Conrey Elizabeth J, Hade Erinn M, Norton Angela, Scarpitti Heidi
Ohio Department of Health, State Epidemiology Office, 246 N High Street, 7th Fl, Columbus, OH 43215, USA.
Prev Chronic Dis. 2009 Jan;6(1):A08. Epub 2008 Dec 15.
Data on overweight and obesity prevalence among children enable state and local officials to develop, target, fund, and evaluate policies and programs to address childhood overweight. During the 2004-2005 school year, the Ohio Department of Health (ODH) conducted surveillance of elementary school-aged children through coordination with the ODH oral health survey to create a system that would provide county and state estimates of obesity and overweight prevalence.
We used a stratified, cluster-sampling survey design. Schools were considered clusters and were sampled from strata determined by their county and by their participation rate in the Free and Reduced Price Meal program. We selected public elementary schools by probability proportional to size sampling without replacement. We requested consent from the guardian or parent of each third-grade student. Trained health care professionals used state-purchased equipment to weigh students and measure their height. We removed implausible observations and calculated sex-specific, body mass index (BMI)-for-age percentiles using Centers for Disease Control and Prevention growth charts.
Of eligible schools, 374 agreed to height and weight screening; 41 were considered substitutes. Of 26,590 enrolled students, 17,557 (66.0%) returned consent forms, and 15,209 (57.2%) provided consent. BMI estimates were generated for 14,451 students, resulting in an overall response rate of 54.3%. The overall oral health response rate was 52.8%.
By adding BMI screening to Ohio's third-grade oral health survey and incorporating trained volunteer screeners, the ODH successfully implemented overweight and obesity surveillance using minimal resources. Future efforts should focus on improving student response rate.
有关儿童超重和肥胖患病率的数据能使州和地方官员制定、瞄准、资助并评估应对儿童超重问题的政策和项目。在2004 - 2005学年，俄亥俄州卫生部（ODH）通过与ODH口腔健康调查协调，对小学适龄儿童进行了监测，以创建一个能提供县和州肥胖及超重患病率估计值的系统。
我们采用了分层整群抽样调查设计。学校被视为群，从根据其所在县以及参与免费和减价餐计划的比例确定的层中进行抽样。我们通过与规模成比例的概率抽样不放回地选择公立小学。我们请求三年级每位学生的监护人或家长给予同意。经过培训的医疗保健专业人员使用州里购买的设备为学生称重并测量身高。我们剔除了不合理的观测值，并使用疾病控制与预防中心的生长图表计算特定性别的年龄别体重指数（BMI）百分位数。
在符合条件的学校中，374所同意进行身高和体重筛查；41所被视为替代学校。在26,590名注册学生中，17,557名（66.0%）返回了同意书，15,209名（57.2%）给予了同意。为14,451名学生生成了BMI估计值，总体回复率为54.3%。总体口腔健康回复率为52.8%。
通过在俄亥俄州三年级口腔健康调查中增加BMI筛查并纳入经过培训的志愿者筛查人员，ODH以最少的资源成功实施了超重和肥胖监测。未来的工作应集中在提高学生回复率上。
