TITLE: An evaluation of Georgia?s SHAPE policy to prevent childhood obesity The prevalence of being obese or overweight has been on the rise in the United States over the last four decades, reaching 30% in the state of Georgia. Childhood obesity is one of the biggest concerns in this epidemic, which is associated with a variety of poor health outcomes, lost productivity, and staggering healthcare costs. In response, many states have enacted policies to increase physical activity at schools and Georgia is no exception with the passage of the SHAPE policy, a statewide comprehensive policy that combines physical activity requirements, assessment, and support for all public elementary schools. To date, there have been very few evaluations of statewide obesity prevention policies, particularly around barriers and facilitators to successful implementation. Building from the long-standing relationship we have with Georgia?s Department of Public Health, in this study we have a unique opportunity to prospectively evaluate the implementation of the SHAPE policy and its related activities to promote increased physical activity in Georgia?s schools. Our goals in this study are to 1) answer key process evaluation questions related to the implementation of the SHAPE policy and 2) answer key impact evaluation questions related to the outcomes of the SHAPE policy in schools, achieved through three specific aims.
The first aim i s to assess parental awareness, attitudes, and activities associated with the SHAPE policy. The key steps will be the development and administration of a cross-sectional survey of parents with elementary school-aged children about the SHAPE policy in the state of Georgia.
The second aim i s to assess school implementation and costs of the SHAPE policy. An already developed and piloted school interview and observation survey will be administered to a subset of Georgia elementary schools to provide process evaluation information on school context, reach, implementation as intended, and facilitators and barriers to implementation. Additionally, a survey sent to all public elementary schools in the state of Georgia at baseline and at follow-up will provide an analysis of school-level changes in physical activity policies, activities, and available resources for the prevention of childhood obesity.
The third aim i s to assess what variables impact school implementation of the SHAPE policy and how that implementation impacts school-level obesity and fitness levels. First, school-level variables will be connected to the survey data collected from all public elementary schools in the state of Georgia to determine successful school implementation. Second, successful implementation of the SHAPE policy will be connected to information collected from all schools from annual physical fitness assessments. Ultimately, the results of these analyses will provide information to policymakers at the state, public-private partners supporting implementation, and other states interested in implementation of a similar policy initiative to combat childhood obesity.

Public Health Relevance

Childhood obesity is a costly epidemic resulting in many long-term health problems. Georgia has implemented a statewide comprehensive policy to address this important public health concern. In this study, we fill a critical need in the field by evaluating this policy to assess awareness, implementation and costs, and impacts on school-level obesity and physical fitness levels. This evaluation will inform other states considering similar policies.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
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Dissemination and Implementation Research in Health Study Section (DIRH)
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Esposito, Layla E
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University of Georgia
Public Health & Prev Medicine
Schools of Public Health
United States
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