Madsen Kristine A, Linchey Jennifer, Ritchie Lorrene, Thompson Hannah R
UC Berkeley School of Public Health, University Hall, Box 7360, Berkeley, CA 94720-7369, United States.
Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, 1111 Franklin Street #10123, Oakland, CA 94607, United States.
Contemp Clin Trials. 2017 Jul;58:40-46. doi: 10.1016/j.cct.2017.05.005. Epub 2017 May 4.
In the U.S., 25 states conduct body mass index (BMI) screening in schools, just under half of which report results to parents. While some experts recommend the practice, evidence demonstrating its efficacy to reduce obesity is lacking, and concerns about weight-related stigma have been raised.
METHODS/DESIGN: The Fit Study is a 3-arm cluster-randomized trial assessing the effectiveness of school-based BMI screening and reporting in reducing pediatric obesity and identifying unintended consequences. Seventy-nine elementary and middle schools across California were randomized to 1 of 3 Arms: 1) BMI screening and reporting; 2) BMI screening only; or 3) no BMI screening or reporting. In Arm 1 schools, students were further randomized to receive reports with BMI results alone or both BMI and fitness test results. Over 3 consecutive years, staff in schools in Arms 1 and 2 will measure students' BMI (grades 3-8) and additional aspects of fitness (grades 5-8), and students in grades 4-8 in all Arms will complete surveys to assess weight-based stigmatization. Change in BMI z-score will be compared between Arm 1 and Arm 2 to determine the impact of BMI reporting on weight status, with sub-analyses stratified by report type (BMI results alone versus BMI plus fitness results) and by race/ethnicity. The potential for BMI reports to lead to weight-based stigma will be assessed by comparing student survey results among the 3 study Arms.
This study will provide evidence on both the benefit and potential unintended harms of school-based BMI screening and reporting.
在美国，25个州在学校开展体重指数（BMI）筛查，其中不到一半会向家长报告结果。虽然一些专家推荐这种做法，但缺乏证明其降低肥胖症有效性的证据，并且人们对与体重相关的污名化问题也表示担忧。
方法/设计：“健康研究”是一项三臂整群随机试验，旨在评估基于学校的BMI筛查和报告在降低儿童肥胖症以及识别意外后果方面的有效性。加利福尼亚州的79所中小学被随机分为3组中的1组：1）BMI筛查并报告；2）仅进行BMI筛查；或3）不进行BMI筛查或报告。在第1组学校中，学生被进一步随机分组，分别接收仅包含BMI结果的报告或同时包含BMI和体能测试结果的报告。在连续3年的时间里，第1组和第2组学校的工作人员将测量学生的BMI（3 - 8年级）以及体能的其他方面（5 - 8年级），所有组中4 - 8年级的学生将完成调查问卷，以评估基于体重的污名化情况。将比较第1组和第2组之间BMI z评分的变化，以确定BMI报告对体重状况的影响，并按报告类型（仅BMI结果与BMI加体能结果）和种族/族裔进行亚组分析。将通过比较3个研究组中学生的调查结果来评估BMI报告导致基于体重的污名化的可能性。
本研究将为基于学校的BMI筛查和报告的益处及潜在意外危害提供证据。
