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Randomized Controlled Trial
. 2022 Dec 1;150(6):e2021055730.
doi: 10.1542/peds.2021-055730.

BMI Reporting and Accuracy of Child's Weight Perception

Kevin A Gee  1 , Hannah R Thompson  2 , Sarah A Sliwa  3 , Kristine A Madsen  2
Affiliations
Randomized Controlled Trial

BMI Reporting and Accuracy of Child's Weight Perception

Kevin A Gee et al. Pediatrics. .

Abstract

Objectives: To estimate whether school-based body mass index (BMI) reports impacted the accuracy of children's self-reported weight category, for children overall and within subgroups.

Methods: We analyzed existing data from the Fit Study, a randomized controlled trial of a BMI screening and reporting intervention conducted in California from 2014 to 2017. The sample included 4690 children in 27 schools randomized to receive BMI reports and 4975 children in 27 controls schools that received BMI screening only. To estimate how BMI reporting affected accuracy, we fit multinomial logistic regression models to our data. We calculated average marginal effects, which capture the change in probability that children more accurately reported their weight category because of BMI reporting.

Results: We detected no impact of BMI reporting on children's self-reported weight accuracy. Exploratory subgroup analyses show that for Black children, exposure to 1 round of BMI reporting was associated with a 10.0 percentage point increase in the probability of accurately reporting their weight category (95% confidence interval [CI]: 2.6 to 17.4). Two rounds of reporting were associated with an increase in the probability of accuracy for Asian children (6.6 percentage points; 95% CI: 0.4 to 12.8), 5th graders (11.1 percentage points; 95% CI: 1.6 to 20.5), and those with BMI <5th percentile (17.1 percentage points; 95% CI: 2.7 to 31.6).

Conclusions: BMI reporting has limited efficacy in increasing children's weight perception accuracy. Although exploratory analyses show that specific subpopulations became more accurate, future prospective studies should be designed to confirm these results.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Flow diagram of eligible students available for secondary data analysis.
FIGURE 2
FIGURE 2
Intervention timeline and depiction of the study samples. Boxes in gray represent the sample exposed to at least 1 round of screening (control) or screening and reporting (treatment) (n = 9665). The dashed box represents the sample exposed to 2 rounds of screening or screening and reporting (n = 2795).
See this image and copyright information in PMC

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