being of youth and staff in OST programs. Click here to learn more about our work and resources for the field .

Out-of-school time (OST) programs serve over 7 million youth — an estimated 3 million may have chronic health conditions. Join the Collaborative for Health Equity in Out-of-School Time (CAHE-OST) on Thursday, April 30 from 2 to 3 p.m. Eastern for their upcoming webinar, Prepared & Empowered: Action Planning for Chronic Health Conditions in OST. Learn more and register today.

Out-of-school time (OST) programs serve over 7 million youth — an estimated 3 million may have chronic health conditions. Join the Collaborative for Health Equity in Out-of-School Time (CAHE-OST) on Thursday, April 30 from 2 to 3 p.m. Eastern for their upcoming webinar, Prepared & Empowered: Action Planning for Chronic Health Conditions in OST.

This free virtual training equips OST providers with practical tools to create effective action plans to support youth with common chronic health conditions. Learn how to increase staff confidence, strengthen emergency preparedness, and partner with youth and families to promote safety, belonging, and full participation!

By the end of the session, participants will: 

• Know how to access resources to create action plans that address common chronic health conditions youth in OST may experience.  
• Understand the benefits of including youth and families in the creation of action plans.
• Be able to create a process for creating action plans from identification to implementation. 

Register Today

Youth with chronic health conditions participate in out-of-school time (OST) programs every day, and with the right support, these environments can play a powerful role in their overall well-being. This training equips OST professionals with the knowledge and strategies needed to create safe and supportive experiences for all youth. Join the Collaborative for Advancing Health Equity in Out-of-School Time (CAHE-OST)  to build your confidence, improve collaboration, and create safer, more inclusive OST environments for all young people!

Register for the Supporting Youth with Chronic Health Conditions in OST webinar on January 29, 2026 from 2 to 3 p.m. EST to learn practical strategies for supporting youth with chronic health conditions in OST programs. Strengthen coordination, improve communication, and help every young person thrive!

Register Now!

Join the next HEPA in Action session on December 18 at 2:00 p.m. Eastern. Dive into hands-on ideas, connect with peers, and leave each session ready to make an impact. Let’s build healthier OST programs together! Learn more and register here.

Are you ready to energize your OST program? Register for HEPA in Action: Practical Solutions for OST Professionals, upcoming virtual meetings from the Collaborative for Advancing Healthy Experiences in OST (CAHE-OST). Attend one or all sessions for fast, fun, and practical conversations packed with real-world tips for healthy, active learning.

Dive into hands-on ideas, connect with peers, and leave each session ready to make an impact. Each session will take a deep dive into one of the content areas in the HEPA Standards, provide opportunities to share and learn from each other, and apply strategies to go from assessment to putting the HEPA Standards into action. Let’s build healthier OST programs together.

Register Now!

All sessions will be from 11am-PT/2pm-ET to 12:00pm-PT/3:00pm-ET:

• October 16: Content and Quality Standards
• December 18: Staff Training Standards
• February 19: Social Support Standards
• April 16: Program Support Standards & Environmental Supports

Free for all OST professionals, thanks to CDC support! Join to connect with peers, sharpen your HEPA skills, and get expert advice for your unique program in these flexible, drop-in sessions. Contact the Collaborative for Healthy Experiences in OST at healthyost@edc.org if you have any questions.

On September 30 from 2:00 to 3:00 p.m. Eastern, the Collaborative for Advancing Healthy Experiences in OST (CAHE-OST) will host a meet-up for out-of-school time professionals interested in promoting wellness for themselves, their colleagues, and the young people and families served by their programs.

Learn more and register today!

On September 30 from 2:00 to 3:00 p.m. Eastern, the Collaborative for Advancing Healthy Experiences in OST (CAHE-OST) will host a meet-up for out-of-school time professionals interested in promoting wellness for themselves, their colleagues, and the young people and families served by their programs.

Register Today!

Join OST professionals for an energizing virtual meet-up designed to help you recharge, reflect, and refocus. Together, we’ll exchange fresh ideas and challenge ourselves to make space for personal wellness – while also exploring fun, practical activities you can bring back to your OST program and staff.

Our goal for this time together is to spark inspiration and equip you with a growing “wellness toolbox” full of short, simple strategies you can use both in your own life and in your work with young people. Click through to register today!

According to the CDC, over 40% of U.S. school-aged children and adolescents have at least one chronic health condition, including asthma, obesity, and behavior/learning challenges. Additionally, approximately 7.7 million U.S. children participate in out-of-school-time (OST) programs. From these figures, it's reasonable to estimate that around 3 million youth with chronic conditions are participating in OST programs. The magnitude of this number represents the challenge for OST programs in ensuring safety through daily management and addressing potential emergencies, but also provides a huge opportunity to support youth in building skills and habits for lifelong health. 

