Body Mass Index Screening Research Articles

Diabetes mellitus among adults on highly active anti-retroviral therapy and its associated factors in Ethiopia: Systematic review and meta-analysis

BackgroundDiabetes mellitus occurs as a comorbid illness among people living with HIV and, in particular those on Highly Active Anti-retroviral therapies (HAART). Previous studies have documented the prevalence of diabetes mellitus among adults on HAART; however, there is lack of comprehensive estimation. Hence, this study was aimed to estimate the pooled prevalence and associated factors of diabetes mellitus among adults on HAART in Ethiopia. MethodsPrimary studies were exhaustively searched using Cochrane, PubMed, Google Scholar, Scopus and Web of science databases until February 2021. Eligible studies were selected and critically appraised for quality using the Joanna Briggs Institute (JBI) quality appraisal checklist. The required data were extracted and exported to Stata version 16 for meta-analysis. The overall prevalence of diabetes mellitus among adults on HAART was estimated using a weighted inverse random effect model. Sensitivity and sub-group analysis were conducted for evidence of heterogeneity. Trim and fill analysis was performed after Egger’s test and funnel plot were indicating the presence of publication bias. ResultsA total of 17 studies with 6,052 subjects on HAART were included. The pooled prevalence of diabetes mellitus among patients on HAART was 16.04% [95% Confidence Interval (CI); 11.6, 20.92]. Abnormal High Density Lipoprotein Cholesterol (HDL-C) [Adjusted Odd Ratio (AOR) = 4.68, 95% CI; 2.54, 6.82], Body Mass Index (BMI) ≥ 25 kg/m2 [AOR = 7.41, 95% CI; 2.75, 12.08], ≥6 years ART [AOR = 8.14, 95% CI; 5.85, 30.43], hypertension [AOR = 3.29, 95% CI; 2.13, 4.45], age 35–44 years [AOR = 6.28; 95% CI; 4.20, 8.37, BMI ≥ 30 kg/m2 [AOR = 7.81, 95% CI; 4.97, 10.64], educational status above diploma [AOR = 6.42, 95% CI; 1.28, 11.57] and age 45–55 years [AOR = 4.46, 95% CI; 2.81, 6.10] were positively associated with diabetes mellitus comorbidity among adults on HAART. ConclusionThe higher prevalence of diabetes mellitus was observed for adults on HAART. HDL-C, duration of ART, hypertension, overweight, obesity, age and educational status of participants increases the prevalence of diabetes mellitus. The study highlights the importance of timely screening of HDL-C level, blood pressure and BMI for adults on HAART.

Nutritional predictors of pharyngocutaneous fistula after total laryngectomy: A multivariate analytic study in a single institution

ObjectiveThe objective of this study was to evaluate, through multivariate analysis, the configuration of nutritional predictors that impact the development pharyngocutaneous fistula (PCF) after total laryngectomy. MethodsA retrospective cohort study carried out on 203 consecutive patients with laryngeal squamous cell carcinoma who underwent total laryngectomy with neck dissection between June 2015 and June 2020. Patients with risk factors for PCF formation, other than malnutrition, were excluded to eliminate the potential impact of that risk factors on PCF formation and to make the study group homogenous. Five parameters were evaluated including preoperative serum prealbumin, albumin and transferrin levels, Body Mass Index (BMI) and Malnutrition Screening Tool (MST). ResultsUnivariate analysis revealed that preoperative prealbumin, albumin and transferrin levels significantly correlated with PCF development. Multivariate logistic regression analysis revealed that preoperative prealbumin level was the best independent nutritional predictor of PCF (P value <0.001, odd ratio 11.951 [95% CI 3.686-38.749]) followed by preoperative albumin (P value 0.006, odd ratio 3.985 [95% CI 1.485- 10.694]). ConclusionPreoperative prealbumin level is considered the best independent nutritional predictor of PCF. It should be used to evaluate the nutritional status of patients undergoing total laryngectomy and hence their need for nutritional support.

