BMI Health Report Cards: Parents' Perceptions and Use

Background/Purpose: In 2003 Arkansas became the first state to require BMI testing in public schools.  According to the CDC, little is known about the effectiveness of BMI measurement programs.  The purpose of this study was to determine if BMI health report cards had an impact on general parental BMI knowledge, on parental actions regarding their child’s health, and to measure the accuracy of parental perceptions of their child as being underweight, normal weight, or overweight based on their child’s BMI.  

Method: A questionnaire was developed for this study with the assistance of physical educators, pediatricians, and exercise scientists. Over a six month period, the questionnaire was distributed to parents and guardians of children who sought medical care at two pediatrician’s offices in northeast Arkansas.  The participants were divided into two groups:  Group 1 (n=66) included parents of school age children, and Group 2 (n=41) included parents that had children that were below school age.   Parents in both groups were asked to report their child’s height and weight, which was assessed at the pediatrician’s office. The researchers then used the child’s height and weight to calculate BMI. The accuracy of the parent’s perception of their child’s BMI category (underweight, normal weight, overweight, or obese) was determined by comparing it to the child’s calculated BMI.  

Analysis/Results: Overall, the results from both groups show that sixty percent of parents incorrectly categorized their child’s BMI. Additionally, for Group 1, the study found that the majority of parents are not making changes to their child’s diet and exercise habits even if their child is classified as “at risk” or “overweight” based on their child’s BMI report card.  Findings from Group 1 show that 13.2% of parents responded ‘yes they did make changes’, 28.9% responded ‘no they did not make any changes’, and 39.5% responded with ‘NA’.  When asked if their child’s BMI report card lead the parent(s) to rethink their family’s health habits, the majority of parents responded “no” (37.9%), while 18.20% answered ‘yes’ the report did lead them to think about their family’s health habits. All participants were asked if public schools should be required to report a child’s BMI to parents; 45.50% responded ‘yes’, 42.40% responded ‘no’, while 12.10% reported they were ‘unsure’.  

Conclusions:  Based on findings from this study additional measures may need to be taken to help parents better understand the potential disease risks that accompany higher BMI values in children and adults.