Evaluating the Impact of Statewide BMI Screening Initiative in Elementary Schools

描述（由申请人提供）：许多公共卫生组织建议发展以学校为基础的肥胖筛查，但对这种以政策为基础的肥胖预防策略的有效性知之甚少。本研究将采用自然主义的纵向设计，研究不同BMI筛查方法和不同反馈/教育方法对预防小学年龄儿童肥胖的有效性。该项目利用宾夕法尼亚州现有的BMI跟踪和肥胖预防基础设施。宾夕法尼亚州是每年向所有K-12学生的父母提供BMI筛查结果的四个州之一。由宾夕法尼亚州立大学（PSU）管理的宾夕法尼亚营养和活动倡导者（PANA）与宾夕法尼亚州卫生部（PDH）合作，协调培训、家长沟通和教育工作。这一基础设施将使人们有可能评估不同的BMI筛查方法的有效性，以及评估基于行为的补充筛查和基于家庭的教育对预防超重和肥胖的附加效益。目标1的目的是评估不同BMI报告实践对学校BMI结果的影响。BMI的纵向（3年）趋势将与BMI报告类型相关，以确定不同方法的相对有效性。目标2的目标是评估采用经验证的基于行为的筛查工具（家庭营养和身体活动筛查工具）与标准BMI报告结合使用的潜力，以促进家庭环境的意识和变化。学校将随机接受标准或补充报告，并将通过调查和BMI趋势评估效果。目标3的目的是评估一个扩展为基础的家庭教育计划（家庭健身）的有效性时，作为一个正常的BMI筛查计划的扩展实施。该计划利用宾夕法尼亚州的自然实验来回答有关如何提高BMI筛查有效性的重要问题，BMI筛查是一项广泛推荐的公共卫生策略。长期目标是建立一个证据基础，以促进采取一级预防战略，在身体变化和行为变得根深蒂固之前降低超重和肥胖的风险。 公共卫生相关性：这项拟议的研究将评估宾夕法尼亚州正在进行的学校BMI筛查计划的BMI轨迹，以确定用于协调肥胖预防规划的最佳实践。标准BMI报告卡的结果将与补充使用基于行为的筛查工具和基于扩展的家长教育计划的结果进行比较，以评估建立家庭环境和实践的策略，这些策略和实践可以帮助防止儿童超重。这项研究将为如何提高学校BMI筛查计划的有效性提供关键见解，这是一项广泛推荐的公共卫生策略。

DESCRIPTION (provided by applicant): The development of school-based obesity screening has been recommended by many public health groups but little is known about the effectiveness of this policy-based obesity prevention strategy. The proposed research will utilize a naturalistic, longitudinal design to study the effectiveness of different BMI screening practices and different feedback/education approaches on preventing obesity among elementary age children. The project capitalizes on an existing infrastructure for BMI tracking and obesity prevention within the state of Pennsylvania. Pennsylvania is one of four states that provide BMI screening results to parents of all K-12 students annually. The Pennsylvania Advocates for Nutrition and Activity (PANA), administered by Pennsylvania State University (PSU) has partnered with the Pennsylvania Department of Health (PDH) to coordinate training, parent communication and education efforts. This infrastructure will make it possible to evaluate the effectiveness of different BMI screening approaches as well as to evaluate the additive benefits of supplemental behaviorally-based screening and family-based education for the prevention of overweight and obesity. The goal of Aim 1 is to evaluate the impact of different BMI reporting practices on school-level BMI outcomes. Longitudinal (3 year) trends in BMI will be related to the type of BMI reporting to determine the relative effectiveness of different approaches. The goal of Aim 2 is to evaluate the potential of employing a validated, behaviorally-based screening tool (Family Nutrition and Physical Activity Screening Tool) in conjunction with standard BMI reports to promote awareness and changes in home environments. Schools will be randomized to receive the standard or supplemental report and effects will be evaluated with surveys and BMI trends. The goal of Aim 3 is to evaluate the effectiveness of an Extension-based family education program (Family Fitness) when implemented as an extension of normal BMI screening programming. The proposed initiative takes advantage of the natural experiment taking place within the state of Pennsylvania to answer important questions about how to enhance the effectiveness of BMI screening, a widely recommended public health strategy. The long-term goal is to develop an evidence-base to facilitate the adoption of primary prevention strategies to reduce risks for overweight and obesity before body changes and behaviors have become entrenched. PUBLIC HEALTH RELEVANCE: The proposed study will evaluate BMI trajectories from an ongoing school-based BMI screening initiative in the state of Pennsylvania to determine best practices for use in coordinated obesity prevention programming. Outcomes from standard BMI report cards will be compared to outcomes from the supplemental use of a behaviorally-based screening tool and an extension- based parent education program to evaluate strategies to establish home environments and practices that can help prevent children from becoming overweight. The study will provide key insights about how to enhance the effectiveness of school-based BMI screening programs, a widely recommended public health strategy.