School Health and Student Assessments

School health services are the focus of attention in programs such as CDC’s comprehensive school health programs. However, it is difficult to assess whether progress in involving school health services in obesity prevention efforts is being made. The committee did not find a systematic assessment of obesity prevention efforts in school health services, which indicates a need for a comprehensive evaluation. SHPPS has a section devoted to school health services with relevant questions focused on school screening for height, weight, or BMI. The upcoming results from the 2006 SHPPS may provide insight into current screening efforts.

Assessments of the weight, height, and BMI of each student are implemented in some states as an additional form of health screening, similar to screening for vision or hearing problems (Scheier, 2004). Concerns regarding BMI screening have focused on protecting the privacy of students and ensuring that, along with the screening results, information is provided to assist students and parents in determining next steps and reducing the potential negative impact of the results on students’ mental health.

Arkansas was one of the first states to actively explore and implement assessments of the weight, height, and BMI of each student in which the results are reported to parents and guardians (Ryan et al., 2006). In addition to other provisions regarding childhood obesity prevention, the Arkansas Act 1220 (enacted in 2003) mandated that parents be provided with an annual measure of their child’s BMI, along with an explanation of BMI and the health effects associated with childhood obesity. The recently completed year 2 evaluation of Arkansas Act 1220 was conducted through surveys of school principals, school district superintendents, and licensed Arkansas pediatricians, as well as telephone interviews with a randomly selected sample of families (e.g., parents and adolescents were interviewed if consent was obtained), site visits to assess the presence and content of school vending machines, and interviews with key officials (University of Arkansas for Medical Sciences, 2006). The evaluation found that parents and adolescents were generally accepting of BMI measurements and comfortable with the confidentiality provisions. Parents had increased their awareness of the health consequences of obesity, and increased numbers of families reported changes in planning and preparation of healthier meals. Potential negative outcomes or consequences—such as teasing, use of diet pills, or skipping meals—have not detectably increased with the distribution of BMI measurements compared with those at the baseline assessments. School principals and superintendents reported that some parents expressed concerns regarding the assessments; however, approximately one-third (34 percent) of the superintendents reported that no parent had con-



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