Screening for Childhood Obesity Table 1

Screening for Childhood Obesity 3Screeningfor Childhood Obesity

Table1

S.

Study Design and Period

Findings

Strengths

Weaknesses

Conclusions

1

2003-2005, Multistage Stratified study N=1551 b/n policy intervention

60% of parents underestimated weight at baseline, parents of boys and girls differed in weight perception (p=0.57)

Large sample size, Stratified sampling thus representativeness, Diversity thus generalizability of outcomes

High level of panel attrition, only 63/113 in baseline participated in the follow-up

BMI screening and feedback program improves parental awareness of child overweight

2

Qualitative interviews, N= 1500, age 4-8 years, BMI&gt85th

Majority of children uncomfortable discussing obesity with parents, efficacy of long-term weight management not clear

Rigor-Interviews, trials and follow-up interviews

No verifiable outcomes, for baseline (12-24) months

Cost-effective programs required to reduce obesity in children

3

K-8 BMI Screening, n=50 for 4 child-overweight categories

Normal weight parents likely to recall child weight than obese parent (75.6% v 54.9%, z=2.89, p= 0.002)

Use of t and χ2 statistics in logistic regression result interpretation

Stratified sampling

Heavy reliance on telephone interviews, small sample size N= 200

Most parents prefer school-based BMI screening

4

Survey studies in 1988-1994 (N=2871)

and 2005-2010 (N=3202), Children (6-11) years

More decrease of perception of obesity for girls than boys (PR=0.76 v PR=0.83), (0.60,0.86) v (0.69, 0.99)

Stratified sampling thus representative, High response rate, 85%, adequate sample size

High rates of panel attrition

Social norms pertaining to body weight impair perception of children as obese

5

Survey, 1500 parents, children in grades (2, 4, 5, 7 and 9), self-reported parameters, weight, height

45% of parents expressed concern over child weight (χ2=63.04, P&lt0.001), concerned parents put child on: diet (p&lt0.001, p), skipped meals (p&lt0.05), stopped snacks (p&lt0.01)

Large sample size, N=1500, analysis to a final concern model

Self-reported height and weight, lack of diversity (geographical, ethnicity &amp racial)

Accurate BMI feedback optimizes parental concern about child weight

6

Cluster Randomized Controlled Trial, 3-stage analysis, children (5-17) years

Ongoing Study

Use of techno-based app for interview, application of SBIRT tool

Low (expected) sample size

SBIRT tool enhances child motivation to healthy lifestyle

Table2

S

Study Design and Period

Findings

Strengths

Weaknesses

Conclusions

7

2010-2011, Field Survey, N=1844

Majority of parents-good knowledge of health risks to obesity (baeline-74.8%, follow-up, 81.9%), increased recognition of obesity (21.9% to 37.7%)

Large Sample size N=1844, Involvement of experts in data collection

Low Response rate,18.9%

Feedback provision enhances recognition of child weight

8

Systematic Article Review, use of sample surveillance

School-based BMI is widely accepted, purpose of school-based BMI not known in most instances

Expert analysis,

Surveillance in obtaining data

Over-reliance on qualitative data for empirical purposes

BMI screening ought consider attitudes, knowledge and esteem on weight

9

Qualitative Study, N=1400, focus group interviews

School-based height and weight screening most significant for families without health cover

Focus Interviews, Thematic data analysis,

Focus group interview not suitable for sensitive and controversial information

Parents are supportive of school-based BMI screening if privacy of children is assured

10

2004-2005

Quasiexperimental research study, for elementary schools

Screening of height and weight is more important to parents of girls than boys (χ2 = 6, p=0.01)

High response rate, 70%, verifiability of outcomes

Self-administration of questionnaires not very reliable, lacks clarification

School-based BMI screening and notification programs preferred as prevention strategies

11

Descriptive study, 358 children, 287 parents completed questionnaire

Parents have increased accuracy in identifying females as obese than males (59% v 27%,p=0.036)

Sensitivity in measurement and feedback delivery, minimal adverse effects to “treatment”

Power analyses on child esteem (subjective),Lack generalizability (ethnicity, socio-economic class)

‘opt-in’ measurement and feedback program recommended by parents

12

Online Systematic Review of Literature, Surveillance Programs, BMI Legislation

School-based BMI screening programs have differing goals among schools and states but all aim at reducing obesity

Diversity n content and methodology of literatures

Study “exempt from examination by Institutional Review Board”.