Effect of school-based body mass index reporting in California public schools: a randomized clinical trial

Importance Annually, US schools screen millions of students’ body mass index (BMI) and report the results to parents, with little experimental evidence on potential benefits and harms. Objective To determine the impact of school-based BMI reporting on weight status and adverse outcomes (weight stigmatization and weight-related perceptions and behaviors) among a diverse student population. Design, Setting, and Participants Cluster randomized clinical trial. The Fit Study (2014-2017) randomized 79 California schools to BMI screening and reporting (group 1), BMI screening only (group 2), or control (no BMI screening or reporting [group 3]) in grades 3 to 8. The setting was California elementary and middle schools. Students in grades 3 to 7 at baseline participated for up to 3 years. A modified intent-to-treat protocol was used. Data analysis was conducted from April 13, 2017, to March 26, 2020. Interventions School staff assessed BMI each spring among students in groups 1 and 2. Parents of students in group 1 were sent a BMI report each fall for up to 2 years. Main Outcomes and Measures Changes in BMIzscore and in adverse outcomes (based on surveys conducted each fall among students in grades 4 to 8) from baseline to 1 and 2 years of follow-up. Results A total of 28 641 students (14 645 [51.1%] male) in grades 3 to 7 at baseline participated in the study for up to 3 years. Among 6534 of 16 622 students with a baseline BMI in the 85th percentile or higher (39.3%), BMI reporting had no effect on BMIzscore change (−0.003; 95% CI, −0.02 to 0.01 at 1 year and 0.01; 95% CI, −0.02 to 0.03 at 2 years). Weight dissatisfaction increased more among students having BMI screened at school (8694 students in groups 1 and 2) than among control participants (5674 students in group 3). Results of the effect of BMI reporting on other adverse outcomes were mixed: compared with the control (group 3), among students weighed at school (groups 1 and 2), weight satisfaction declined more after 2 years (−0.11; 95% CI, −0.18 to −0.05), and peer weight talk increased more after 1 year (0.05; 95% CI, 0.01-0.09); however, concerning weight control behaviors declined more after 1 year (−0.06; 95% CI, −0.10 to −0.02). Conclusions and Relevance Body mass index reports alone do not improve children’s weight status and may decrease weight satisfaction. To improve student health, schools should consider investing resources in evidence-based interventions. Trial Registration ClinicalTrials.gov Identifier:NCT02088086

Weight management across preconception, pregnancy, and postpartum: A systematic review and quality appraisal of international clinical practice guidelines.

This systematic review and quality appraisal evaluated clinical practice guidelines (CPGs) for weight management and weight-related behaviors across preconception, pregnancy, and postpartum. CPGs published in English were identified from research and guideline-specific databases between 2010 and 2019. Recommendations were categorized into weight (body mass index screening, weight loss, weight gain prevention, and gestational weight gain), diet, food safety, physical activity, and behavioral strategies. Three independent appraisers assessed CPG quality using the Appraisal of Guidelines Research and Evaluation II instrument. Twenty-two CPGs were included across preconception (n= 2), pregnancy (n=8), postpartum (n=2), or a combination (n=10). Overall, 45% of CPGs were appraised as poor quality, 32% as moderate, and 23% as high. Evaluation of body mass index and supplementation recommendations were most common across CPGs, alongside secondary weight management recommendations for women with obesity in fewer CPGs. Accompanying recommendations for diet, physical activity, and behavior were highly variable between guidelines. We report significant ambiguity in existing guidance and an absence of important considerations, including targeting weight gain prevention and limiting excess gestational weight gain. Results emphasize the need for development of robust, comprehensive, and high quality guidelines on healthy lifestyle and weight management across these formative reproductive life stages.

Reaching underserved South Africans with integrated chronic disease screening and mobile HIV counselling and testing: A retrospective, longitudinal study conducted in Cape Town.

