BOX 7-4

Arkansas BMI Initiative

Arkansas Act 1220, approved by the Arkansas General Assembly and Governor in 2003, established a multipronged state initiative to improve the health of Arkansas children (ACHI, 2004). The act mandated that parents be provided with their child’s annual BMI, as well as an explanation of the BMI measure and information on health effects associated with obesity.

This mandate is being implemented in three phases using a confidential health report. Eleven schools participated in Phase I in which measurement methodologies, equipment, and reporting forms were developed and tested for validity and accuracy. Phase II consisted of field testing in a second round of schools. The final phase involves the statewide rollout of the program which began in Spring 2004 (ACHI, 2004). Community health nurses are an important part of this effort, because they are first certified in height and weight research measurements at Arkansas Children’s Hospital and subsequently train school nurses and other school personnel (ACHI, 2004). Training of health-care professionals involved in pediatric and adolescent development is also a part of this initiative.

The reports being sent to parents include the child’s BMI as well as information to assist them in contacting local resources for additional information. Data also will be aggregated at the school, district, and state levels. Evaluation of the program is ongoing and will include focus groups with parents.

Participant safety was continuously monitored by an independent data and safety monitoring board. A study of elementary school students and their parents in Cambridge, Massachusetts, found that, among parents of overweight children, those who received the health report card intervention were more likely to begin or consider looking into clinical services, dieting, or physical activity than those parents who received general information or no information (Chomitz et al., 2003). Evaluation of the report card approach is ongoing, but further research is needed on alternate methods for conducting weight-status assessments and conveying the information thus obtained to parents and to the students themselves (as age appropriate).

Schools should measure yearly each student’s weight, height, and gender- and age-specific BMI percentile and make this information available to parents and to the student (when age appropriate). Implementation of yearly measures may be resource-intensive for schools that are currently conducting such measures. However, it is important for parents to have information about their child’s BMI and other weight-status and physical fitness measures, just as they need information about other health or academic matters.

The committee recognizes that providing follow-up health-care services for children identified as being obese or at high risk for obesity will present

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