Prediction of BMI Change in Young Children with the Family Nutrition and Physical Activity (FNPA) Screening Tool
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ORIGINAL ARTICLE
Prediction of BMI Change in Young Children with the Family Nutrition and Physical Activity (FNPA) Screening Tool Michelle A. Ihmels, Ph.D. & Gregory J. Welk, Ph.D. & Joey C. Eisenmann, Ph.D. & Sarah M. Nusser, Ph.D. & Esther F. Myers, Ph.D., R.D.
Published online: 6 October 2009 # The Society of Behavioral Medicine 2009
Abstract Background Youth obesity prevention practices would be enhanced if modifiable risk factors can be identified before children become overweight. Purpose This study evaluated the predictive validity of the Family Nutrition and Physical Activity (FNPA) screening tool, a behaviorally based screening tool designed to assess family environments and behaviors that may predispose youth to becoming overweight. Methods Parents from a large urban school district completed the FNPA screening when children were in first grade. Oneyear change in measured body mass index (BMI) was used as the primary outcome, and this was computed using the relative change in distance from the BMI value at the 50th percentile.
Descriptive, correlation, and mixed modeling analyses were used for survey validation. Results Over half of the participants exhibited an increase in BMI percentile over the 1-year follow-up with an average change of 0.51±11.5% which is indicative of trends to overweight. Although baseline BMI predicted BMI at follow-up, the FNPA total score explained unique variance in child BMI at follow-up after accounting for baseline BMI, parent BMI, and other demographic variables (p=0.049). Conclusions This study demonstrates the potential validity of a simple, easy-to-use screening tool for identifying children that may be at risk for becoming overweight. Keywords Childhood obesity . Screening tool . Physical activity . Nutrition
M. A. Ihmels (*) : G. J. Welk Department of Kinesiology, Iowa State University, Ames, IA, USA e-mail: [email protected] G. J. Welk e-mail: [email protected] J. C. Eisenmann Department of Kinesiology, Michigan State University, East Lansing, MI, USA e-mail: [email protected] S. M. Nusser Department of Statistics, Iowa State University, Ames, IA, USA e-mail: [email protected] E. F. Myers American Dietetic Association, Chicago, IL, USA e-mail: [email protected]
Introduction The recent secular trend in the prevalence of overweight and obesity in youth over the past few decades have been well chronicled [1]. Attenuating and reversing this trend is a critical public health priority since child obesity tracks through adolescence [2] and into adulthood [3–5]. Many professional organizations have recommended body mass index (BMI) screening in schools to facilitate early referral and treatment [6–9]. Current practice in some schools (and physician offices) has been to measure and monitor BMI in comparison to percentile norms from the Centers for Disease Control (CDC) [10]. A limitation of this approach is that it essentially identifies children after a child has become overweight. A more effective screening procedure for the prevention of overweight would identify family
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