Improving school-to-parent communication about pediatric overweight/obesity with a tailored BMI report card: Using segmentation analysis to define a typology of parents/guardians and perceptual mapping methods for message development

School-based body mass index (BMI) screenings and report cards have been shown to improve parents' recall and increase concern about their child's weight. These benefits may be better realized if parents have knowledge about BMI measures, positive perceptions of screening programs, and trust in their child's school and nurse; all of these issues can be addressed with a well-tailored BMI report card. We report on a project that developed a tailored BMI report card for a large urban school district. Perceived risks and benefits of school-based BMI screenings and report cards (derived from focus groups) were used to develop a survey completed by 105 parents/guardians. A segmentation (cluster) analysis revealed a typology of 4 distinct clusters of parents/guardians: “Passive Parents” (25.7%), “Neutral Parents” (19.0%), “Confident Advocates” (28.6%) and “Active Worriers” (26.7%). Unlike previous research, which has only examined differences in parents' perceptions about BMI screenings and report cards by demographic variables, we used chi-squares, ANOVAs, and perceptual maps to identify each cluster's unique perceptions. Vector message design analyses were then used with the perceptual maps to develop optimal messages for each type of parent/guardian (e.g. “Only the school nurse, your child, and you have access to your child's health results.”). The combination of methods to define the types of parents/guardians and to develop messages for a tailored BMI report card demonstrates an innovative approach to improve school-to-parent communication about students' weight status. These methods can be applied to a broad range of other health issues and public health campaign design.