School-based BMI screening is critical for school-base obesity prevention efforts and is supported by all stakeholders

**The studies have been classified based on the evidence presented by study results in line with study objectives as well as the methodologies employed according to the key

References

  1. West, Delia S., James M. Raczynski, Martha M. Phillips, Zoran Bursac, C. Heath Gauss, and Brooke EE Montgomery. &quotParental Recognition of Overweight in School‐age Children.&quot Obesity 16, no. 3 (2008): 630-636.

  2. Taylor, Rachael W., Deirdre Brown, Anna M. Dawson, Jill Haszard, Adell Cox, Elaine A. Rose, Barry J. Taylor et al. &quotMotivational interviewing for screening and feedback and encouraging lifestyle changes to reduce relative weight in 4-8 year old children: design of the MInT study.&quot BMC Public Health 10, no. 1 (2010): 271.

  3. Johnson, Suzanne Bennett, Lorri L. Pilkington, Camilla Lamp, Jianghua He, and Larry C. Deeb. &quotParent reactions to a school‐based body mass index screening program.&quot Journal of School Health 79, no. 5 (2009): 216-223.

  4. Moore, Lucas C., Carole V. Harris, and Andrew S. Bradlyn. &quotExploring the relationship between parental concern and the management of childhood obesity.&quot Maternal and child health journal 16, no. 4 (2012): 902-908.

  5. Hansen, Andrew R., Dustin T. Duncan, Yelena N. Tarasenko, Fei Yan, and Jian Zhang. &quotGenerational shift in parental perceptions of overweight among school-aged children.&quot Pediatrics 134, no. 3 (2014): 481-488.

  6. Avis, Jillian LS, Andrew L. Cave, Stephanie Donaldson, Carol Ellendt, Nicholas L. Holt, Susan Jelinski, Patricia Martz et al. &quotWorking With Parents to Prevent Childhood Obesity: Protocol for a Primary Care-Based eHealth Study.&quot JMIR research protocols 4, no. 1 (2015).

  7. Falconer, Catherine L., Min H. Park, Helen Croker, Áine Skow, James Black, Sonia Saxena, Anthony S. Kessel et al. &quotThe benefits and harms of providing parents with weight feedback as part of the national child measurement programme: a prospective cohort study.&quot BMC public health 14, no. 1 (2014): 549.

  8. Nihiser, Allison J., Sarah M. Lee, Howell Wechsler, Mary McKenna, Erica Odom, Chris Reinold, Diane Thompson, and Larry Grummer‐Strawn. &quotBody Mass Index Measurement in Schools*.&quot Journal of School Health 77, no. 10 (2007): 651-671.

  9. Kubik, Martha Young, Mary Story, and Gayle Rieland. &quotDeveloping school-based BMI screening and parent notification programs: findings from focus groups with parents of elementary school students.&quot Health Education &amp Behavior 34, no. 4 (2007): 622-633.

  10. Kubik, Martha Y., Jayne A. Fulkerson, Mary Story, and Gayle Rieland. &quotParents of elementary school students weigh in on height, weight, and body mass index screening at school.&quot Journal of School Health 76, no. 10 (2006): 496-501.

  11. Grimmett, Chloe, Helen Croker, Susan Carnell, and Jane Wardle. &quotTelling parents their child`s weight status: psychological impact of a weight-screening program.&quot Pediatrics 122, no. 3 (2008): e682-e688.

  12. Ruggieri, Dominique G., and Sarah B. Bass. &quotA Comprehensive Review of School‐Based Body Mass Index Screening Programs and Their Implications for School Health: Do the Controversies Accurately Reflect the Research?&quot Journal of School Health 85, no. 1 (2015): 61-72.