Best Practices

• Establish a system to identify youth with chronic health conditions.
• Coordinate with school administrators, school nurses, or other health providers to create plans with actionable steps to support youth.
• Provide staff training and encourage staff to learn about identifying chronic conditions and best practices to ensure a safe and supportive environment for all participants.
• Involve youth in planning! Let youth share what they need and how they want to be supported. Invite them to participate in setting accommodations and routines.
• Empower families to be advocates through education, communication, and intentional support.

Learn more about these best practices with the following resources:

• Supporting Students with Chronic Health Conditions in School-Based Out of School Time Programs, CDC
• Engaging Families in Out-of-School Time Programs Toolkit, BOSTnet
• Chronic Health Conditions Toolkit: A Resource for Non-Medical Staff in Schools, Tennessee Department of Education

Supporting Families to be Advocates

OST programs can be a much-needed source of support for parents, caregivers, and families by empowering them to advocate for their youth including:

• Providing opportunities to share with staff about how they would like to see their youth’s health needs addressed, making them aware of any known health triggers, and what they can do proactively manage their child’s health conditions.
• Helping parents understand and complete intake, consent, medication administration (if needed), and other forms.
• Clearly explaining how policies or protocols are different during OST activities versus during the school day.
• Creating effective communication pathways and collaboration between parents, schools, and medical providers.

Improving Communication

One of the ways to improve and increase communication between families, schools, and medical providers is through shared consent forms (giving permission for providers to share information with each other related to the child’s health condition, how to best support them, and how to respond in emergencies). A new tool co-created by the American Academy of Pediatrics (AAP) and the National Association of School Nurses (NASN) includes an information-sharing consent form template and Implementation Toolkit that can be adapted for use by OST programs.

The template is designed to facilitate communication between schools and the primary medical home and can be used by OST programs as well. OST programs can use this template to make communication about a child’s health conditions flow more seamlessly between the program, school and/or medical providers and reduce the communication burden on parents.

The Implementation Toolkit is packed with resources including commonly asked questions, a planning and implementation checklist, environmental scan, information about privacy laws and scripted language that can be adapted for use with families in OST settings to explain the consent process to them and how and why you are asking them to share their child’s medical information so that you can plan how to best support their child.

Getting started

• Learn more about managing chronic conditions in OST by watching the webinar: Leveraging OST and School Partnerships for Youth with Chronic Health Conditions from the Collaborative for Advancing Healthy Experiences in Out-Of-School Time (CAHE-OST).
• Explore the Implementation Toolkit from AAP and NASN.
• Gather a team to help review existing resources and processes and discuss what is working well and where you can make improvements. The environmental scan in the Implementation Toolkit is a great way to do this. Consider including parents, school health and wellness staff (including school nurses), local medical professionals (including pediatricians), and youth with chronic medical conditions themselves.
• Get started by choosing one thing to work towards can give you the early wins and momentum you need that lead to greater changes. Don’t let worries about time, support, or resources keep you from beginning. These can be tackled as you build more support. The important thing is to take the first step.

Reach out for help! There are many resources available to support you and your staff as you work to support youth with chronic medical conditions. Reach out anytime to:

• CAHE-OST at HealthyOST@edc.org, for trainings, resources, and individual, tailored support on a variety of topics that increase the health of OST staff and youth.
• SchoolHealth@aap.org for questions about the information-sharing consent form template, the Implementation Toolkit, or how to use these resources.

At the National AfterSchool Association (NAA), we recognize that out-of-school time (OST) professionals and organizations navigate a complex landscape while balancing funding uncertainties, policy shifts, and ongoing workforce challenges, including job quality, recruitment, and retention. As these challenges persist, NAA Affiliates and other state and local OST intermediaries continue to lead the charge in strengthening the field. Through advocacy, professional development, and collaborative initiatives, these organizations act as critical on-the-ground experts, driving sustainable solutions and advancing the profession.

Our Spring 2025 issue of NAA’s bi-annual magazine, AfterSchool Today, focused on the power of local leadership and bold innovation. Dubbed the “Changemakers” issue, this edition highlights the dynamic, future-focused work of state and regional intermediaries — many of them NAA Affiliates — who are shaping the future of afterschool. Click through to read our article about the ways in which state and local organizations are developing innovative approaches to advancing the profession.

