Construct Validity of an Obesity Risk Screening Tool in Two Age Groups

Abstract

Home environment influences child health, but the impact varies as children move into adolescence. The Family Nutrition and Physical Activity (FNPA) screening tool has been used to evaluate home environments, but studies have not compared the utility of the tool in different age groups. The purpose of this study was to examine the efficacy of the FNPA tool in first and tenth grade samples. Parents of first grade (n = 250) and tenth grade (n = 99) students completed the FNPA and results were linked to body mass index (BMI) data. FNPA scores were examined by gender, income, race, and school-level socioeconomic status (SES). Correlations examined associations between FNPA scores and several BMI indicators. Logistic and linear regression analyses evaluated the construct validity of the FNPA in both groups. Mean FNPA score differed by age group, by SES in both age groups, and by race in the first grade sample only. Correlations between FNPA score and BMI indicators were higher in the first grade sample, but SES was significantly associated with BMI only in tenth graders. The FNPA has stronger utility in younger children, while school SES is a stronger predictor of adolescent weight status.

Feasibility of enhancing well‐child visits with family nutrition and physical activity risk assessment on body mass index

“…This is the first study to demonstrate the feasibility and clinical effectiveness of implementing an automated risk assessment during WCV for paediatric preventive care. Lower FNPA summary scores were associated with greater odds for overweight, obesity and severe obesity among school-aged children, consistent with prior research, as well as among preschool-aged children, a population previously uninvestigated (9,11). On average, children whose parent completed of the FNPA risk assessment, and thus had exposure to the intervention, experienced smaller increases in BMI z-score compared with non-respondent children.…”

“…The FNPA risk assessment is a valid tool to identify risk factors associated with overweight and obesity among school‐aged and preschool‐aged children. The results with children aged 6–9 align with previous research demonstrating that the FNPA summary score is associated with odds of overweight, obesity and severe obesity . Prevention prior to age 5 years is essential as obesity tends to persist once established ; however, no risk assessments were identified for children as young as age 2 years when the study was designed.…”

“…As shown in Table 3, the summary scores for intervention children significantly differed by weight category for children aged 2-9 and in both age groups (all P's ≤ 0.01). The summary scores were grouped into tertiles by age and evaluated for odds of overweight or obesity at baseline (9,11). In the present study, on average, the lowest tertile of summary scores was associated with greater odds ratio of being over-…”

“…Implementation feasibility was evaluated by one factor, but clinic staff, patient experience, provider acceptance and years of practice should be evaluated. The relationship between FNPA risk score and baseline weight did not control for parent BMI, a covariate that influenced this relationship in prior studies . Significant differences between the groups on nearly all characteristics and inconsistent results between the intervention and comparison groups could be explained by lack of random assignment at the clinic or individual level and uncollected variables.…”

“…The email included a link to the FNPA risk assessment. As shown in Table 1, the 20-item tool includes 10 constructs predictive of childhood obesity (9)(10)(11).…”