Community-based, mobile HIV counselling and testing (HCT) and screening for non-communicable diseases (NCDs) may improve early diagnosis and referral for care in underserved populations. We evaluated HCT/NCD data and described population characteristics of those visiting a mobile clinic in high HIV disease burden settings in Cape Town, South Africa, between 2008 and 2016. Trained counsellors registered patients ≥12 years old at a mobile clinic, which offered HCT and blood pressure, diabetes (glucose testing) and obesity (body mass index) screening. A nurse referred patients who required HIV treatment or NCD care. Using multivariable logistic regression, we estimated correlates of new HIV diagnoses adjusting for gender, age and year. Overall, 43,938 individuals (50% male; 29% <25 years; median age = 31 years) tested for HIV at the mobile clinic, where 27% of patients (66% of males, 34% of females) reported being debut HIV testers. Males not previously tested for HIV had higher rates of HIV positivity (11%) than females (7%). Over half (55%, n = 1,343) of those previously diagnosed HIV-positive had not initiated ART. More than one-quarter (26%) of patients screened positive for hypertension (males 28%, females 24%, p<0.001). Females were more likely overweight (25% vs 20%) or obese (43% vs 9%) and presented with more diabetes symptoms than males (8% vs 4%). Females (3%) reported more symptoms of STIs than males (1%). Reporting symptoms of sexually transmitted infections (aOR = 3.45, 95% CI = 2.84, 4.20), diabetes symptoms (aOR = 1.61, 95% 1.35, 1.92), and TB symptoms (aOR = 4.40, 95% CI = 3.85, 5.01) were associated with higher odds of a new HIV diagnosis after adjusting for covariates. Findings demonstrate that mobile clinics providing integrated HCT and NCD screening may offer the opportunity of early diagnosis and referral for care for those who delay screening, including men living with HIV not previously tested.

Parents' Perceptions of and Responses to School-Based Body Mass Index Screening Programs-A Systematic Review.

Evidence for the effectiveness of state-mandated body mass index (BMI) screening programs in the United States has been inconclusive, and potential unintended consequences of the programs have been debated. The present review aims to understand parents' perceptions of and responses to school-based BMI screening, and to highlight racial/ethnic differences. We systematically identified studies published January 2003-May 2019 examining parent and/or youth perceptions of and/or responses to US school-based BMI screening. A total of 16 studies were included in the review. Studies suggested that while parents largely found BMI screening helpful, they held concerns regarding stigma, lack of privacy, and unhealthy behaviors and attitudes resulting from school-based screening. Furthermore, parents did not frequently follow-up with health care providers, although they reported some healthy behavior changes. Our review highlights existing parent perceptions of school-based BMI screening including the potential for healthy behavior change and important concerns regarding weight-stigma and disturbed eating attitudes/behaviors. Additionally, racial/ethnic differences in screening preferences and experiences were found. Limitations of existing literature included a need to understand youths' experiences and a lack of standardized, reliable outcomes research. Implications for future research and the role of parents, schools, and providers are discussed.

Health Information Technology Use Among Healthcare Providers Treating Children and Adolescents With Obesity: a Systematic Review

A systematic review was performed to synthesize the latest evidence of health information technology (HIT) used by healthcare professionals to address overweight/obesity among children and adolescents. This literature has not been summarized since 2012 despite the rapidly changing nature of HIT, the millions of federal healthcare dollars invested in the last decade, and the continued burden of childhood obesity and associated metabolic diseases. Three databases were searched from January, 2012 to August, 2020. Experimental and quasi-experimental studies, including pilot and feasibility studies, using HIT to address obesity and behavior (physical activity and nutrition) change among children and adolescents aged 2-18 years were included. Studies were required to report the impact on clinical/behavioral outcomes or care processes (e.g., body mass index (BMI) screening). Twenty-five studies met inclusion criteria. In sum, HIT tools improved care processes (e.g., screening rates), yet it remains unclear whether improvements in care processes translate to changes in clinical/behavioral outcomes (e.g., BMI). The majority of studies included implementation outcomes, yet outcomes were mainly operationalized as satisfaction and lacked diversity. Studies commonly used a patient-centered approach, yet rarely employed precision medicine to individualize care based on the patient’s data. Few studies specifically targeted disadvantaged populations or social determinants of health and/or used behavioral theory. High quality, rigorous efficacy, and effectiveness studies are needed to address the knowledge gaps in this emerging field of science.

Body mass index and neuropsychological and emotional variables: joint contribution for the screening of sleep apnoea syndrome in obese.