Promoting and integrating healthy eating and physical activity during out-of-school time can have a significant effect on youth, supporting both physical health and mental well-being. The benefits are substantial, including improved mood, reduced stress, and heightened self-esteem. These factors lead to better focus, enhanced academic performance, and positive classroom behavior while fostering vital social skills, teamwork, and emotional regulation. NAA’s Healthy Eating and Physical Activity (HEPA) Standards provide a clear menu of ways that you can increase your efforts to include physical activity and healthy eating in your out-of-school time program.

The Collaborative for Advancing Healthy Experiences in Out-of-School Time (CAHE-OST) has created a series of training shorts that demonstrate how programs have incorporated HEPA and what this looks like in action. These training shorts provide a view of how programs have taken on broad program and policy changes as well as tips and ideas that you can incorporate right away.

Selected CAHE-OST training shorts:

• National AfterSchool Association’s Healthy Eating and Physical Activity (HEPA) Standards Overview, Kate Goddard, CAHE-OST
• From Assessment to Action, Katilyn Falk, Erie Public Schools
• Increasing Healthy OST through FIT and the NAA’s HEPA Standards, Krista Caldwell, Early Childhood Connections in South Dakota
• Making the Healthy Choice the Easy Choice, Ashely Edmonson and Amy Moody, Let’s Go Maine

Ideas for using the CAHE-OST training shorts:

Watch them together at a staff meeting or send them to staff to watch individually and then follow up with a discussion. Suggested discussion prompts:

• What did you see in the video that we are already doing well at our site?
• What is one thing from the video that you wish we could do at our program? What would it take to make that happen?
• How can we bring youth voice and choice into implementing additional healthy eating or physical activities?
• How can we engage families in increasing health and well-being?

Use the discussion to create a plan with concrete steps. Consider some “low hanging fruit” that you can start doing right away, such as incorporating daily brain breaks as well as standards that may take a longer time to plan, gather resources, and implement. CAHE-OST has created an Assessment to Action Guide that is a helpful tool for walking through these steps.

Share them with partners and funders to increase support and resources.

Use them to identify areas for professional development. Identify HEPA standards you want to know more about and use that to plan your professional development activities. Then check out all the offerings and resources from CAHE-OST!

In addition to the highlighted training shorts, CAHE-OST has a library of webinars and videos, peer learning communities, live events and resources all created to help OST professionals increase the health and well-being of youth, families and OST staff. We also offer individual, tailored support. You can find out more about what we have to offer, how you can connect with other OST professionals to share ideas, resources and challenges, and how you can have your own program highlighted by signing up for our newsletter, visiting our webpage on NAA’s website, or reaching out to us directly at healthyOST@edc.org.

Celebrate and learn with us as the Collaborative for Advancing Healthy Experiences in OST (CAHE-OST) and the National AfterSchool Association (NAA) spotlight success stories from the field to uplift the impactful work that out-of-school time professionals are leading across the nation to support the health and wellness of young people and their staff. 

Join us on Tuesday, May 6 at 2:00 p.m. Eastern. Featured speakers include our Healthy OST Champions. Click through to read their feature stories!

• Enrique Garcia, Healthy Kids Director, United Way of El Paso County Texas
• Carla Chinavare, Executive Director of Whole Family Integration, Wayne Metro Community Action Agency in Detroit
• Krista Caldwell, School-Age Specialist, Early Childhood Connections in South Dakota

Register Today!

We hope OST professionals leave this webinar with revitalized revitalized energy, innovative ideas, and valuable resources. Join us to empower your community and make a lasting impact! 

Healthy, active kids learn better, perform better academically and experience fewer behavioral problems. But many young people are not getting the healthy food and physical activity they need each day. Out-of-school time (OST) professionals and the programs they provide are key partners in a comprehensive effort to help children grow up healthy.

During the recent event,Healthy Eating & Physical Activity Standards in Out-of-School Time: Training 101, theCollaborative for Advancing Health Equity in Out-of-School Time brought together OST professionals to hear from leaders in the field and share actionable ideas and resources to increase implementation of the standards in a way that accessible, achievable and equitable.

Key learnings:

• Studies of OST programs have demonstrated many positive outcomes for students, including: engagement in school, improved school-day attendance and fewer unexcused absences, fewer disciplinary problems and behavior problems, and improved social skills.
• OST programs are a key partner in shaping whole child health and wellness. Afterschool programs provide access to healthy foods and physical activity, safe environments that create a sense of belonging, challenging and purposeful opportunities to learn and interact with each other, increased capacity to learn and grow, and supports through positive relationships with adults and peers.
• The adoption policies to make nutritious foods and physical activity routinely available is key. Programs can implement NAA’s Healthy Eating and Physical Activity (HEPA) Standards, which comprises evidence-based strategies that improve the health and wellness outcomes of youth and staff in OST.
• The HEPA Standards translate nutrition and physical activity science into actions OST programs can take to offer healthy foods, beverages, and physical activity. The standards also address staff training, program culture, polices, program management, and environment. The standards are aspirational in nature. They are meant to be a guidepost toward which programs should work, and programs should feel free to tailor them to their specific capacity and context.