Screening for Childhood Obesity Table 1

Screening for Childhood Obesity 3Screeningfor Childhood Obesity

Table1

S.

Study Design and Period

Findings

Strengths

Weaknesses

Conclusions

1

2003-2005, Multistage cross- sectional N=1551 b/n policy intervention

60% of parents underestimated weight at baseline, parents of boys and girls differed in weight perception (p=0.57)

Large sample size, Stratified sampling thus representativeness, Diversity thus outcome generalization

High level of panel attrition, only 63/113 in baseline participated in the follow-up

BMI screening and feedback program improves parental awareness of child overweight

2

2010. Cross-sectional study, N= 1500, age 4-8 years, BMI&gt85th

Majority of children uncomfortable discussing obesity with parents, efficacy of long-term weight management not clear

Rigor-Interviews, trials and follow-up interviews

No verifiable outcomes, for baseline (12-24) months

Cost-effective programs required to reduce obesity in children

3

A prospective cohort study. K-8 BMI Screening, n=50 for 4 child-overweight categories

Normal weight parents likely to recall child weight than obese parent (75.6% v 54.9%, z=2.89, p= 0.002)

Use of t and χ2 statistics in logistic regression result interpretation

Stratified sampling

Heavy reliance on telephone interviews, small sample size N= 200

Most parents prefer school-based BMI screening

4

Longitudinal Survey studies in 1988-1994 (N=2871)

and 2005-2010 (N=3202), Children (6-11) years

More decrease of perception of obesity for girls than boys (PR=0.76 v PR=0.83), (0.60,0.86) v (0.69, 0.99)

Stratified sampling thus representative, High response rate, 85%, adequate sample size

High rates of panel attrition

Social norms pertaining to body weight impair perception of children as obese

5

Cross-sectional Survey, 1500 parents, children in grades (2, 4, 5, 7 and 9), self-reported parameters, weight, height

45% of parents expressed concern over child weight (χ2=63.04, P&lt0.001), concerned parents put child on: diet (p&lt0.001, p), skipped meals (p&lt0.05), stopped snacks (p&lt0.01)

Large sample size, N=1500, analysis to a final concern model

Self-reported height and weight, lack of diversity (geographical, ethnicity &amp racial)

Accurate BMI feedback optimizes parental concern about child weight

6

Controlled survey Trial, 3-stage analysis, children (5-17) years

Ongoing Study

Use of techno-based app for interview, application of SBIRT tool

Low (expected) sample size

SBIRT tool enhances child motivation to healthy lifestyle

Table2

S

Study Design and Period

Findings

Strengths

Weaknesses

Conclusions

7

2010-2011, cohort Survey, N=1844

Majority of parents-good knowledge of health risks to obesity (baeline-74.8%, follow-up, 81.9%), increased recognition of obesity (21.9% to 37.7%)

Large Sample size N=1844, Involvement of experts in data collection

Low Response rate,18.9%

Feedback provision enhances recognition of child weight

8

Systematic Article Review, use of sample surveillance

School-based BMI is widely accepted, purpose of school-based BMI not known in most instances

Expert analysis,

Surveillance in obtaining data

Over-reliance on qualitative data for empirical purposes

BMI screening ought consider attitudes, knowledge and esteem on weight

9

Qualitative Study, N=1400, focus group interviews

School-based height and weight screening most significant for families without health cover

Focus Interviews, Thematic data analysis,

Focus group interview not suitable for sensitive information

Parents are supportive of school-based BMI screening if privacy of children is assured

10

2004-2005

Quasi experimental research study, for elementary schools

Screening of height and weight is more important to parents of girls than boys (χ2 = 6, p=0.01)

High response rate, 70%, verifiability of outcomes

Self-administration of questionnaires not very reliable, lacks clarification

School-based BMI screening and notification programs preferred as prevention strategies

11

Descriptive study, 358 children, 287 parents completed questionnaire

Parents have increased accuracy in identifying females as obese than males (59% v 27%,p=0.036)

Sensitivity in measurement and feedback delivery, minimal adverse effects to “treatment”

Power analyses on child esteem (subjective),Lack generalizability

‘opt-in’ measurement and feedback program recommended by parents

12

Online Systematic Review of Literature, Surveillance Programs, BMI Legislation

School-based BMI screening programs have differing goals among schools and states but all aim at reducing obesity

Diversity n content and methodology of literatures

Study “exempt from examination by Institutional Review Board”.

