Abstract Body: Background
Engagement in afterschool programing (ASP) is associated with improved health behaviors and cardiorespiratory fitness, therefore increasing access to existing ASP may hold promise as an intervention for reducing CV risk in children.

Research Question
Is existing community-based ASP a feasible intervention for reducing childhood CV risk?

Goals/Aims
Our aim was to assess the feasibility of recruiting children with elevated CV risk, providing free ASP as an intervention, and collecting measures related to CV risk onsite during the programs.

Methods
In a metropolitan area of the Southeastern US, potentially eligible children were invited by mailed flyer to participate in Afterschool Rx, a single-group feasibility study. Children were eligible if CV risk factors were identified via EMR (January-June 2023;overweight/obesity [OWOB], and/or elevated systolic and diastolic BP). Children had to attend an elementary school providing transportation to a participating ASP. Participants were provided with 17-weeks of free ASP in Spring 2024. Height, weight, body composition (BIA), and carotid femoral PWV were measured onsite at the beginning and end of the program. Descriptive feasibility data is presented.

Results From EMR records, 7,265 children were eligible. Of those, 2,239 lived in a zip code with a participating ASP and 1,787 were randomly selected to receive mailed recruitment flyers. Flyer QR codes were scanned 222 times (10% engagement), 74 families consented to participate (33% conversion), of which 32 children attended schools with participating ASP. Across 5 ASPs, 22 spots were initially available, though 5 families dropped out of the study prior to registration and 5 were unable to register due to capacity limitations at ASPs. At baseline, the 12 enrolled children had a mean age of 10 (SD 1.24; range 8-13), 58% (n=7) were female, and 42% (n=5) were non-Hispanic Black. Six children had OWOB with normal BP, one had normal weight and elevated BP, 5 had OWOB and elevated BP. Height, weight, body composition, and BP measures were taken for 92% (n=11) at pre and post, while PWV was captured for 10 (83%).

Conclusion
Afterschool Rx was successful in recruiting children with elevated CV risk, providing free ASP, and collecting measures onsite at ASP. Difficulties with ASP enrollment was identified an intervention transition point that could be improved. Overall community-based prescription for ASPs is feasible and well-suited for additional development and testing.