ObjectiveObstructive sleep apnoea (OSA) is the most common sleep disorder and its prevalence has increased with the obesity pandemic. We aimed to explore the presence of OSA in severe obesity and to evaluate the association of body mass index (BMI) with sleep architecture, cognition, emotional distress and comorbidities in OSA versus non-OSA patients.MethodsA sample of 61 patients performed a neuropsychological battery that included tasks of attention, memory, perceptual/visuospatial ability, vocabulary, inhibition, cognitive flexibility and distress symptomatology, before overnight polysomnography.ResultsMore than half of the sample had OSA. Excessive daytime sleepiness was not a prominent complaint. Sleep architecture was worse in the OSA than in the non-OSA group, and hypertension was increased with OSA, especially in the severe OSA group. A higher BMI was associated with cognitive distress and sleep variables and with type 2 diabetes. The apnoea-hypopnoea index (AHI) was correlated with gender and cognitive measurements. Cognitive complaints were associated with enhanced distress in both OSA and non-OSA patients.DiscussionOSA is considerably present in severely obese patients. The BMI was strongly associated with other important anthropometric measurements along with worsening sleep architecture and lower executive functioning, both of which may contribute to weight gain. The AHI was significantly higher in men and affected memory and maintaining sets on the Wisconsin Card Sorting Test which may represent a barrier to treatment adherence for this disorder. The substantial presence of cognitive complaints in OSA and non-OSA patients suggests the need for psychological intervention focused on adaptive coping strategies, mostly for depressive symptoms. Given the current obesity epidemic, these results support the need for routine sleep investigation in obese people, particularly in primary care settings. BMI, neuropsychological and emotional screening can provide crucial information about asymptomatic and high-risk patients who require prompt sleep intervention and obesity treatment.

Effect of School-Based Body Mass Index Reporting in California Public Schools

Annually, US schools screen millions of students' body mass index (BMI) and report the results to parents, with little experimental evidence on potential benefits and harms. To determine the impact of school-based BMI reporting on weight status and adverse outcomes (weight stigmatization and weight-related perceptions and behaviors) among a diverse student population. Cluster randomized clinical trial. The Fit Study (2014-2017) randomized 79 California schools to BMI screening and reporting (group 1), BMI screening only (group 2), or control (no BMI screening or reporting [group 3]) in grades 3 to 8. The setting was California elementary and middle schools. Students in grades 3 to 7 at baseline participated for up to 3 years. A modified intent-to-treat protocol was used. Data analysis was conducted from April 13, 2017, to March 26, 2020. School staff assessed BMI each spring among students in groups 1 and 2. Parents of students in group 1 were sent a BMI report each fall for up to 2 years. Changes in BMI z score and in adverse outcomes (based on surveys conducted each fall among students in grades 4 to 8) from baseline to 1 and 2 years of follow-up. A total of 28 641 students (14 645 [51.1%] male) in grades 3 to 7 at baseline participated in the study for up to 3 years. Among 6534 of 16 622 students with a baseline BMI in the 85th percentile or higher (39.3%), BMI reporting had no effect on BMI z score change (-0.003; 95% CI, -0.02 to 0.01 at 1 year and 0.01; 95% CI, -0.02 to 0.03 at 2 years). Weight dissatisfaction increased more among students having BMI screened at school (8694 students in groups 1 and 2) than among control participants (5674 students in group 3). Results of the effect of BMI reporting on other adverse outcomes were mixed: compared with the control (group 3), among students weighed at school (groups 1 and 2), weight satisfaction declined more after 2 years (-0.11; 95% CI, -0.18 to -0.05), and peer weight talk increased more after 1 year (0.05; 95% CI, 0.01-0.09); however, concerning weight control behaviors declined more after 1 year (-0.06; 95% CI, -0.10 to -0.02). Body mass index reports alone do not improve children's weight status and may decrease weight satisfaction. To improve student health, schools should consider investing resources in evidence-based interventions. ClinicalTrials.gov Identifier: NCT02088086.

Malnutrition and Frailty Screening in Older Adults

We conducted a Web-based survey of Commission on Dietetic Registration members to identify opportunities and challenges related to malnutrition and frailty screening among older adults (≥65 years old). Of the 9279 surveys sent out in emails, 903 registered dietitian nutritionists (RDNs) returned the surveys (10% response rate), and of those who responded, 576 RDNs were working with adults 65 years or older. They reported greater familiarity with screening tools for malnutrition than for frailty and little use of any frailty screening tools. For malnutrition screening, RDNs were most familiar with the body mass index (99%), Subjective Global Assessment (79%), and Malnutrition Screening Tool (75%). The body mass index (86%) and Malnutrition Screening Tool (42%) were most commonly used for malnutrition screening. For frailty screening, virtually all of the respondents (90%) were unfamiliar with individual tools. Registered dietitian nutritionists were most familiar with the Frailty Index (9%) and Simple FRAIL Questionnaire (6%), and the Simple FRAIL Questionnaire (2%) and Frailty Index (2%) were most commonly used. Major risk factors RDNs considered when screening for malnutrition and frailty were weight loss (malnutrition, 99%; frailty, 87%) and appetite loss (malnutrition, 95%; frailty, 45%), respectively. Although 70% of respondents reported their organizations had policies for malnutrition screening, only 6% did for frailty screening. Most RDNs (68%) agreed that dietetic professionals should play a role in frailty screening. To take a leading role in frailty screening and intervention, RDNs working with older adults need skills-based competency, education, and training.

