Construct Validity of an Obesity Risk Screening Tool in Two Age Groups.

Karissa Peyer,Greg Welk

doi:10.3390/ijerph14040419

Abstract

Home environment influences child health, but the impact varies as children move into adolescence. The Family Nutrition and Physical Activity (FNPA) screening tool has been used to evaluate home environments, but studies have not compared the utility of the tool in different age groups. The purpose of this study was to examine the efficacy of the FNPA tool in first and tenth grade samples. Parents of first grade (n = 250) and tenth grade (n = 99) students completed the FNPA and results were linked to body mass index (BMI) data. FNPA scores were examined by gender, income, race, and school-level socioeconomic status (SES). Correlations examined associations between FNPA scores and several BMI indicators. Logistic and linear regression analyses evaluated the construct validity of the FNPA in both groups. Mean FNPA score differed by age group, by SES in both age groups, and by race in the first grade sample only. Correlations between FNPA score and BMI indicators were higher in the first grade sample, but SES was significantly associated with BMI only in tenth graders. The FNPA has stronger utility in younger children, while school SES is a stronger predictor of adolescent weight status.

Highlights

The overall prevalence of childhood obesity has been largely stable since 2003–2004, but different trends are evident for children and adolescents
In the tenth grade sample, survey and anthropometric data were available for 99 students: males (n = 53) and females (n = 46)
The inclusion of parent weight status rendered the Family Nutrition and Physical Activity (FNPA) tertile non-significant in both studies; it is important to note that the relationship between FNPA and odds of overweight/obesity appears stronger in the current study, suggesting that changes to the FNPA since its original development may have strengthened the ability of the tool to identify risk for overweight

Summary

Introduction

The overall prevalence of childhood obesity has been largely stable since 2003–2004, but different trends are evident for children and adolescents. Evidence suggests that there are disparities in patterns of obesity across ethnic groups with higher prevalence of obesity among Black and Latino children than in White children [2]. These discordant patterns suggest that different factors may play a role in the prevalence of overweight and obesity in these different age groups. Parenting behaviors and the home environment play a critical role in the adoption of lifestyle behaviors in youth [3,4,5,6,7,8,9,10,11,12,13,14], but evidence suggests the effect is weaker as children move into adolescence [15,16,17]. Davison and colleagues proposed a model based on Ecological Systems Theory to explain how child physical activity, dietary intake, and sedentary behavior are influenced by parent behaviors and societal characteristics [18], but screening methods are needed to identify these behavioral and environmental risks before youth become overweight or obese [19,20]

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Conclusion