Objectively measured physical activity in Danish after-school cares: Does sport certification matter? S. L. Domazet 1 , N. C. Møller 1 , J. T. Støckel 1 , M. Ried-Larsen 2 1 Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark, 2 Centre of Inflammation and Metabolism, Rigshospitalet, Copenhagen, Denmark Corresponding author: Mathias Ried-Larsen, Centre of Inflammation and Metabolism, Rigshospitalet, Blegdamsvej 9, Section M7641, DK-2100 Copenhagen, Denmark. Tel: +45 21 78 20 87, E-mail: mathias.ried-larsen@regionh.dk Accepted for publication 11 October 2014 Inactivity and more sedentary time predominate the daily activity level of many of today’s children. In Denmark, certified sport after-school cares have been established in order to increase children’s daily physical activity (PA) level. This cross-sectional study aimed to investigate the activity level among participants in certified sport after- school cares vs regular after-school cares. The study was carried out in 2011 in 10 after-school cares (5 sport/5 regular) throughout Denmark, whereof 475 children aged 5–11 years participated. PA level was assessed using Actigraph GT3X and GT3X+ activity monitors worn by the children for at least 8 consecutive days. Anthropom- etry and cardiorespiratory fitness were measured as well. A multivariate regression analysis was carried out to check for the differences in the PA level across the two care systems. However, there did not appear to be any differences in overall PA or in time-specific day parts (e.g., during after-school care). The activity levels were quite similar across after-school cares and were mutually high during time spent in the care facility. In the last decade, there has been a pronounced polar- ization in physical activity (PA) level among Danish children and youth, implying that active children have become even more active while an increasing amount of children has become completely inactive (Pilgaard, 2008). This has severe health implications as inactivity and sedentary time are important contributors to non- communicable diseases (Bauman et al., 2012). A pos- sible way to change this picture might be prevention of sedentary time early in life in order to facilitate a long- term engagement in an active life. Such a contention is founded in tracking studies of sedentary time (Biddle et al., 2010) and PA(Telama et al., 2014) showing a low to moderate correlation from childhood to adulthood. This has been the breeding ground for school-based interventions that have focused on increasing children’s PA in order to prevent or change current or future unde- sirable health behaviors and less favorable health profiles (Kriemler et al., 2011; Dobbins et al., 2013). A recent review on the effectiveness of after-school interventions has showed mixed results regarding the increase of chil- dren’s PA. Four out of six randomized controlled trials were able to produce increases in PA among children in the intervention group, whereas the other two were only able to demonstrate trends toward increased activity levels among African–American girls (Pate, 2009). Fur- thermore, there are a lot of culture-specific implications related to different after-school care systems, which, in general, hinder a direct comparison of after-school inter- ventions across nations. In Denmark, the certification to acquire the title sport after-school care was established in 2008. The certifica- tion is managed by the Sports Confederation of Denmark and the Danish Gymnastics and Sports Associations, who aimed to increase PA through continuing education of all pedagogical personnel, development of a move- ment policy, accessibility of sports facilities, and encour- aging play environments (Rasmussen & Bødtger, 2011; Sandholm et al., 2011). In practice, the personnel should secure a high PA level through adult-led activities that included all enrolled children. In Scandinavia, the after- school care system is quite similar across national borders and reaches nearly equal popularity in terms of attendance. In Denmark, 74% (2014f) of all children aged 6–9 years are enrolled in an after-school care, whereas the percentage rate is 73% (2014d) in Sweden and approximately 60% (2014e) in Norway, respec- tively. Due to a high attendance rate and a non-scheduled time relative to the school, it might be convenient to target the after-school care when implementing PA inter- ventions. The high attendance, furthermore, presents an opportunity to target high risk children within the age range. This study is unique in the sense that it is the first of its kind to objectively measure and compare the activity level across sport and regular after-school cares in Scand J Med Sci Sports 2014: ••: ••–•• doi: 10.1111/sms.12361 © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd 1