Lessons Learned While Implementing a Legislated School Policy: Body Mass Index Assessments Among Arkansas’s Public School Students

Justus, Michélle Barreto; Ryan, Kevin; Rockenbach, Joy; Katterapalli, Chaitanya; Card-Higginson, Paula

doi:10.1111/j.1746-1561.2007.00255.x

Cited by 47 publications

(47 citation statements)

References 8 publications

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“…However, the integration of funding into existing systems (eg, school nurse responsibilities, Department of Health chronic disease programming) may have safeguarded the activities during legislative challenges because there was no budget to cut. No food or beverage to be used as rewards School cafeterias/dining areas to reflect healthy nutrition environments Ensure that all students have access to school meals Drinking water available without charge to all students on campus PE/PA standards Schools to work with local School Nutrition and Physical Activity Advisory Committee to establish strategies for achieving increased PA programs for children and their families in their community and decrease sedentary activities Beginning in the 2006-2007 school year, PE classes in kindergarten through 6th grade will have a maximum student-to-adult ratio of 30:1 Beginning in 2008-2009 school year, for kindergarten through 6th grade, the district will employ at least 1 licensed and/or qualified PE full-time equivalent teacher for every 500 students; this licensed and/or qualified PE teacher will directly supervise PE instruction Beginning with the 2012 school year, all personnel teaching PE in kindergarten through 12th grade will hold a PE license appropriate for the grade levels being taught Initially required by 2007-2008 that kindergarten through 6th grade to receive 150 min/wk of PA (includes 60 min of PE); 7th-8th grades to receive 150 min/ wk of PA; 9th-12th grade to take 1 semester of PE and receive 150 min/wk of PA Legislation amending Board of Education rules and regulations Act 317 of 2007 increased class time by limiting mandated PA in kindergarten through 12th grade; provides 60 min/wk of PE and 90 min/wk of PA for kindergarten through 5th grade only; no PA requirements for grades [6][7][8][9][10][11][12] to be performed among those students in even school grades (kindergarten and 2nd, 4th, 6th, 8th, and 10th grades) to reduce academic interruption, reduce personnel time, and to adopt a standard parental refusal process. Importantly, additional legislative requirements were added regarding adherence to the established protocol.…”

Section: Discussionmentioning

confidence: 99%

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Arkansas' Experience: Statewide Surveillance and Parental Information on the Child Obesity Epidemic

Thompson

Card-Higginson

2009

Pediatrics

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Parents, clinicians, public health officials, and policy makers need readily available information on the extent of the childhood obesity epidemic. As in any epidemic, the strategies and tools used to combat the imminent threat are frequently based on scientific rationale and experience but applied in areas in which we lack complete understanding. The urgent need for information requires execution of decisions that are not risk-free-such is the case of BMI screening obesity. Use of BMI percentiles to classify weight status among youth and quantify the epidemic can inform and engage parents and other key stakeholders. Arkansas has completed its sixth year of BMI screenings for public school students. Through a groundbreaking legislative mandate that requires BMI assessments in public schools, the state has achieved both enhanced awareness among parents and their children and increased engagement by school, clinical, public health, and community leaders in response to the epidemic. External evaluations conducted since institution of BMI assessments have revealed none of the initially feared negative consequences of BMI measurements such as teasing, use of diet pills, or excessive concerns about weight. In the face of this epidemic, the risks of using BMI assessments in clinical or schoolbased settings must be recognized but can be managed. Arkansas' Act 1220 and BMI-reporting efforts have not only afforded parents detailed information about their children's health but also provided longitudinal data needed to fully understand the scope of childhood and adolescent obesity in the state and to track progress made in combating this epidemic. Pediatrics 2009;124:S73-S82

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Section: Discussionmentioning

confidence: 99%

“…As described elsewhere, 12 the ACHI and colleagues from the University of Arkansas for Medical Sciences (UAMS) Department of Pediatrics and Arkansas Children's Hospital conducted studies to test and validate affordable equipment. 13 Tanita (Arlington Heights, IL) HD-314 scales were selected.…”

