Potential Public Health Impact
Reach: MATCH is designed to reach all seventh-grade students enrolled in regular (“mainstream” or non-Exceptional Education) classes at a middle school. In its initial implementation, MATCH reached 92 of 105 (88%) eligible seventh-grade students in one middle school located in a rural county in eastern North Carolina. Subsequent MATCH implementation in two NC schools reached 189 of 206 (92%) eligible seventh-grade students. On average, the student population where MATCH has been implemented is 63% African American, two-thirds with low socioeconomic status, and 51% overweight or obese.
Effectiveness: The MATCH intervention resulted in significant decreases in body mass index z-scores (zBMI) among overweight and obese students in two intervention schools versus the control school: mean zBMI change -0.05 (95% CI:-0.07,-0.03) in intervention schools versus
-0.01 (95% CI:-0.04,0.02) in control school (p=.03). Sub-group analyses also found significant decreases in mean zBMI in the healthy weight sub-category. Although effect sizes were greater in boys (vs girls) and white (vs African American) students, separate analyses of MATCH’s effectiveness in additional schools did not find varying effect sizes by sex or race. Improvements in zBMI were sustained at one- and four-years post-intervention. Also at 4-years post-intervention, MATCH versus control participants had a lower incidence of obesity (13 vs 39%, respectively), fewer total servings of sweetened beverages and snacks (8.8 and 9.5 fewer per week, respectively), and 1.9 fewer hours of weekday TV per week.
Adoption: Adoption of MATCH in middle schools is facilitated by MATCH being embedded within existing curricula and school operations, an online system for teacher resources, and utilization of existing subject-matter teachers for lesson delivery. While adoption does require a MATCH School Coordinator, this position is typically filled by an existing teacher or school staff member without substantial extra duties/time. To date, MATCH has been implemented in 19 middle schools serving rural, socioeconomically poor, and minority children throughout North and South Carolina.
Implementation: The MATCH curriculum is divided into 33 sequenced Core and 45 Supplemental lessons; the online MATCH Curriculum Management System guides the MATCH School Coordinator and subject-matter teachers through lesson delivery, monitoring fidelity, and data management. The MATCH Student Workbook complements the lesson delivery and enables further comprehension of key concepts and skill development; the online Student Dashboard allows the student to complete surveys and log PA activities. MATCH implementation in two schools reported 23 and 26 lessons taught along with implementation of several behavioral activities, such as student self-assessments of nutrition and PA behaviors at baseline and follow-up and student action plans with goal-setting. In these two intervention schools, students maintained their Workbooks and tracked progress throughout the intervention.
Maintenance: Sustained decreases in zBMI, lower incidence of obesity, and positive lifestyle behavior changes in students at 4-years post-intervention provide evidence for the long-term effects of MATCH. Maintenance of MATCH implementation within the middle school requires support from school administrators, adequate resources (both time and money), and commitment from the MATCH School Coordinator and subject-matter teachers. Increased familiarity and experience with MATCH by the School Coordinator and subject-matter teachers with successive implementation of the curriculum and activities also supports its sustainability