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Background: Out of school hours care (OSHC) is the second largest childcare setting in Australia. In OSHC, the types of foods and beverages offered, physical activity levels, and policy environments are relatively unknown. This thesis aimed to a) describe the current healthy eating and physical activity environments, b) examine the environmental factors associated with meeting dietary guidelines, c) investigate environmental factors associated with children achieving at least 30 minutes of moderate- to vigorous-intensity physical activity (MVPA), and d) examine how healthy eating and physical activity (HEPA) policies were associated with staff practices and child physical activity. Methods: A cross-sectional, observation study was conducted to explore the HEPA environments within a sample of 89 OSHC services across two local health districts within New South Wales (NSW). Direct observation was used to document the food and beverages offered, kitchen facilities and weekly food menus. HEPA promotion and program practices were systematically captured using the System for Observing Staff Promotion of Physical Activity and Nutrition (SOSPAN). HEPA policy environments were explored using the Healthy Afterschool Activity and Nutrition Document (HAAND) tool. Physical activity and sedentary behaviours were assessed within 3,614 children using Actigraph accelerometers. Chi square/Fisher’s exact tests were used to test the associations between setting-level factors and providing foods aligning with the Australian Dietary Guidelines and the relationship between healthy eating policy elements and staff promotion practices. ANCOVA with Bonferroni adjustments tested the associations between physical activity policy scores and child activity levels. A mixed effects logistic regression evaluated the association between program practices and children’s achieving 30 minutes of MVPA. Results: Fruit and water were the most frequently offered food and beverages observed of the two observ