Addressing the potential adverse effects of school-based BMI assessments on children's wellbeing

Abstract

INTRODUCTION. Do child obesity prevention research and intervention measures have the potential to generate adverse concerns about body image by focussing on food, physical activity and body weight? Research findings now demonstrate the emergence of body image concerns in children as young as 5 years. In the context of a large school-community-based child health promotion and obesity prevention study, we aimed to address the potential negative effects of height and weight measures on child wellbeing by developing and implementing an evidence-informed protocol to protect and prevent body image concerns. fun 'n healthy in Moreland! is a cluster randomised controlled trial of a child health promotion and obesity prevention intervention in 23 primary schools in an inner urban area of Melbourne, Australia. Body image considerations were incorporated into the study philosophies, aims, methods, staff training, language, data collection and reporting procedures of this study. This was informed by the published literature, professional body image expertise, pilot testing and implementation in the conduct of baseline data collection and the intervention. This study is the first record of a body image protection protocol being an integral part of the research processes of a child obesity prevention study. Whilst we are yet to measure its impact and outcome, we have developed and tested a protocol based on the evidence and with support from stakeholders in order to minimise the adverse impact of study processes on child body image concerns.

School Health Initiatives and Childhood Obesity: BMI Screening and Reporting

“…Confidentiality and the potential of stigma, teasing, and body image concerns related to screening children may lead to eating disorders. An important intervention would be sensitivity training for staff, teachers, and BMI data collectors to ensure that a supportive and child well-being protective environment would be maintained (Gibbs et al 2008). Nurses could take the lead in initiating these training sessions prior to establishing large-scale school screening programs.…”

“…Fifty-eight percent of overweight female students found screening uncomfortable compared with 21% of healthy weight females. Because restrictive dieting, body image concerns, and body dissatisfaction are serious risk factors, a recent article described the use of and development of a body sensitivity protocol to be included with BMI screening when it is used for research or parental feedback (Gibbs et al, 2008). This train the trainer program reported in one research study followed a basic approach to childhood overweight as one of a supportive heath promoting environment intervention and protecting child well-being.…”

“…This train the trainer program reported in one research study followed a basic approach to childhood overweight as one of a supportive heath promoting environment intervention and protecting child well-being. Modules were developed for staff and collectors of BMI data (Gibbs et al, 2008). The modules presented in a group discussion format focused on topics such as the existence of body image concerns in children, the perceptions of negative stereotypes of overweight people, and images and language in the mass media that contribute to body image dissatisfaction.…”

Student and Parental Perceptions of School-Based Body Mass Index Screening and Notification

“…Gibbs etal. [19] has suggested that because sufficient studies have not been conducted in this area, there is a possibility that withholding a child's weight may unintentionally generate anxiety. One study on BMI measurement at school provided students with their weight and height, but not with their BMI or weight status and found that 59% of students found it beneficial to become aware of their weight [18].…”

The challenges of quantitative evaluation of a multi-setting, multi-strategy community-based childhood obesity prevention programme: lessons learnt from the eat well be active Community Programs in South Australia

“…One male and one female staff member were present to take measurements. Particular steps were taken to minimise body image concerns, based on the work of Gibbs et al (21) (Table 2).…”