P96 Your Child is Overweight, Now What? Understanding How North Carolina Head Start Staff Communicate with Families about Childhood Obesity

Background Children (3-5 years) enrolled in Head Start (HS) are at increased risk for obesity. In an effort to prevent childhood obesity, HS implemented a Body Mass Index screening program in 2012. This program provides opportunities for HS to engage families by communicating information about children's weight status; however, limited research is available to describe the barriers and facilitators HS staff face when communicating this information to families. Objective Explore common experiences of HS Health/Nutrition Managers when communicating information to families about their child's weight status. Study Design, Setting, Participants Researchers conducted 15 in-depth telephone interviews with Managers across North Carolina. Measurable Outcome/Analysis Phenomenology was used to guide study design and analysis. Interviews were recorded and transcribed verbatim. Researchers identified significant statements through open-coding and grouped them into themes focusing “what” and “how” participants experienced the phenomenon. Results Researchers identified 3 themes: Process of Communication; Barriers to Communication; and Communication Supports. Programs used different methods to communicate about children's weight (eg, letters, meetings, no communication). Parent reactions to children's weight status often dictated communication methods chosen; negative reactions often resulted in limited communication. Managers perceived parents’ backgrounds (socioeconomic status, education) and the “shame” associated with having an overweight/obese child as communication barriers. HS (eg, consulting dietitian) and community-based (eg, WIC) educational/counseling opportunities for families were identified as supportive of Manager efforts to communicate about children's weight status. Conclusions Participating HS programs acknowledged the importance of communicating with parents about their children's weight status. However, findings also indicated parents’ personal feelings about their child's weight status may influence the type of communication they receive and their willingness to utilize other educational/counseling opportunities. More research is needed to explore parents’ perceptions of HS communication methods, as well as effective strategies for supporting and educating parents about healthy weight in childhood. Funding East Carolina University Graduate Student Thesis Award.

Feasibility of an Online, Interactive Body Mass Index Parental Notification Letter (e-BMI).

School-based body mass index (BMI) screening is required in 50% of states with parent notification letters distributed among 11 of those states. Additional research is needed to effectively communicate screening results to parents. We conducted a pilot investigation of parent acceptability of an electronic, interactive BMI parental notification letter (e-BMI) along with the feasibility of implementing an e-BMI letter in the school setting. In addition, we assessed parental attitudes and practices regarding their child's weight-related behaviors. Electronic letter distribution and parent receipt were consistent with traditional paper letter mailings; however, we did not observe any significant behavioral impacts with either letter format. Parents reported interest in wellness programming offered by the school, a potential opportunity for schools to engage families in healthful practices. Additional research is needed to understand the impact of e-BMI letters and accompanying web-based resources specifically for parents of students with overweight or obesity.

#CRCFREE: Using Social Media to Reduce Colorectal Cancer Risk in Rural Adults.

Objectives: In this study, we pilot-tested #CRCFree, a Facebook-based intervention aimed at reducing colorectal cancer (CRC) risk in rural Appalachian adults at risk for CRC. Methods: Participants were 56 rural Appalachian adults aged > 50 years. Daily #CRCFree Facebook posts addressed diet, physical activity, and CRC screening. Participants' sociodemographics, diet, body mass index, physical activity, and CRC screening status were measured pre- and post-intervention. The Healthy Eating Index (HEI) and the Dietary Inflammatory Index (DII) assessed dietary patterns. Facebook engagement was measured throughout the intervention. A post-intervention focus group evaluated intervention acceptability. Results: Participants were Caucasian, aged 58 ± 6 years, and predominantly female (66%). Post-intervention, HEI scores increased (49.9 ± 9.9 vs 58.6 ± 12.1, p = <.001), and DII scores decreased from baseline (2.8 ± 1.1 vs 1.6 ± 1.7, p = .002). There was no change in physical activity, BMI, or CRC screening status. Focus group participants found the intervention to be educational and motivating. Conclusions: These results provide preliminary evidence to support using Facebook to address CRC risk in this population. Participants were responsive to this intervention, and Facebook is a novel and accessible modality for health promotion.

