Nationally, 71.3% of middle schoolers do not meet physical activity recommendations [1]. Low levels of physical activity have contributed to increased rates of poor health, chronic disease, and obesity [2]. Obesity rates among youth have risen by nearly 7% in the last 20 years [3]. In 2018, over 1 in 5 youth (21.2%) were obese. Racial and ethnic minority youth are disproportionately affected by weight status. In 2017, it was reported that 37.7% of Black youth and 38.8% of Hispanic youth were overweight or obese, whereas 27.7% of White youth were overweight or obese [1]. Similarly, concerning trends are seen in physical activity rates. Physical activity rates have decreased by 5.5% among adolescents in the last 8 years alone, with only 21.1% of Black youth, 20.9% of Hispanic youth, and 25.6% of White youth engaging in at least 1 hour of moderate to vigorous physical activity (MVPA) per day in 2019 [4].

Evidence suggests that sports participation is associated with increased physical activity [5,6]. Therefore, playing sports outside of school hours is a promising strategy for physical activity interventions. However, sports participation differs by race, ethnicity, gender, and socioeconomic status [7,8]. Racial and ethnic minority students, as well as those who are socioeconomically disadvantaged, have lower rates of participation in sports [7]. Adolescent girls also participate less in sports teams than adolescent boys [8]. To increase participation, middle schoolers recommend that programming should incorporate a variety of sports in noncompetitive environments [9].

A barrier to sports participation is lacking the skills to be able to have fun and enjoy playing sports [10]. The “motivation, confidence, physical competence, knowledge, and understanding to value and take responsibility for engagement in physical activities for life” are determinants of physical literacy [11]. Physical literacy is increasingly recognized as a core construct in physical activity interventions and sports programming [12-14]. Overall, children have low levels of physical literacy, with 85% demonstrating inadequate levels [15]. Little is known about the relationship between physical literacy and long-term health outcomes, but emerging evidence suggests that physical literacy is related to physical activity levels and other health outcomes [16]. Although there has been a robust scientific conversation around the concept of physical literacy, more research is needed to explore relationships among physical literacy, physical activity, and health outcomes [17].

Sport sampling interventions may be a potential mechanism for increasing physical activity and physical literacy among youth. However, to date, a school-based, culturally tailored, participant-informed sport sampling intervention has not been evaluated for effectiveness. Therefore, the purpose of this study was to examine the effectiveness of an after-school, culturally tailored, participant-informed sport sampling program on physical activity, physical literacy, and BMI among underserved racial and ethnic minority youth in the Midwest.

Of the 179 intervention youths that initially consented to participating in this study, 42 were excluded, and 56 were lost to follow-up, resulting in 81 intervention youths being included in the analyses. Of the 50 control youths that initially consented to participating in this study, 15 were lost to follow-up, resulting in 35 control youths being included in the analyses (Figure 1).

Table 2 presents demographic information on the intervention and control participants. In the intervention group, participants were aged 13.4 (SD 1.0) years and distributed among the sixth (31/81, 38%), seventh (26/81, 32%), and eighth (24/81, 30%) grades. Further, 64.2% (52/81) reported being male, 76.5% (62/81) reported being African American or Black, 15% (12/81) reported being Hispanic or Latinx, and 19% (15/81) reported being White. In the control group, participants were aged 13.8 (SD 0.97) years, and more participants were in the eighth grade, with 11% (4/35), 31% (11/35), and 57% (20/35) in grades 6, 7, and 8, respectively. Moreover, 49% (17/35) reported being male, 51% (18/35) reported being African American or Black, 9% (3/35) reported being Hispanic or Latinx, and 11% (4/35) reported being White.

Chi-square difference tests were conducted for all categorial variables to understand if there was a difference in demographic variables between the intervention and control groups. There were no significant differences among demographic variables between groups.

Table 3 presents differences in BMIs, physical literacy, and accelerometry-measured physical activity between the intervention and control groups. The mean BMI was 23.37 (SD 5.91) kg/m² for intervention participants and 25.19 (SD 7.10) kg/m² for control participants. The small difference in BMIs between groups was not statistically significant (t₁₁₅=1.41; P=.90).

