The Program Being Evaluated
This project was an extension of the Early Assessment of Promising Policies and Practices to Prevent Childhood Obesity project, which the Robert Wood Johnson Foundation (RWJF) awarded to the Centers for Disease Control and Prevention (CDC) to discover a variety of policies with the best potential to prevent childhood obesity. The project identified New York City’s regulations for licensed day-care centers as a high priority for full evaluation. New York City’s regulations designate the amount of time that children are to spend in physical activity, provide nutrition standards for foods on the premises, and place limits on television viewing.
About the Evaluation
The evaluation studied the regulations’ impact on children’s diets and levels of physical activity and the factors affecting implementation of the regulations.
The lead evaluators for this program were Laura Kettel Khan, Obesity Management Team for the Division of Nutrition, Physical Activity and Obesity for the CDC; Cathy Nonas, New York City Health Department; and Beth Dixon of New York University (NYU). The team worked with ICF Macro, who lead the study's implementation.
Summary of Methods
The project was carried out in two phases. In the first phase, the evaluation team randomly sampled 200 city day-care centers (about 12%), ranging in size from 20 to 100 children, from low-income neighborhoods of the city. The team identified the most important factors affecting implementation of the day-care regulations. One of those factors was whether the city had provided technical assistance in services for nutrition and physical activity. Although the city subjects all licensed day-care centers to inspection and citation of possible violations, the Health Department provides special technical assistance to three higher-need neighborhoods in the South Bronx, East and Central Harlem, and North and Central Brooklyn. Other neighborhoods with similar demographics have yet to receive technical assistance from the city, making the day-care centers in those neighborhoods a high-quality comparison group for understanding the effects of such assistance. Other factors affecting implementation are likely to include staff turnover, day-care center infrastructure and capacity, and the operator’s motivation to provide a healthier environment for children.
In the second phase, the evaluation team measured over two years the eating habits and physical activity levels of children attending the centers. For that phase, the evaluation team further studied 100 centers from the first-phase sample, based on the extent to which they were implementing the regulations. Centers that implemented the policy more completely were giving the children a greater “dose” of a healthy environment, thus allowing for more change in their diet and physical activity.
Products and Dissemination
Deliverables include an annual report on findings to date, as well as a final report to both RWJF and the New York City Health Department (for internal use only.)
UPDATE: On October 16, 2014, the CDC released a special issue of Preventing Chronic Disease that included the published findings from this evaluation.
RWJF and the CDC completed a two-year collaborative project to identify and assess local-level programs and policies that appear promising to improve the eating habits and physical activity levels of children.