Getting started with the HEPA Standards:

• If you were not able to attend, watch a recording of the webinar .
• Check out our Assessment to Action Guide that breaks implementing the standards down into smaller, actionable pieces with guiding questions, templates and additional resources.
• Read through NAA’s HEPA Standards and share them with your team. Then complete the HEPA Self-Assessment Tool to give you an idea of what to celebrate that you are already doing well and where to start working towards improvements.
• Complete the Out-of-School Time Equity Planning Checklist to create a plan for how you can incorporate addressing health equity into your work.

Education Development Center, Inc (EDC), in partnership with the National AfterSchool Association (NAA), is leading the Collaborative for Advancing Health Equity in Out-of-School Time (CAHE-OST). Funded by the Centers for Disease Control & Prevention (CDC), CAHE-OST is working to improve the health and well-being of youth and staff in OST programs, with a focus on populations who are the most impacted by health disparities. Reach out to us at the Collaborative, healthequityost@edc.org for tailored assistance and support as you identify standards you want to work towards!

Healthy, active kids learn better, perform better academically and experience fewer behavioral problems. But many young people are not getting the healthy food and physical activity they need each day. Out-of-school time (OST) professionals and the programs they provide are key partners in a comprehensive effort to help children grow up healthy.

During the recent event, Healthy Eating & Physical Activity Standards in Out-of-School Time: Training 101, the Collaborative for Advancing Health Equity in Out-of-School Time brought together OST professionals to hear from leaders in the field and share actionable ideas and resources to increase implementation of the standards in a way that accessible, achievable and equitable.

Key learnings:

• Studies of OST programs have demonstrated many positive outcomes for students, including: engagement in school, improved school-day attendance and fewer unexcused absences, fewer disciplinary problems and behavior problems, and improved social skills.
• OST programs are a key partner in shaping whole child health and wellness. Afterschool programs provide access to healthy foods and physical activity, safe environments that create a sense of belonging, challenging and purposeful opportunities to learn and interact with each other, increased capacity to learn and grow, and supports through positive relationships with adults and peers.
• The adoption policies to make nutritious foods and physical activity routinely available is key. Programs can implement NAA’s Healthy Eating and Physical Activity (HEPA) Standards, which comprises evidence-based strategies that improve the health and wellness outcomes of youth and staff in OST.
• The HEPA Standards translate nutrition and physical activity science into actions OST programs can take to offer healthy foods, beverages, and physical activity. The standards also address staff training, program culture, polices, program management, and environment. The standards are aspirational in nature. They are meant to be a guidepost toward which programs should work, and programs should feel free to tailor them to their specific capacity and context.

Getting started with the HEPA Standards:

• If you were not able to attend, watch a recording of the webinar .
• Check out our Assessment to Action Guide that breaks implementing the standards down into smaller, actionable pieces with guiding questions, templates and additional resources.
•  Read through NAA’s HEPA Standards and share them with your team. Then complete the HEPA Self-Assessment Tool to give you an idea of what to celebrate that you are already doing well and where to start working towards improvements.
• Complete the Out-of-School Time Equity Planning Checklist to create a plan for how you can incorporate addressing health equity into your work.

Education Development Center, Inc (EDC), in partnership with the National AfterSchool Association (NAA), is leading the Collaborative for Advancing Health Equity in Out-of-School Time (CAHE-OST). Funded by the Centers for Disease Control & Prevention (CDC), CAHE-OST is working to improve the health and well-being of youth and staff in OST programs, with a focus on populations who are the most impacted by health disparities. Reach out to us at the Collaborative, healthequityost@edc.org for tailored assistance and support as you identify standards you want to work towards!

Contributed by Rebekah Stone, Therapeutic Recreation Branch Manager at Fairfax County Therapeutic Recreation Services (TRS) and 2023 NAA Next Generation of Afterschool Leaders honoree. TRS provides opportunities for individuals with disabilities so they may acquire the skills that enable them to participate in the recreation programs of their choice.

Our bodies are constantly engaging with the world around us. Whether we are aware of it or not, our senses are processing information all throughout the day. Typically, when we think about our senses, we consider our base five: sight, smell, touch, taste, and sound. As it turns out, our body has a few more senses, including our vestibular and proprioceptive senses. The vestibular sense helps us with our balance and spatial orientation. Imagine yourself riding a bike — that is your body engaging and utilizing its vestibular sense. And our proprioceptive sense gives us the ability to understand our body in relation to space and movement occurring around it. This what allows us to make a pass to our teammate in soccer without looking down at the ball.