Physical literacy was statistically different between the intervention and control groups (t₁₁₅=7.57; P=.004). Participants in the intervention group had an average physical literacy score of 75.62 (SD 14.13), indicating a proficient ranking, while the participants in the control group had an average physical literacy score of 50.71 (SD 19.73), indicating a competent ranking. The mean difference in physical literacy between groups was 24.91 on the 100-point scale.

Minutes per week of MVPA (t₁₁₅=4.28; P=.04) and steps per day (t₁₁₅=4.29; P=.03) were statistically different between groups. On average, participants in the intervention group engaged in 107.01 (SD 34.94) minutes of MVPA per week and 10,847.11 (SD 3758.33) steps per day. Participants in the control group engaged in 53.01 (SD 11.17) minutes of MVPA per week and 5030.09 (SD 1128.24) steps per day. The mean differences between groups were 53.99 minutes of MVPA per week and 5817.01 steps per day.

The purpose of this study was to examine the potential effectiveness of an after-school sport sampling program on physical activity, physical literacy, and BMI among underserved racial and ethnic minority youth in the Midwest. Overall, intervention participants had significantly higher physical literacy scores (P=.004) and engaged in more MVPA (P=.04) and steps (P=.03) than youth in the control group after the intervention. This study aids in the understanding of physical activity for youth in a large, urban Midwest city and provides some evidence that a participant-informed, culturally tailored sport sampling intervention may be a mechanism for increasing physical activity and physical literacy among youth.

This study observed significant differences in MVPA between the intervention and control groups. This difference is consistent with past research that found that after-school programming is an effective strategy for increasing physical activity [26,27]. This study also adds important evidence on the use of sport sampling interventions to potentially reduce health inequality for Black and Hispanic youth.

Move More, Get More allowed youth to provide input on which sports they wanted to learn and practice. By incorporating youths’ preferences for which sports they want to engage in, we are potentially better able to maintain their interest in sports and physical activity. Future research should empirically examine if this participant-led approach results in maintained engagement in sports and physical activity for the long-term.

Physical literacy was significantly better in the intervention group compared to that in the control group (P=.004), indicating that a sport sampling intervention may be a good strategy for increasing physical literacy. Rajabiyan and Talebi [28] similarly found that an intervention of selected sports was effective in improving physical literacy. More broadly, a recent systematic review found that physical literacy–related interventions can be successful [29]. Evidence supports that physical literacy is associated with physical activity [17] and is believed to contribute to lifelong physical activity [16]. Future research should examine the long-term impacts of physical activity interventions on physical literacy and related health outcomes.

Unexpectedly, there was no significant difference in BMIs between youth in the intervention group and youth in the control group at posttest (P=.90). The Centers for Disease Control and Prevention recommend increasing BMI cutoff points for youth until the age of 20 years [30]. Although increases in BMI are usually indicative of poorer health behaviors, as middle school students grow and mature, increases in BMI may be an expected part of normal development. Future studies may consider alternative measures to assess body composition for this age group.

There are several strengths to this study. First, this study was conducted in an urban environment where 100% of the school districts’ students qualify for free lunches or lunches at reduced costs and schools serve predominantly racial and ethnic minority individuals. Second, this study adds to the limited research on the effectiveness of sport sampling interventions on physical literacy and physical activity. Additionally, this study assessed physical activity via accelerometry and objectively measured physical literacy and BMIs by using reliable and validated tools.

This study however relies on a posttest-only design that may contribute to type 2 error. A posttest-only design is one way to assess differences among groups while also delivering a needed intervention for underserved populations. Although not ideal, several physical activity studies have used a posttest-only design to increase the external reliability of real-world interventions [31-33].

Over 10 million youths participate annually in after-school programming [26]. These programs have the potential to provide a unique opportunity to help millions of youths become more active and improve MVPA. Although limited, our study and other evidence suggest that after-school sport sampling interventions are effective strategies for increasing physical literacy and physical activity among underserved racial and ethnic minority youth. Future research needs to be conducted on the best way to scale such interventions to board populations of youth to improve physical activity, physical literacy, and health equity.