A cross-sectional online survey was conducted from June to August 2020. Ethical approval was provided by the University’s institution ethics board (no. 202898).
A 150-item purpose-designed survey instrument was developed (supplementary file 2) which collected:
Location (state), average daily attendance, and the care sessions provided (before-school, after-school). Socioeconomic status was determined from postcode, based upon Australian Bureau of Statistics’ Socio-Economic Indexes for Areas (SEIFA)(16).
Activities offered and typical duration of the activities were captured using a items developed in a previous OSHC study(9) Participants were invited to report the availability of various activities in three domains: general (9 items – e.g. lego, role play), screen-based activities (7 items - e.g. TV/DVD viewing) and physical activities (7 items – e.g. outdoor play, sports equipment). For each activity, participants were asked if the activity was offered daily, if so, they then reported the time if was offered in 15-minute increments. The survey items were intentionally ordered to capture general activities first, and then ST and PA, to reduce the emphasis on PA and ST, to minimise social desirability bias(17). The scheduling tool has been validated relative to directly observed PA (r=0.41) and ST (r=0.73)(18).
The OSHC-sector PA and ST guidelines (supplementary file 1) and elaboration document(15) were presented to participants, and participants’ perceptions were explored through 16 items. The first question was open-ended and invited overall feedback on the guidelines and elaboration document. Likert items were used to obtain feedback on the durations of PA and ST recommendations for before-school care, after-school care and vacation care, with the response options “too high”, "just right" or "too low". Additional comments regarding the duration and wording of the PA and ST recommendations were captured using open-ended items. Two items explored OSHC directors' confidence to implement the PA and ST guidelines using a 5-point Likert scale (1: not at all confident – 5: extremely confident).
The importance of potential barriers (e.g. behaviour management issues, workplace culture, children's attitudes) and enablers (e.g. staff training, workplace policy and staff knowledge) to guideline uptake were ranked (using based on factors identified from the Delphi study(15)). Open-ended items allowed participants to suggest additional barriers and enablers.
All OSHC directors in any metropolitan, rural or remote location in both public and private settings were eligible. A list of email addresses for all Australian OSHC service was obtained from the Australian Children’s Education and Care Quality Authority (ACECQA) website. The survey was open for 4 weeks, with weekly email invitation reminders. In addition, the survey was distributed to members of National Outside School Hours Services Alliance (NOSHSA) - the peak Australian OSHC body, and it was posted on OSHC specific Facebook® groups (OSHC/OOSH Network, OSHC Educators, OOSH Connect and Community Childcare Association). A $100 random prize draw was offered for survey participation.
All responses were downloaded into SPSS(19). Demographic and scheduling data were analysed descriptively. Non-responder bias was examined by comparing responders' and non-responders' SEIFA and state using chi-square.
To calculate the total amount of time scheduled for PA and ST in each OSHC service during before and/or after-school care sessions, the total number of 15-minute timeslots offering any PA or recreational ST, respectively, were summed.
ANOVA was used to determine whether the amount of time scheduled for PA varied by SES and state (normal distribution), whilst Kruskal-Wallis was used to examine whether ST practices varied by SES or state (because data were skewed data). In each case, two models were run: one for before-school and one for after-school care.
The PA and ST duration data were then used to calculate whether each OSHC service met each component of the guidelines, i.e. before-school PA scheduled opportunity ≥45 minutes; before-school ST scheduled opportunity ≤ 30 minutes; after-school PA scheduled opportunity ≥90 minutes; after-school ST scheduled opportunity ≤60 minutes. From this, the percentage of OSHC services meeting all four guideline components was calculated. ANOVA with Tukey Post Hoc testing was used to determine whether the number of guidelines components met varied according to state and SES tertile. For all statistical analyses, significance was set at p<0.05.
Free text responses to open-ended questions were compiled and categorised into naturally emerging themes by the first author (RV) and cross-checked by the senior author (CM).