The cost of screening adolescents for overweight and hypertension using a community partnership model

Parents' Perceptions and Use of School-Based Body Mass Index Report Cards

BACKGROUND

Obesity in children and adolescents has become one of the most critical public health problems in the United States. Schools may play an important role in raising awareness and possibly slowing the obesity epidemic.

METHODS

The purpose of this study was to gather information on parents' perception and use of body mass index (BMI) report cards provided by public schools through the administration of a questionnaire. The questionnaire was developed with the assistance of physical educators, pediatricians, and exercise scientists. The questionnaires were backpacked home with 1127 students in 6 Arkansas public schools. Parents completed and returned 404 questionnaires.

RESULTS

Findings indicate that parents are supportive of schools reporting BMI and providing information on healthier lifestyles. However, most parents reported not making any adjustment to their child's diet and physical activity habits based on the BMI reports. Approximately half of parents (55%) thought the BMI report accurately reflected their child's health status. Approximately half of the parents reported their child's BMI report led them to think about their family's health habits.

CONCLUSIONS

Although parents do support receiving BMI information from schools, many did not indicate using the data to initiate changes such as increased physical activity or healthy eating.

A comprehensive review of school-based body mass index screening programs and their implications for school health: do the controversies accurately reflect the research?

BACKGROUND

Whereas legislation for body mass index (BMI) surveillance and screening programs has passed in 25 states, the programs are often subject to ethical debates about confidentiality and privacy, school-to-parent communication, and safety and self-esteem issues for students. Despite this debate, no comprehensive analysis has been completed that compares and contrasts how these issues differentially affect schools, parents, and students.

METHODS

A keyword search from electronic databases and a review of state legislation related to BMI surveillance and screening were used to identify relevant literature and data focused on surveillance and screening policies, BMI report cards, and parental perceptions of BMI screenings and their child's weight status [corrected].

RESULTS

This article addresses the gap of previous literature by outlining the ethical considerations and implications that BMI screening programs and report cards have for schools, parents, and students, and links these with outcome studies to address whether these controversies are supported by research.

CONCLUSIONS

Despite the controversies surrounding these programs, this review shows that they can be valuable for all parties and demonstrates BMI screening programs to be vital to the development of robust school-based obesity prevention programs and promotion of healthy lifestyles in schools.

A structured, interactive method for youth participation in a school district-university partnership to prevent obesity

BACKGROUND

The involvement of school-age children in participatory research is described in the context of a school district-university partnership to prevent obesity in children. The purpose of this study was to elicit, from children in kindergarten (K) through sixth grade, perceptions of foods and activities that would inform the design of developmentally appropriate interventions to prevent and reduce childhood obesity.

METHODS

Children (N = 218) were selected through a random sample of K through sixth grade classrooms in 3 schools. They participated in structured, interactive, small group exercises focused on perceptions of foods (taste and healthy/unhealthy) and activities (fun and active/sedentary). High school students in the same school district were trained to facilitate the children's groups in collaboration with university faculty and students.

RESULTS

Qualitative data analysis was used to discern patterns across grade levels. There were grade-level differences in perceptions of the taste and healthfulness of foods. Younger children (K-1) equated foods that tasted good with foods that were "good for you." Older children were more discriminating and gave reasons for their perceptions. For activities, fun was positively associated with the number of people involved and the amount of movement. There were fewer differences across grade levels in preferences for types of sedentary activities, compared with sports and other activities that "make you move."

CONCLUSIONS

The findings have implications for developmentally appropriate health promotion interventions to prevent obesity. These structured but highly interactive methods could be used by school personnel to assess the unique needs of a school population.

Overweight and central adiposity in school-age children and links with hypertension

The purpose of this study of school-age children was to estimate prevalence and interrelationships of overweight, central adiposity, and hypertension. It included 1,070 children in kindergarten through sixth grade (67% Hispanic, 26% African American, mean age = 8.9 years). Measures included body mass index (BMI), waist circumference (WC), systolic and/or diastolic hypertension identified by measurements on three separate occasions. Percentage overweight (BMI >or=95th percentile) was 28.7%, 17.9% were at risk of overweight, 28.8% had WC >or=90th percentile, and 9.4% had elevated (>or=90th percentile) systolic and/or diastolic blood pressure (BP). If we had screened only for BMI and examined those with BMI >or=85th percentile or underweight for hypertension, we would have missed 26% of the children with persistently elevated BP. WC explained variance in elevated BP not explained by BMI (p < .001). Measurement of WC is easily incorporated in a school-based screening protocol.