Hannah R Thompson1, Jennifer K Linchey2, Benjamin King2, John H Himes3, Kristine A Madsen2. 1. UC Berkeley School of Public Health, 2115 Milvia Street, Third Floor, Berkeley, CA, 94704. 2. University of California at Berkeley, School of Public Health, 50 University Hall, Berkeley, CA 94720. 3. University of Minnesota, School of Public Health, Mayo A301, 420 Delaware St SE Minneapolis, MN 55455.
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.
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.
Authors: Stephanie S Berkson; Janice Espinola; Katherine A Corso; Howard Cabral; Robert McGowan; Virginia R Chomitz Journal: J Sch Health Date: 2013-01 Impact factor: 2.118
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