Why does understanding our senses matter? From the moment a young person sees a yellow school bus to the moment they hear the final school bell, they are utilizing their senses to help interpret their world. Our environments have a direct effect on our senses, which influence how we think, feel, and make decisions. Creating sensory-friendly spaces in our out-of-school time programs promotes and provides a calming space for our youth, a place to decompress and process sensory information. Making simple changes to our environments can help young people feel safe and successful and know that they belong. Below are some simple ideas to create sensory-friendly and relaxing environments through and by engaging our distinct senses.

Visual: Focus on using calming colors in the space, like pastel greens, blues or purples. Create soft lighting by turning off overhead lights and use soft lamp lighting instead. There are so many lighting options, such as ocean light projectors, lava lamps, and light strips. Hang soft fabrics or a simple canopy to the wall/ceiling. It may be helpful to have an agenda clearly posted to promote rules and expectations. For activities, consider using a flashlight, a lava lamp, or artificial fish tank to promote eye tracking.

Vestibular and proprioceptive: Use wiggle pads, bean bags, soft mats, wobble stools or other flexible seating to allow and promote appropriate motion. Small trampolines, balance platforms, Bosu balls, or medicine balls may also be appropriate. Creating an obstacle course is another excellent way to incorporate both senses. Climbing over and crawling under items are great motor planning activities that integrate multiple senses.

Tactile/touch: Create simple texture panels for sensory input using cardboard panels and add mermaid fabric, zippers, pipe cleaners, felt, buttons, etc. Soft blankets, pillows, and various textured items may provide comfort and help calm and regulate individuals. Fill bins or containers with beans, beads, rice, dry pasta, sand, or water beads to receive tactile input. There is a plethora of fidget items, such as tangles, cackles, pop-its, rings, liquid timers, etc., that can be utilized to help regulate and provide tactile input.

Taste and smell: Cooking activities (non-bake or oven-bake) are an excellent way to engage with multiple senses. Cover spice labels and have youth describe the smell (sweet, sour, spicy, earthy, etc.) and/or what the smell reminds them of (e.g., vanilla may remind someone of baking cookies with a family member). This helps to promote using descriptive words and recall/memory. You may also use an aroma diffuser to emit different scents. Smells like vanilla and lavender are especially calming.

Auditory/sound: With younger children, you may sing songs or blow bubbles, both of which involve breathing techniques and engaging our diaphragm and lungs. Play “name that sound/song” and have youth identify the song and/or the number of different sounds they hear. Discriminating if a sound is near, far, high, low, loud, or soft can also increase concentration skills. To create a calmer environment, play a white noise or ambient noises on YouTube. For someone with auditory sensitivities, consider using noise-canceling headphones to help them adjust to new or different sounds and surroundings.

Sensory-friendly spaces can help youth feel safe, free to explore with their senses, and discover new techniques and tools that help them engage in the world around them—both in our afterschool programs and beyond.

Are you interested in learning how the National AfterSchool Association’s Healthy Eating and Physical Activity (HEPA) Standards can be used to support youth and staff health and well-being in out-of-school time? Join the Collaborative for Advancing Health Equity in OST (CAHE-OST) for a four-part series designed to raise awareness of the NAA HEPA Standards as well as support OST professionals with putting them into action.

Moving from Assessment to Action with the NAA HEPA Standards
This series of four virtual workshops will provide a highly engaging space for OST leaders to come together with their peers and other experts to think big and make concrete progress toward their OST wellness goals using the Collaborative for Advancing Health Equity in OST's Assessment to Action Guide: Six steps for implementing the National AfterSchool Association’s (NAA) Healthy Eating and Physical Activity (HEPA) Standards for OST, through an equity lens. 

Each session will feature opportunities to interact with tools and resources you can immediately apply and discussions with other OST professionals and Collaborative staff to identify and work through challenges or roadblocks and share successes. Between workshops, you can engage in self-paced activities that will keep you on track to identify and achieve your goals and take advantage of individualized support for you and your project.

Sessions at-a-glance (all meetings will be held from 12pm-PT/2pm-ET to 1pm-PT/3:00pm-ET):

• November 13: Getting started: Taking stock and building partnerships
• December 11: Identifying, prioritizing, and anticipating challenges to strategy adoption
• January 29: Planning for success: Creating smarter (using “SMARTIE”) action plans
• February 26: Bringing it all together: Putting plans into action and next steps for continued success

Participants are expected to attend the four virtual meetings, complete session feedback surveys, and create an action plan. A certificate of completion will be provided to all attendees.

