Abstract
BackgroundWeight screening in schools has been proposed as one strategy to address childhood obesity. Students' response to such screening is unexplored, however. In this study we evaluated the perceived comfort, utility and impact of school-based weight screening from the perspective of middle school-aged students.MethodsA cross-sectional study of 852 ethnically diverse 5th–8th grade students. Associations were investigated between measured height and weight screening data and responses to a self-administered questionnaire completed immediately following weight screening in physical education class. BMI categories were based on the revised 2000 CDC growth chart and definitions: 5th–85th BMI percentile = healthy weight, 85th–95th BMI percentile = at risk for overweight, and >95th percentile BMI = overweight.ResultsOverall, students' comfort level with weight screening varied depending on the student's own weight status. More overweight students (38.1%) reported being uncomfortable than healthy weight students (8.1%) (p < 0.001). In particular, overweight female students (54.8%) compared to healthy weight female students (21.6%) reported being uncomfortable (p < 0.01). About half (54.9%) of all students reported knowing their weight prior to screening, and 58.9% reported that it was useful to learn their height and weight. Compared to healthy weight students, overweight students were significantly more likely to report the intention to perform weight modification related activities such as visiting a doctor (Odds ratio (OR) = 2.0, 95% CI = 1.3, 3.1), eating more fruits and vegetables (OR = 2.7, 95% CI = 1.7, 4.1), and increasing physical activity (OR = 4.3, 95% CI = 2.7, 7.0).ConclusionOverall, the majority of the middle school students did not report discomfort with school-based weight screening, did report that receiving height and weight information was useful, and generally report appropriate weight control intentions. These proportions varied across weight status categories, however, with students who were at risk for overweight or overweight reporting higher levels of discomfort. For schools that conduct weight screening, it is essential that they also provide comfortable and private settings as well as education or counseling regarding healthy weight control practices.
Highlights
Weight screening in schools has been proposed as one strategy to address childhood obesity
The 2004 Institute of Medicine (IOM) report suggests that schools gather weight, height, and body mass index (BMI) measurements on students annually and that schools communicate the results of screening to parents [2]
Of the 986 students who were eligible for the study, 23 opted out of the study, 111 were absent on the day of their class was scheduled for weight screening, 54 were missing one or more variables required to determine their BMI classification and 12 underweight subjects were excluded from the study analyses because our interest was in the comparison between healthy weight and overweight and there were too few students in this category to consider it separately
Summary
The 2004 Institute of Medicine (IOM) report suggests that schools gather weight, height, and body mass index (BMI) measurements on students annually and that schools communicate the results of screening to parents [2]. This relatively new role for schools reflects concern over the substantial physical and psychosocial health risks associated with overweight in childhood and the likelihood that childhood obesity will persist into adulthood [1,3,4,5]. A comprehensive review of policies and research related to BMI screening [15] concluded that BMI screening is not necessary for obesity monitoring at the national level, the practice could provide useful information for monitoring trends at the state and local level
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