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

• Main Authors: Himes, J.H (Author), King, B. (Author), Linchey, J.K (Author), Madsen, K.A (Author), Thompson, H.R (Author)
• Format: Article
• Language: English
• Published: Blackwell Publishing Ltd 2019
• Subjects: article; body height; Body Height; body mass; Body Mass Index; body mass index (BMI); body weight; Body Weight; child; Child; controlled study; correlation coefficient; Cross-Sectional Studies; cross-sectional study; female; Female; height; human; human experiment; Humans; major clinical study; male; Male; mass screening; Mass Screening; measurement; measurement accuracy; physical education; physical education teachers; procedures; reliability; reproducibility; Reproducibility of Results; school health nursing; school health service; School Health Services; school nurses; scientist; screening and reporting; student; teacher
• Online Access: View Fulltext in Publisher
• ISBN: 00224391 (ISSN)
• DOI: 10.1111/josh.12788

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. © 2019, American School Health Association