SIGN UP HERE!

According to CDC Healthy Schools, Supporting Students with Chronic Health Conditions in School-Based OST Programs, “in the United States, more than 40% of school-aged children and adolescents have at least one chronic health condition, such as asthma, obesity, other physical conditions, and behavior/learning problems."

The Collaborative for Advancing Health Equity in Out-of-School Time (CAHE-OST) is committed to ensuring that all youth have a fair and just opportunity to be as healthy as possible. We envision an environment where all children and youth with special healthcare needs have access to the skills, resources, supports and services they need to thrive. For this to happen, coordination is key. “When students move between school-day classes and OST programs, their health needs travel with them. Coordination and communication across home, school, and OST settings provides for continuity of care. To best serve students with chronic health conditions, a multi-faceted approach involves supportive adults, including family.” ^[1]

The Collaborative recently held a webinar to bring together experts from the American Academy of Pediatrics Council on School Health, National Association of School Nurses (NASN), and Early Childhood Connections to discuss best practices to build relationships across student care teams, including the youth themselves, parents, school nurses, OST program staff, and other health care providers. Panelists included: Karen Graf, NASN; Deborah Buccino, AAP Council on School Health; Rose Ludeman, Early Childhood Connections. The following are some key takeaways:

Supporting Children with Chronic Conditions in OST Programs
Chronic conditions can impact emotional well-being, attendance, performance, and motivation. It is important to understand the challenges these students face. OST programs should partner with school nurses, families, and pediatric primary care providers (PCPs) to optimize efficiency and quality of care both for routine care and for managing emergencies as they arise.

Importance of Youth & Family Engagement
Youth and families are experts in their care and family engagement leads to improved
satisfaction, communication and health status. OST programs can build family trust by:

• Actively listening
• Honoring family’s knowledge, strengths, values and culture
• Using shared decision making
• Ensuring communication is in forms that families can easily understand.

Elements and Examples of Successful Partnership
Collaboration and communication are crucial. Team members should work to understand each other’s environment, processes, and culture; build relationships through common projects and goals and respect each other’s knowledge, skills and experiences.

Some examples for how to create successful partnerships Include:

• Involving OST staff in School Health Advisory Councils
• Including OST administrators on communications re school wellness initiatives/policies
• Inviting health services staff to coordinate and transition care to OST activities, including sharing information with appropriate parties
• Providing OST staff training in management of chronic conditions and making these trainings readily available to new staff
• Clearly communicating protocols for students with chronic conditions, especially where they differ from those during school hours.

Access the full webinar recording and a list of resources compiled specifically for this event for free!

^[1] Source: Centers for Disease Control and Prevention, Supporting Students with Chronic Health Conditions in School-Based Out of School Time Programs.

Are you interested in learning how the National AfterSchool Association’s Healthy Eating and Physical Activity (HEPA) Standards can be used to support youth and staff health and well-being in out-of-school time? Join the Collaborative for Advancing Health Equity in OST (CAHE-OST) this fall for two unique learning opportunities designed to raise awareness of the NAA HEPA Standards as well as support OST professionals with putting them into action.

Healthy Eating & Physical Activity Standards in Out-of-School Time: Training 101
Date & Time: October 23, 2024 from 2:00 - 3:30 p.m. Eastern

This free, interactive webinar will showcase how the National AfterSchool Association’s Healthy Eating and Physical Activity (HEPA) Standards can be used to support youth and staff health and well-being in out-of-school time (OST)! Hear from experts in the field and leave with actionable ideas and resources that you can implement immediately to promote healthy habits and provide access to nutritious foods and safe spaces for physical activity in OST.

REGISTER HERE!

Moving from Assessment to Action with the NAA HEPA Standards
This series of four virtual workshops will provide a highly engaging space for OST leaders to come together with their peers and other experts to think big and make concrete progress toward their OST wellness goals using the Collaborative for Advancing Health Equity in OST's Assessment to Action Guide: Six steps for implementing the National AfterSchool Association’s (NAA) Healthy Eating and Physical Activity (HEPA) Standards for OST, through an equity lens. 

Each session will feature opportunities to interact with tools and resources you can immediately apply and discussions with other OST professionals and Collaborative staff to identify and work through challenges or roadblocks and share successes. Between workshops, you can engage in self-paced activities that will keep you on track to identify and achieve your goals and take advantage of individualized support for you and your project.

Sessions at-a-glance (all meetings will be held from 12pm-PT/2pm-ET to 1pm-PT/3:00pm-ET):

• November 13: Getting started: Taking stock and building partnerships
• December 11: Identifying, prioritizing, and anticipating challenges to strategy adoption
• January 29: Planning for success: Creating smarter (using “SMARTIE”) action plans
• February 26: Bringing it all together: Putting plans into action and next steps for continued success

Participants are expected to attend the four virtual meetings, complete session feedback surveys, and create an action plan. A certificate of completion will be provided to all attendees.

