School Screenings of BMI and Their Effect on Childhood Obesity

This study investigated whether notifying parents about the body mass index (BMI) of their children has any effect on the prevalence of obesity. It also analyzed whether the results differ among different ethnic groups or races. The results showed that there was no improvement in the BMI scores of students whose parents were notified when compared to those whose parents were not notified. The race or ethnic group they belonged to did not influence the results. Hence, changes in the students’ environment and community policies, rather than parental notification, are needed to reduce pediatric obesity.

Pediatric obesity is an epidemic that requires considerable attention and public health approaches to mitigate the problem and its associated health risks. School-based BMI screening and notifying parents about their child’s BMI status if the child is at risk are believed to reduce pediatric obesity, as parents would take appropriate action to improve their child’s weight status. However, there was lack of evidence to support this belief. In spite of this, 41 percent of school districts across the United States had made height and weight assessments mandatory. Of these, 72 percent had mandated that parents should be notified of the results obtained from these assessments. In the present study, the researchers investigated whether such assessments and parental notifications had any effect on the weight status of children. Public schools in California were chosen for the purpose.

* Telephonic interviews were conducted with district and school authorities to know whether parent intimation on BMI screening of students is a part of district-level policy and whether the school deviated from the district policy.
* BMI data for 6.96 million students (72.7 percent of the total students whose parents were intimated about their BMI data) taken during 2001 to 2008, were included in the study. The students belonged to the 5th, 7th, and 9th grades. Identity of individual students was not available.
* The primary predictor was parental notification and the primary outcome was the BMI level of the student two years after the notification. For example, parent notification in the 5th grade predicted the BMI score in the 7th grade and so on.

Key findings

* There was a 16 percent increase in parental notification of BMI screening from 2001 (35 percent) to 2008 (51 percent).
* There was no influence of parental notification on the BMI of the students two years later. The results were the same, irrespective of their race or ethnic group.
* The results did not vary based on the different methods of parental notification, namely, by using U.S. mail or by sending it along with the students to their homes.

Next steps/Shortcomings
There was a probability of students changing districts between grades 5 and 9, and there could have been differences in the notification status in the districts. This could have resulted in misclassification of data. Although the schools had intimated parents by different means, it is uncertain whether the parents received the intimation. The method and accuracy of BMI evaluation of students may vary for different districts and schools.

The effectiveness of parental notification about the BMI results of their children depends on the willingness and ability of the parents to make changes. Previous studies have shown motivation among parents to maintain a normal BMI of their children. However, they belonged to higher socioeconomic groups. The present study shows that mere parental notification does not produce the desired results. This may be because “parents frequently believe their child will ‘grow into their weight’” and obese adults “do not perceive themselves to be at increased risk.” Therefore, increasing awareness among parents to dispel misconceptions about pediatric obesity is essential. Increased physical activity, ban on sweetened beverages and snacks, and healthier vending machine options during schooldays may prove useful in reducing obesity and increasing fitness.

For More Information:
School-Based Body Mass Index Screening and Parent Notification: A Statewide Natural Experiment
Publication Journal: Archives of Pediatrics and Adolescent Medicine, July 2011
By Kristine A. Madsen, MD; Department of Pediatrics, University of California, San Francisco

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