Shape NC Evaluation Report: Final Report

Shape NC is a technical assistance (TA) model used in childcare settings to improve health and nutrition practices, increase physical activity, and engage children and childcare providers in healthy lifestyle activities. Through the model, the Shape NC coaches partner with subgrantees (TA providers) to serve childcare sites in four counties in North Carolina: Randolph, Durham, Wake, and Wilson. Shape NC integrates tools and best practices from three programs:

1. Be Active Kids (BAK)
2. Nutrition and Physical Activity Self-Assessment for Child Care (Go NAP SACC)
3. Preventing Obesity by Design (POD).

Study Goals

The purpose of the evaluation is to assess the impact of Shape NC TA model on childcare sites and the children enrolled in these sites in four counties in North Carolina.

Research Questions

The research questions were:

• What is the impact of Shape NC TA model on the number of health and nutrition best practices implemented in participating childcare sites receiving 1 or 2 years of treatment relative to comparison sites?
• What is the impact of Shape NC TA model on attitudes of participating children toward healthy eating and physical activity relative to children in comparison sites?
• What is the impact of Shape NC TA model on the percentage of participating children at a healthy weight as measured by child body mass index (BMI) status relative to children in comparison sites?

Findings

The evaluation found key findings for children at three weight categories:

• Obese category at baseline:
  • After 1 year of treatment, the average BMI percentile decreased significantly (from 20.0 at baseline to 19.3) (p < 0.01). Among children in this dosage group (n=116), 27 percent (31 children) moved to the overweight category and 7 percent (9 children) moved to the healthy weight category.
  • After 2 years of treatment, the average BMI percentile decreased among the 20 children who were obese at baseline (from 20.3 at baseline to 19.6). However, the decline was not statistically significant (p > 0.05). Additionally, 15 percent (3 children) moved to the overweight category and 25 percent (5 children) moved to the healthy weight category.
  • Among the 104 children in the obese category in the comparison group, the average BMI percentile decreased significantly at follow up (from 20.1 at baseline to 19.4) (p < 0.01). Data showed that 26 percent (27 children) moved to the overweight category and 8 percent (8 children) moved to the healthy weight category.
• Overweight category at baseline:
  • After 1 year of treatment, there were statistically significant decreases in the average BMI percentile (from 17.7 at baseline to 17.3) (p < 0.01). That is, among the 134 children in the overweight category at baseline, 40 percent (54 children) moved to the healthy weight category.
  • After 2 years of treatment, the average BMI percentile among children in this dosage group (28 children) decreased significantly from 18.1 to 17.5 (p=0.04). Three percent (9 children) moved to the healthy weight category.
  • Among the 129 children in the comparison group, the average BMI percentile decreased significantly from 17.7 at baseline to 17.2 at follow-up (p < 0.01). Data showed that 49 percent (64 children) moved to the healthy weight category at follow up.
• Underweight category at baseline:
  • After 1 year of treatment, there were significant increases in the average BMI percentile for 38 children in this category from 13.5 at baseline to 13.9 (p < 0.01). Among the 38 children in the underweight category at baseline, 39 percent (17 children) moved to the healthy weight category at follow up.
  • Among the 7 children that received 2 years of treatment, the average BMI decreased from 14.0 at baseline to 14.1 after 2 years of treatment. However, the change was not statistically significant (p > 0.05). Additionally, three children moved to the healthy weight category.
  • Among the 37 children in the comparison group, the average BMI percentile increased statistically significantly from 13.5 at baseline to 14.3 at follow-up (p < 0.01). Data showed that 46 percent (17 children) moved to the healthy weight category.

For more information, download the full report and brief.