Comparison of Perioperative Standard and Immunomodulating Enteral Nutrition in Patients Received Major Abdominal Cancer Surgery: a Prospective, Randomized, Controlled Clinical Trial

The aim of this study was to compare the effects of standard and immunomodulating enteral nutrition on the clinical outcomes of the patients undergoing major abdominal cancer surgery. Patients who underwent a major elective abdominal cancer surgery in our clinic were randomly assigned preoperatively to two groups according to enteral nutritional intervention; Standard (ST) or Immunomodulating (IM) group. The patients who were randomized to ST and IM groups received Resource® 2.0 fiber and OraI Impact® RTD 7 days prior to surgery and 30 days after surgery, respectively. The outcome variables were as follows; infections (surgical site infection, pneumonia, abdominal abscess or septicemia), non-infectious complications (wound dehiscence, anastomotic leak, adult respiratory distress syndrome (ARDS), multi-organ failure), need for intensive care unit admission, need for re-operation, length of hospital stay, and hospital mortality. A total of 78 patients were randomized (n = 39 in each group). Forty-five (58%) of patients were male and mean age was 62.9 ± 13.4 (25–85). The mean pre-operative Body Mass Index (BMI) and Nutritional Risk Screening (NRS-2002) scores were 26.5 ± 5.4 and 2.3 ± 1.1, respectively. There were no significant differences in gender, age, BMI, and NRS-2002 scores between groups (p ≥ 0.05). ASA scores, surgical interventions also were similar in two groups. Rate of surgical site infection in groups ST and IM was 72% (n = 28) and 15% (n = 6), (p < 0.001). Rate of pneumonia in groups ST and IM was 25% (n = 10) and 0% (n = 0), (p < 0.001). Rate of urinary tract infection in groups ST and IM was 33.3% (n = 13) and 5.1% (n = 2), (p < 0.03). Length of hospital stay in groups ST and IM was 8.4 ± 4.8 and 6.1 ± 1.4, respectively (p < 0,003). There were no significant differences in other outcome variables between groups (p ≥ 0.05, for all comparisons). Perioperative immunomodulating enteral nutrition may reduce the incidence of surgical site infection, pneumonia, urinary tract infection and length of hospital stays in patients who received abdominal cancer surgery.

The Role of Mean Arterial Pressure (MAP), Roll Over Test (ROT), and Body mass Index (BMI) in Preeclampsia Screening in Indonesia

Objective: To evaluate the role of MAP, ROT, and BMI in preeclampsia screening in low resources setting. Method and Material: This is a retrospective study conducted on 1011 pregnant women who had an antenatal care at Public Health Center in Indonesia. Data taken from public health medical report. The sample groups were 45 preeclampsia patients who have had complete screening of MAP, ROT and BMI. The control groups were normal pregnant women who attained same inclusion criteria. Results: The preeclampsia group had positif MAP and obesity result respectively 95.6% and 40% of patients, but in control group only had 40% and 11.1% of patient have positive MAP and obesity respectively. Statistical test illustrates a significant association between MAP and BMI screening with the incidence of preeclampsia (p 0.0001, OR = 32.250 and p 0.002, OR = 5.333).Whereas positive ROT showed in 40% PE groups and 57.8% control group. There is no association between ROT screening and the incidence of preeclampsia (p 0.092). Conclusion: MAP and BMI can be used as baseline screening tools of preeclampsia in low resources setting. But ROT is not associated with the incidence of preeclampsia.

The Role of Mean Arterial Pressure (MAP) Roll Over Test (ROT) and Body Mass Index (BMI) in Preeclampsia Screening in Indonesia

Objective: To evaluate the role of MAP, ROT, and BMI in preeclampsia screening in low resources setting. Method and Material: This is a retrospective study conducted on 1011 pregnant women who had an antenatal care at Public Health Center in Indonesia. Data taken from public health medical report. The sample groups were 45 preeclampsia patients who have had complete screening of MAP, ROT and BMI. The control groups were normal pregnant women who attained same inclusion criteria. Results: The pre eclampsia group had positif MAP and obesity result respectively 95.6% and 40% of patients, but in control group only had 40% and 11.1% of patient have positive MAP and obesity respectively. Statistical test illustrates a significant association between MAP and BMI screening with the incidence of preeclampsia (p 0.0001, OR = 32.250 and p 0.002, OR = 5.333).Whereas positive ROT showed in 40% PE groups and 57.8% control group. There is no association between ROT screening and the incidence of preeclampsia (p 0.092). Conclusion: MAP and BMI can be used as baseline screening tools of preeclampsia in low resources setting. But ROT is not associated with the incidence of preeclampsia.

A Weight Management Program Within a High School Health Center

A program for helping adolescent students manage their weight was implemented within a school-based health center to promote evidence-based practice and identify barriers to successful weight management. Voluntary student participation included 6 visits with an advanced practice registered nurse. Body mass index screenings (n = 702) and system variables for case-managed students (n = 41) were examined to identify treatment gaps. Despite a high number of eligible students (n = 250), a low percentage of students (16%) enrolled in case management services. Building effective and sustainable approaches for weight loss in this population requires adequate staffing and community resources.

Availability of Services Related to Achieving Pregnancy in U.S. Publicly Funded Family Planning Clinics.

Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. A nationally representative sample of publicly funded clinics was surveyed in 2013-2014 (n=1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42-1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01-1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01-1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40-0.74) and primary care services (aPR, 0.74; 95% CI, 0.68-0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway.

A Community Bundle to Lower School-Aged Obesity Rates in a Small Midwestern City

Background: Multi-component interventions in large communities such as Philadelphia can effectively lower childhood obesity rates. It is less clear whether this type of intervention can be successful in smaller communities with more limited resources. Norwood, Ohio is a small Midwestern city with a population of 19,207. In 2010, Ohio passed a school health law requiring Body Mass Index (BMI) screening of students in kindergarten and grades 3, 5 and 9 along with restrictions on competitive foods and vending machine products and a physical education requirement of 30 min per day. In 2014, Norwood implemented a multi-component childhood obesity prevention and treatment bundle of interventions. Our objective was to describe the effects if this bundle on childhood overweight/obesity (OW/OB) rates. We hypothesized that implementation of the bundle would lower the prevalence of OW/OB in Norwood school children. Methods: In 2012, the Healthy Kids Ohio Act was fully implemented in the Norwood City School District (NCSD). In 2014 a comprehensive bundle was implemented that included: 1. A student gardening program; 2. Supplementation of fresh produce to a local food pantry and a family shelter; 3. A farmers market; 4. A health newsletter; 5. Incentives in the school cafeterias to promote healthy food selection; 6. A 100-mile walking club; 7. “Cook for America” (a “cooked from scratch” intervention for school cafeterias); 8. A school-based obesity treatment clinic; Results: The OW/OB rate in the NCSD was 43% at the time of the Bundle implementation in 2014 and 37% in 2016 (p = 0.029). Conclusions: A childhood OW/OB prevention bundle can be implemented in a small city and is associated with a favorable change in BMI.

Accuracy of School Staff‐Measured Height and Weight Used for Body Mass Index Screening and Reporting

The accuracy of students' heights and weights measured by school staff for body mass index (BMI) screening/reporting has not been established. This study examined school staffs' measurement accuracy, comparing accuracy by staff- and student-level characteristics. School staff and researchers measured the height and weight of 1008 4th-8th grade students, within 1 month of each other. Bland-Altman plots, mean differences, and intraclass correlation coefficients (ICCs) were calculated to examine measurement accuracy. Linear mixed effects models assessed accuracy by staff- and student-level characteristics. Bland-Altman plots revealed no appreciable bias in differences between researcher and staff measurements. The mean absolute difference between researcher and school staff measurements were 1.0 ± 1.6cm (height), 0.7 ± 1.8kg (weight), and 0.4 ± 0.8kg/m2 (BMI). Inter-rater ICC values were ≥0.97, demonstrating "excellent" reliability. Categorical weight status was correctly classified for 94% of students (kappa 0.90), and for 96% with a BMI ≥95th% (kappa 0.94). Physical education (PE) teachers were slightly less accurate than school nurses in measuring height (0.4cm less accurate; p=.045) and weight (0.4kg; p=.015). School staff conducted height/weight measurements on 4th-8th grade students with high accuracy. Resultant school-based BMI reports using similar protocols should validly reflect weight status for almost all students.