School-based BMI screening is critical for school-base obesity prevention efforts and is supported by all stakeholders

**The studies have been classified based on the evidence presented by study results in line with study objectives as well as the methodologies employed according to the key

References

Avis,Jillian LS, Andrew L. Cave, Stephanie Donaldson, Carol Ellendt,Nicholas L. Holt, Susan Jelinski, Patricia Martz et al. &quotWorkingWith Parents to Prevent Childhood Obesity: Protocol for a PrimaryCare-Based eHealth Study.&quot JMIRresearch protocols4, no. 1 (2015).

Falconer,Catherine L., Min H. Park, Helen Croker, Áine Skow, James Black,Sonia Saxena, Anthony S. Kessel et al. &quotThe benefits and harmsof providing parents with weight feedback as part of the nationalchild measurement programme: a prospective cohort study.&quot BMCpublic health14, no. 1 (2014): 549.

Grimmett,Chloe, Helen Croker, Susan Carnell, and Jane Wardle. &quotTellingparents their child`s weight status: psychological impact of aweight-screening program.&quot Pediatrics122, no. 3 (2008): e682-e688.

Hansen,Andrew R., Dustin T. Duncan, Yelena N. Tarasenko, Fei Yan, and JianZhang. &quotGenerational shift in parental perceptions of overweightamong school-aged children.&quot Pediatrics134, no. 3 (2014): 481-488.

Johnson,Suzanne Bennett, Lorri L. Pilkington, Camilla Lamp, Jianghua He, andLarry C. Deeb. &quotParent reactions to a school‐basedbody mass index screening program.&quot Journalof School Health79, no. 5 (2009): 216-223.

Kubik,Martha Y., Jayne A. Fulkerson, Mary Story, and Gayle Rieland.&quotParents of elementary school students weigh in on height,weight, and body mass index screening at school.&quot Journalof School Health76, no. 10 (2006): 496-501.

Kubik,Martha Young, Mary Story, and Gayle Rieland. &quotDevelopingschool-based BMI screening and parent notification programs: findingsfrom focus groups with parents of elementary school students.&quotHealthEducation &amp Behavior34, no. 4 (2007): 622-633.

Moore,Lucas C., Carole V. Harris, and Andrew S. Bradlyn. &quotExploringthe relationship between parental concern and the management ofchildhood obesity.&quot Maternaland child health journal16, no. 4 (2012): 902-908.

Nihiser,Allison J., Sarah M. Lee, Howell Wechsler, Mary McKenna, Erica Odom,Chris Reinold, Diane Thompson, and Larry Grummer‐Strawn.&quotBody Mass Index Measurement in Schools*.&quot Journalof School Health77, no. 10 (2007): 651-671.

Ruggieri,Dominique G., and Sarah B. Bass. &quotA Comprehensive Review ofSchool‐BasedBody Mass Index Screening Programs and Their Implications for SchoolHealth: Do the Controversies Accurately Reflect the Research?&quotJournalof School Health85, no. 1 (2015): 61-72.

Taylor,Rachael W., Deirdre Brown, Anna M. Dawson, Jill Haszard, Adell Cox,Elaine A. Rose, Barry J. Taylor et al. &quotMotivationalinterviewing for screening and feedback and encouraging lifestylechanges to reduce relative weight in 4-8 year old children: design ofthe MInT study.&quot BMCPublic Health10, no. 1 (2010): 271.

West,Delia S., James M. Raczynski, Martha M. Phillips, Zoran Bursac, C.Heath Gauss, and Brooke EE Montgomery. &quotParental Recognition ofOverweight in School‐ageChildren.&quot Obesity16, no. 3 (2008): 630-636.