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. 2019 Aug;89(8):629-635.
doi: 10.1111/josh.12788. Epub 2019 May 28.

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

Hannah R Thompson  1 , Jennifer K Linchey  2 , Benjamin King  2 , John H Himes  3 , Kristine A Madsen  2
Affiliations

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

Hannah R Thompson et al. J Sch Health. 2019 Aug.

Abstract

Background: 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.

Methods: 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.

Results: 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 ± 1.6 cm (height), 0.7 ± 1.8 kg (weight), and 0.4 ± 0.8 kg/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 (0.4 cm less accurate; p = .045) and weight (0.4 kg; p = .015).

Conclusions: 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.

Trial registration: ClinicalTrials.gov NCT02088086.

Keywords: body mass index (BMI); measurement; physical education teachers; school nurses; screening and reporting.

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Figures

Figure 1:
Figure 1:
Bland-Altman Plots of Height, Weight, and Body Mass Index (BMI)
Figure 2:
Figure 2:. Body Mass Index (BMI) Category Misclassification by School Staff
Graphs exclude students (N = 19) whose body mass index (BMI) was an outlier according to Bland-Altman plots.
See this image and copyright information in PMC

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