SIGN UP HERE!

Join the Collaborative for Advancing Health Equity in OST for a free, interactive webinar showcasing how the National AfterSchool Association’s Healthy Eating and Physical Activity (HEPA) Standards can be used to support youth and staff health and well-being in out-of-school time (OST)! Hear from experts in the field and leave with actionable ideas and resources that you can implement immediately to promote healthy habits and provide access to nutritious foods and safe spaces for physical activity in OST.

The webinar will be held on Oct. 23 from 2 p.m. to 3:30 p.m. ET.

Click here to register!

Visit the CAHE-OST webpage to access training resources and contact CAHE-OST at healthequityOST@naaweb.org to join the mailing list so you can continue to access important resources.

Out-of-school time (OST) is an ideal environment for building protective factors, such as caring relationships, high expectations, and meaningful opportunities for contribution. These protective factors are essential to meeting the basic developmental needs felt by people of all ages for safety, love, belonging, respect, a sense of mastery, personal power, and meaning in life. When these needs are met, the negative effects of trauma, adversity, or other stressors are mitigated, and people are more likely to feel connected, develop social-emotional competency, and avoid engaging in risky behaviors. The Collaborative for Advancing Health Equity in Out-of-School Time (CAHE-OST) recently held a webinar, Promoting Lifelong Benefits for Youth Through Out-Of-School Time, featuring experts from the field sharing ideas for building protective factors in OST – highlights from the event are summarized here!

Natalie Wilkins, a Health Scientist with the CDC, kicked off the webinar by sharing that the 2021 Youth Risk Behavior Surveillance System (YRBS) showed that 61% of 9-12^th graders reported they felt close to people at school. She stated, “the good news is that is that’s over half of all high schoolers… of those students who reported they felt close to people at school, they had better outcomes across a range of outcomes including mental health and suicide related outcomes, sexual health related outcomes and behaviors, substance use related outcomes, as well as violence related outcomes.”  Unfortunately, “the bad news is almost 40% are reporting they don’t feel close to those at school, and we see disparities in the data. When we break it down, boys are reporting feeling more connected than girls. Asian youth and White youth report feeling more connected than youth of other racial and ethnic backgrounds, and heterosexual youth are reporting feeling more connected than their LGBQ+ peers. When we think about this from an equity perspective it’s really critical and important in all the connectedness promoting work we are doing within school time and out of school time that we are thinking in particular about those youth who may be experiencing disproportionate marginalization.”

So, how do we ensure our connectedness focused programming, policies, and services are really centering the needs of students who may be at higher risk for feeling disconnected? By increasing youth’s protective factors! Evidence shows^[1] that we can do this by building caring relationships, setting and communicating high expectations, creating meaningful opportunities for contribution, and providing healthy, safe and supportive environments, including nutrition programs, physical activity and inclusivity programs and policies. But all of this needs to happen with equity at the center of everything we do. As a program, ask the following questions:

• What protective factors are we already promoting?
• How do we engage and build relationships with youth, including those who experience chronic absences, exhibit challenging behavior, or  appear unengaged?
• How does our program make decisions about service and leadership roles?
• How can we become more aware of our unconscious biases?

Then move to taking action – start by assessing who is being called on, given leadership opportunities, disciplined or given favored seating or roles. Then, use that information to identify patterns that may emerge around race, gender, sexual orientation, socio-economic status. Next, support professional growth and development by identifying resources available for staff to examine their own implicit bias and how this impacts their actions, differentiate engagement based on behavioral or cognitive challenges, and increase protective factors among youth.

If you are interested in more tips, resources, and learning opportunities to ensure that all youth have a fair and just opportunity to be as healthy as possible, visit our CAHE-OST webpage to view and download all of our resources, sign up for our distribution list, and learn more about upcoming events.

Contributed by Clare Grace Jones, Collaborative for Advancing Health Equity in Out-of-School Time. (CAHE-OST).

^[1] Austin, G., Wendt, S., Klinicka, L. (2021). Promoting Protective Factors in California’s Afterschool Programs.

Join the Collaborative for Advancing Health Equity in Out-of-School Time (CAHE-OST) to jumpstart the 2024-2025 school year with a professional development opportunity for school staff and out-of-school time (OST) professionals. Their August 22 webinar is specifically designed to help you create intentional processes and partnerships to support youth with chronic health conditions. 

Click here to register.

