Using surveys and perceptual mapping methods to understand parents' perceptions and knowledge about BMI measurements, school-based BMI screening programs, and BMI report cards

School-based body mass index (BMI) screenings and report cards can correct parents'/guardians' misperceptions about their child's weight status and can provide valuable health indicators for schools and parents. However, little is known about parents'/guardians' perceptions and knowledge of BMI measures, school-based BMI screening programs, and BMI report cards. Using perceptual mapping, a tool to create three-dimensional models that represent how a survey group conceptualizes elements, we surveyed a diverse sample of parents/guardians (n = 105) of students in a large urban school district who are representative of at-risk populations for pediatric overweight/obesity to learn about their perceptions and knowledge related to BMI measures, screenings, and report cards. A cluster analysis identified 4 distinct types of parents/guardians on the basis of their survey responses: “Passive Parents” (25.7%), “Neutral Parents” (19.0%), “Confident Advocates” (28.6%) and “Active Worriers” (26.7%). Perceptual maps were generated for each type of parent/guardian to graphically illustrate their perceptions about the risks and benefits of BMI measures and school-based BMI screenings and report cards. The perceptual maps also revealed which specific issues were most salient for parents/guardians in this sample. Chi-squares and ANOVAs were used to examine mean differences in parents'/guardians' survey responses to key dependent variables (e.g. knowledge of BMI-for-age, perceived value of school-based BMI screenings, perceived trust of school communication, perceived trust of school nurses, etc.). The perceptual maps and survey analyses revealed key message concepts which, if incorporated into school-to-parent communication about BMI measures and screening programs, may improve parents'/guardians' knowledge and perceptions about these issues.