1. Knopf, John A. MPH
  2. Hahn, Robert A. PhD, MPH
  3. Proia, Krista K. MPH
  4. Truman, Benedict I. MD, MPH
  5. Johnson, Robert L. MD
  6. Muntaner, Carles MD
  7. Fielding, Jonathan E. MD, MA, MPH, MBA
  8. Jones, Camara Phyllis MD, PhD, MPH
  9. Fullilove, Mindy T. MD, MS
  10. Hunt, Pete C. MPH
  11. Qu, Shuli MPH
  12. Chattopadhyay, Sajal K. PhD
  13. Milstein, Bobby PhD, MPH
  14. the Community Preventive Services Task Force


Context: Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education.


Objective: This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity.


Design: Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985-2003) was supplemented with a Community Guide update (search period 2003-2011).


Main Outcome Measure: Standardized mean difference.


Results: Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes.


Conclusions: OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs.