Body mass index screening letter study - phases I and II

Childhood obesity remains a significant public health concern and one in three children in Pennsylvania is considered overweight or obese. School-based behavioral interventions may hold merit in the fight against childhood obesity such as through body mass index (BMI) screening and parental notification programs. Although more than 25% of states require such programs, BMI screening and notification has had limited effectiveness. The objective of this study was to develop and test an effective BMI screening letter that would lead parents to tools and resources for making healthy lifestyle changes for their children. In Phase I, we conducted structured interviews of parents (N=42) of students from central Pennsylvania schools (N=6). Parents were asked to provide feedback on two different BMI notification letters – their standard form and an expert-revised letter. Qualitative analysis of the interviews guided further letter revisions. In Phase II, the revised letter was distributed at five schools and four schools received the standard letter as part of their annual screening notification. Parents were invited to participate in a survey (N=344) to further evaluate the differences between letters. Among parents of overweight or obese children, significantly more recipients of the revised letter intended to take action when compared to those receiving the standard letter (71% v.s 40%, p<0.02). The revised BMI notification letter may instigate parents to take action to address their children's BMI. However, further research is necessary to identify more effective ways of supporting parents to make healthful changes for their at-risk children.