Section: Collecting Statewide Bmi Data: Equipment and Protocolsmentioning

confidence: 99%

Arkansas' Experience: Statewide Surveillance and Parental Information on the Child Obesity Epidemic

Thompson

Card-Higginson

2009

Pediatrics

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“…Despite these concerns and the need for further research on the long-term impact of the benefits and potential harms of school-based weight monitoring, 105 the limited data available reflect support for the school-based screening and parent-notification programs. 24,106,107 Developing BMI-notification programs that recognize and respond to the cultural values and concerns of families represents a substantial challenge. For example, obesity may be so common in some communities that it is normative and possibly not treated with high concern, which could mean that a BMI-notification program might be perceived as irrelevant.…”

Section: Bmi Notification and Behavior Changementioning

confidence: 99%

The Role of Culture in the Context of School-Based BMI Screening

Fitzgibbon

Beech

2009

Pediatrics

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The high prevalence of overweight and obesity is a significant public health concern in the United States. Minority populations are disproportionately affected, and the impact of obesity on minority children is especially alarming. In this article we discuss school-based BMI reporting, which is intended to increase parental awareness of their children's weight status. This information could potentially lead parents of overweight and obese children to carefully examine and possibly change their children's diet and activity patterns. However, any program related to child weight status must consider culturally defined aspects of body size and shape. In other words, the cultural context in which information on child BMI is presented to and received by parents must be considered. In this article we review parental perceptions of child weight. Multiple studies have shown that parents of overweight or obese children often fail to correctly perceive their children as overweight. Possible reasons for, and implications of, this misperception of child weight status among minority parents are then explored within a cultural framework. The PEN-3 model is used to examine influences on health behaviors and could help inform the development of a culturally sensitive BMI-notification program for minority parents. Reporting materials congruent with the social and cultural values and practices of the target audience are likely to maximize program effectiveness. A culturally based BMI-notification program should be conceptualized as a small step in a comprehensive plan to reduce childhood obesity and improve the current and future health of minority children. Pediatrics 2009;124:S50-S62

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“…However, during the same time period, many other weight -and health-related initiatives were also established, so it is difficult to draw the conclusion that BMI screening alone increased parental and child awareness of weight gain issues. Nevertheless, BMI, as part of a broader strategic program aimed toward preventing obesity, was successful in that it provided parents with information that increased awareness (Justus, Ryan, Rockenbach, Katterapalli, & Card-Higginson, 2007;Thompson & CardHigginson, 2009). …”

Section: Effectiveness Of Bmi Screening and Reportingmentioning

confidence: 97%

School Health Initiatives and Childhood Obesity: BMI Screening and Reporting

Soto

White

2010

Policy, Politics, & Nursing Practice

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The prevalence of childhood obesity has reached an epidemic status especially in the United States. Agencies such as the Institute of Medicine, Surgeon General's Office, and the American Academy of Pediatrics have called for action. Schools have been provided with guidelines to address obesity prevention. School-based body mass index screening and parent reporting programs have received a significant amount of attention in the literature. Intended to raise awareness for parents and provide a first step toward intervention for children who are overweight, there is to date limited outcomes of their success. However, one state, Arkansas, with mandated screening has reported success in that following screening in its schools, obesity rates were not increased. A significant concern with screening in schools is its potential harm to children around teasing, body image sensitivity, and possible unhealthy dieting. These controversial issues are explored, and recommendations are suggested for nursing's role in obesity prevention especially in schools.

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Lessons Learned While Implementing a Legislated School Policy: Body Mass Index Assessments Among Arkansas’s Public School Students

Cited by 47 publications

References 8 publications

Arkansas' Experience: Statewide Surveillance and Parental Information on the Child Obesity Epidemic

Arkansas' Experience: Statewide Surveillance and Parental Information on the Child Obesity Epidemic

The Role of Culture in the Context of School-Based BMI Screening

School Health Initiatives and Childhood Obesity: BMI Screening and Reporting

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