BMI report cards: will they pass or fail in the fight against pediatric obesity?
ABSTRACT Pediatric obesity has reached epidemic proportions in the USA and Europe. The use of BMI report cards is one approach to addressing the epidemic that is gaining popularity across the USA and in the UK.
Recent findings suggest that parents of overweight children underestimate child weight status and the majority of pediatric overweight and obesity goes undiagnosed in primary care settings in the USA. Although there is no argument against the efficacy of tracking a child's BMI and informing parents of their child's weight status, there is considerable controversy surrounding whether schools should be involved in BMI screening. Research on the efficacy of BMI report cards suggests that parental awareness of weight status is not improved by BMI report cards. Findings are inconclusive on whether BMI report cards lead to changes in weight-related health behaviors, and there is no evidence to suggest that report cards ultimately impact weight status. Additionally, research indicates that BMI report cards may increase dieting, a risk factor for both increased weight and eating disorders in adolescents.
Research does not suggest that BMI report cards will be effective in reducing rates of pediatric overweight and obesity. Instead, recent findings show that the potential for harm may outweigh possible benefits. States and countries that mandate the use of BMI report cards should make evaluation of these policies a priority.
SourceAvailable from: Deirdre Brown[Show abstract] [Hide abstract]
ABSTRACT: To determine whether a single session of motivational interviewing (MI) for feedback of a child's overweight status promotes engagement in treatment following screening. One thousand ninety-three children aged 4-8 years were recruited through primary and secondary care to attend health screening, including assessment of parenting practices and motivation (questionnaire). Families with normal-weight children were informed about their child's weight but had no further involvement. Parents of overweight (body mass index ≥85th percentile) children (n = 271) were randomised to receive weight feedback via MI or best practice care (BPC) using a traffic light concept to indicate degree of health risk. Follow-up interviews were held 2 weeks later to examine intervention uptake, changes to motivation and behaviour, and parental response to feedback. Recruitment into the intervention was high (76%) and not altered by feedback condition (percentage difference 6.6 (95% confidence interval -2.9, 16.0). High scores on the Health Care Climate Questionnaire (rating of the interviewer) indicated satisfaction with how the information was provided to parents. No differences were observed in multiple indicators of harm. However, self-determined motivation for healthy life-styles was significantly higher in the MI condition at follow-up (0.18: 0.00, 0.35), after only a single session of MI. MI and BPC were both successful in encouraging parents to participate in a family-based intervention, with MI offering little significant benefit over BPC. A traffic light approach to weight feedback is a suitable way of providing sensitive information to parents not expecting such news.Journal of Paediatrics and Child Health 03/2014; 50(6). DOI:10.1111/jpc.12518 · 1.19 Impact Factor
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ABSTRACT: 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.METHODSA keyword search from electronic databases a review of state legislation related to BMI surveillance screening was used to identify relevant literature data focused on surveillance screening policies, BMI report cards, parental perceptions of BMI screenings their child's weight status.RESULTSThis 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.Journal of School Health 01/2015; 85(1). DOI:10.1111/josh.12222 · 1.66 Impact Factor
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ABSTRACT: Introduction: Governments have many “whys” and “hows” to address obesity. While there are similarities, the “why,” “how,” “what,” and “who” behind action are strongly influenced by context, the importance of which is critical for international policy understanding of governmental obesity regulation. Context for Government to Address Obesity & Regulating through Law: Context, e.g., health system and political structure, affects government authority and motivation to address obesity. This snapshot highlights key contextual features to ground law's role in addressing obesity. Comparison of Common Government Approaches to Obesity: Two leading approaches — information and economic incentives — are featured, and major developments shared. Trends and themes emerge, notably the prominence of economic incentives (but divergent uses and targets), and the necessity of incremental strategies. Conclusion and Policy Implications: Contextual complexity cautions against drawing the wrong conclusions: what works in one place may not simply transfer and work in another. And yet, comparative analysis can strengthen the search for transnational measures of policy effectiveness (e.g., equity) and inform discussion of next steps to confront obesity in a diverse but interconnected global society.07/2012; 4(2). DOI:10.1515/1948-4682.1238