Experts from the American Academy of Pediatrics, National Association of School Nurses, and the Collaborative for Advancing Health Equity in Out-of-School Time will share best practices and tools to tap into existing systems and supports; build relationships with student care teams, including parents, schools, and other health care providers; and coordinate more effectively to promote the health, wellness, and safety of youth. 

As a result of participating in this webinar, attendees will have:

• Increased awareness of how OST programs can partner with school health staff to support youth with chronic health conditions.
• Examples from the field for how to build relationships that enhance warm handoffs and collaboration to increase student support and safety.
• Access to tools and resources for creating processes and sharing information with the student’s care team, including schools, parents, and other health care providers.

“As a parent of a child with epilepsy and learning disabilities, I knew that it was important for my child, and for me, to have time away from each other. I desperately needed a break and he needed chances to be a normal kid but with adults around him that could support his needs and be ready to recognize when immediate medical help was required. But it was so scary for me to trust his care to other people! The staff at his afterschool program were amazing. They were open to me sharing about his condition, what to look for, and how to respond. They made it easy for me to connect his school nurse, doctors, and the program staff so they all had the information, medication, and health plans needed to make sure that he was supported and safe.”- Shared by a parent

In the United States, more than 40% of youth have at least one chronic health condition, such as asthma, obesity, other physical conditions, and behavior/learning problems. The healthcare needs of youth with chronic illness can be complex and includes both daily management and addressing potential emergencies.^[i] Proactively managing chronic health conditions in out-of-school time (OST) is not only about safety, it also provides opportunities for youth to build skills and habits for lifelong health.

The following are best practices for OST professionals, adapted from the CDC resource, Supporting Students with Chronic Health Conditions in School-Based Out of School Time Programs.

• Establish a system to identify students with chronic health conditions and understand program needs to better support a child’s health and active participation in OST programs and activities. Examples of this include asking for information on registration forms and during intake interviews.
•  Coordinate with school administrators and school nurses or other health services staff to understand protocols and practices for students with chronic health conditions. When possible, programs can establish agreements to obtain parent permission to share information between school and OST staff including individualized health plans, accommodations, and strategies for health management.
• Provide staff training to promote awareness of potential challenges and appropriate responses for routine and urgent matters for students with chronic health conditions. Identify ways to make these trainings readily available to new staff (e.g., as part of onboarding) to address potential loss of knowledge and skills with staff turnover.
• Communicate with parents about protocols and practices for students with chronic health conditions—especially if they differ from those during school hours. Parents are often the best source of information on their child’s health conditions and what can exacerbate or relieve symptoms. They are also essential partners for providing permission for information sharing between providers and can act as a liaison to share information when protocols prevent the ready exchange of information (for example if a school is unable to share an individual health plan directly the parent may request a copy from the school and share it directly with the OST program).
•  Encourage staff to learn about individual needs of students with chronic health conditions. This can happen during regular program time, during family engagement activities, drop-off and pick-up, and at other times. Each child brings their own strengths and needs and getting to know them individually, and not just as their chronic condition, builds trusting relationships and allows for individuation of support

The Collaborative for Advancing Health Equity in Out-of-School Time is focused on increasing the wellness of youth and staff in OST programs. We do this by offering webinars, communities of practice, and resources to OST professionals. This article is the first in a series of training opportunities and resources focused on management of chronic conditions in OST.

We would love to have you engage with us in the following ways:

• Email us (healthequityOST@edc.org) to join our listserv to find out about upcoming events and resources.
• Visit our webpage on the NAA website to view our previous events, resources, and training shorts.
• Reach out to us any time for individualized support and assistance.

Written by Clare Grace Jones, M.Ed., CPS

Clare Grace Jones works as a Training and Technical Assistance Associate for the Collaborative for Advancing Health Equity in Out-Of-School Time and the Children’s Safety Network at Education Development Center. She brings her many years of experience as a Community Prevention Specialist, instructional designer, and public health expert combined with her lived experience as a parent of a child with special health care needs, former military spouse, single parent and overall efforts to be a kind human raising kind humans to everything she does at work and at home.

^[i] Centers for Disease Control and Prevention. (2021, October 20). Managing chronic health conditions in schools. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyschools/chronicconditions.htm

^[ii] Sickle cell anemia: A parent’s guide for the School Age Child. Sickle Cell Anemia: A Parent’s Guide for the School Age Child | Texas DSHS. (n.d.-b). https://www.dshs.texas.gov/newborn-screening-program/sickle-cell-disease/more-about-sickle-cell/parents-guide

^[iii] Kitsantas, P., Kornides, M. L., Cantiello, J., & Wu, H. (2013, June). Chronic physical health conditions among children of different racial/ethnic backgrounds. Public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086459/