Estimated duration
4 Years
Estimated total value
Northern America
United States
The North Carolina Partnership for Children, Inc. (NCPC); University of North Carolina at Chapel Hill; North Carolina State University; Be Active North Carolina, Be Active Kids; Blue Cross and Blue Shield of North Carolina; Brad Wilson

Shape NC: Healthy Starts for Young Children


In 2010, Blue Cross and Blue Shield of North Carolina (BCBSNC) Foundation committed to partner with the North Carolina Partnership for Children, Inc. (NCPC) to address childhood obesity for North Carolina’s youngest children, from birth to age five. With a focus on the child care setting, this project aimed to improve the policies and practices around physical activity and nutrition, implement active outdoor learning environments, create a resource for ongoing technical assistance, and ultimately increase the number of young children starting school at a healthy weight.


The Shape NC initiative will promote healthy weight among young children through a comprehensive, coordinated early childhood obesity prevention effort among state and local leaders. The initiative hopes to:
-Establish a state-level early childhood taskforce led by the North Carolina Institute of Medicine (NCIOM) to develop a blueprint for future policies and programs
-Establish 30 model communities that will engage diverse stakeholders to develop and implement childhood obesity action plans
-Build an infrastructure to support sustainable development of outdoor learning environments/programs
-Create a comprehensive ‘train-the-trainer’ program
-Establish 30 demonstration centers to serve as training hubs and develop integrated programming and model outdoor learning environments.
Shape NC will take place from October 2010 through September 2013. The state-level task force will complete its recommendations within 18 months, and local partnerships will complete their action plans within one year of funding. The 30 child care centers will develop comprehensive, integrated health, nutrition and physical activity programs, and outdoor learning environments, and provide programs for at least one year. All of the early childhood professionals will participate in at least 75 percent of training events.
Anticipated outcomes include: 30 communities will strengthen partnerships for obesity prevention in young children; 100 early childhood professionals will incorporate Shape NC strategies into their work; 60,000 children, 3,000 families, and 2,500 child care teachers/directors will be reached by these professionals; 750 children attending the demonstration centers will maintain a healthy weight; 35 early childhood staff in five pilot centers will participate in the health and wellness program.
Improvements in the stakeholders who adopt practices that promote healthy weight for young children will be assessed through surveys and interviews focusing on changes in stakeholder practices. Maintenance of healthy weight for young children will be monitored through BMI assessments. Improvements in healthy weight for early childhood staff will be verified through regular assessments.


Childhood obesity is a national health crisis – one in every three children ages 2-19 is overweight or obese (White House Task Force on Childhood Obesity Report to the President: May 2010). While there are numerous initiatives underway to combat the epidemic of childhood obesity, the majority of those target school-age children. Elsie Taveras, MD, MPH, the lead author of a new study Racial/Ethnic Differences in Early-Life Risk Factors for Childhood Obesity published in the March 2010 issue of Pediatrics concludes that waiting until after age two to prevent disparities in obesity may be too late (Robert Wood Johnson Foundation website: accessed May 27, 2010 at
For North Carolina, the statistics could not be more sobering. More than 31 percent of children ages two to four are considered at risk for becoming overweight or are overweight; and these rates have steadily increased since 1995 (North Carolina Nutrition and Physical Activity Surveillance System: NC-NPASS 2008: Prevalence of obesity, overweight, healthy weight and underweight children two to four years of age by county). More than 200,000 children spend all or part of their day in nearly 5,000 licensed child care centers across the state (NC Division of Child Development website: ). Shape NC addresses childhood obesity in North Carolina, focusing specifically on increasing physical activity and healthy eating in the child care setting for the state’s youngest children and those who care for them.

Progress Update

October 2014
Initially a three-year, $3 million collaboration between the BCBSNC Foundation and The North Carolina Partnership for Children, Inc. the commitment has since expanded to a six year, $6 million project, to address childhood obesity specifically in young children.
In the first three years, Shape NC engaged 19 North Carolina communities, spanning 27 counties and reached more than 1000 children ages 0-5. In child care, the percentage of children provided with fruit and vegetables two or more times a day increased by 46 percent and 28 percent, respectively. Additionally, 85 percent of children in Shape NC child care centers engage in at least 90 minutes of developmentally appropriate movement and play by the end of the first three years. Seventy-four staff members at child care facilities improved at least one or more of their own health behaviors, including increasing physical activity, and consuming more fruits and vegetables. And most importantly, over the course of each school year, trends showed the percentage of children who reached a healthy weight to be gradually improving.
Based on the strong progress from the first investment in Shape NC, the BCBSNC Foundation committed another $3 million and extended the efforts for another three years, through 2017. The vision of Shape NC stays the course, with the goals of expanding the success of program in the state, going deeper in existing communities, and broadening out to reach new communities.

Partnership Opportunities

From 2012 Progress Report:
Through Shape NC, the BCBSNC Foundation seeks to establish a framework to increase the number of young children starting school at a healthy weight by addressing the policies, practices and built environments that affect young children. As the project progresses, BCBSNC Foundation continues to seek partnerships to identify best practices in early childhood obesity prevention as well as partners to help publicize and disseminate outcomes from this work.

NOTE: This Clinton Global Initiative (CGI) Commitment to Action is made, implemented, and tracked by the partners listed. CGI is a program dedicated forging new partnerships, providing technical support, and elevating compelling models with potential to scale. CGI does not directly fund or implement these projects.