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. 2014 Feb;94(2):210-7.
doi: 10.1016/j.pec.2013.10.016. Epub 2013 Nov 5.

The Massachusetts BMI letter: a qualitative study of responses from parents of obese children

Lindsay J Moyer  1 , Elena T Carbone  2 , Jean A Anliker  3 , Sarah L Goff  4
Affiliations

The Massachusetts BMI letter: a qualitative study of responses from parents of obese children

Lindsay J Moyer et al. Patient Educ Couns. 2014 Feb.

Abstract

Objectives: Massachusetts (MA) public schools conduct mandated body-mass index (BMI) screening and until recently, communicated results in a letter to parents/caregivers, to encourage primary care visits and provide aggregate data to the state Department of Public Health. This study assessed the letter's readability and qualitatively explored parents' responses to it.

Methods: Readability of the BMI letter was calculated. Audio-taped 1-h focus groups were conducted with parents/caregivers of 8- to 14-year-old obese (≥95th BMI-for-age percentile) children. A semi-structured interview guide was used to elicit responses. Qualitative content analysis was conducted on transcripts to identify emergent themes.

Results: Readability analysis showed higher grade levels than recommended. Eight focus groups consisting of two to six parents each were conducted (n=29); 83% were female, mean age 41±9years, and 65% self-identified as Hispanic/Latino. Key themes identified included usefulness of the BMI letter, concerns about utility of BMI for screening, concerns about impacting self-esteem, and failure to understand the letter.

Conclusions: The MA BMI letter may not have been achieving its desired goal with some parents.

Practice implications: Emergent themes from this study could be used to test effectiveness of similar BMI letters nationwide and develop strategies to improve communication to parents.

Keywords: BMI; Body mass index screening; Health literacy; Patient–provider communication; Weight communication.

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Figures

Fig. 1
Fig. 1
The MA BMI letter with information for a sample child.
See this image and copyright information in PMC

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