Lindsay J Moyer1, Elena T Carbone2, Jean A Anliker3, Sarah L Goff4. 1. Center for Science in the Public Interest, DC, USA. 2. Department of Nutrition, University of Massachusetts Amherst, Amherst, USA. Electronic address: ecarbone@nutrition.umass.edu. 3. Department of Nutrition, University of Massachusetts Amherst, Amherst, USA. 4. Department of Medicine, Baystate Medical Center, Springfield, USA; Clinical and Translational Science Institute, Tufts University School of Medicine, Boston, USA.
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.
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.
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