School of Education, University of California, Davis, Davis, California.
Community Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California.
Pediatrics. 2022 Dec 1;150(6). doi: 10.1542/peds.2021-055730.
To estimate whether school-based body mass index (BMI) reports impacted the accuracy of children's self-reported weight category, for children overall and within subgroups.
We analyzed existing data from the Fit Study, a randomized controlled trial of a BMI screening and reporting intervention conducted in California from 2014 to 2017. The sample included 4690 children in 27 schools randomized to receive BMI reports and 4975 children in 27 controls schools that received BMI screening only. To estimate how BMI reporting affected accuracy, we fit multinomial logistic regression models to our data. We calculated average marginal effects, which capture the change in probability that children more accurately reported their weight category because of BMI reporting.
We detected no impact of BMI reporting on children's self-reported weight accuracy. Exploratory subgroup analyses show that for Black children, exposure to 1 round of BMI reporting was associated with a 10.0 percentage point increase in the probability of accurately reporting their weight category (95% confidence interval [CI]: 2.6 to 17.4). Two rounds of reporting were associated with an increase in the probability of accuracy for Asian children (6.6 percentage points; 95% CI: 0.4 to 12.8), 5th graders (11.1 percentage points; 95% CI: 1.6 to 20.5), and those with BMI <5th percentile (17.1 percentage points; 95% CI: 2.7 to 31.6).
BMI reporting has limited efficacy in increasing children's weight perception accuracy. Although exploratory analyses show that specific subpopulations became more accurate, future prospective studies should be designed to confirm these results.
评估基于学校的体重指数（BMI）报告是否影响儿童自我报告体重类别的准确性，包括整体儿童和亚组儿童。
我们分析了 2014 年至 2017 年在加利福尼亚州进行的 BMI 筛查和报告干预的随机对照试验 Fit 研究中的现有数据。该样本包括 27 所参与学校的 4690 名儿童和仅接受 BMI 筛查的 27 所对照学校的 4975 名儿童。为了评估 BMI 报告如何影响准确性，我们对数据进行了多项逻辑回归模型分析。我们计算了平均边缘效应，该效应捕捉了由于 BMI 报告而使儿童更准确地报告体重类别的概率变化。
我们没有发现 BMI 报告对儿童自我报告体重准确性的影响。探索性亚组分析表明，对于黑人儿童，接触一轮 BMI 报告与准确报告体重类别的概率增加 10.0 个百分点（95%置信区间：2.6 至 17.4）相关。两轮报告与亚洲儿童准确性概率增加相关（6.6 个百分点；95%置信区间：0.4 至 12.8）、五年级学生（11.1 个百分点；95%置信区间：1.6 至 20.5）和 BMI<第 5 百分位数的儿童（17.1 个百分点；95%置信区间：2.7 至 31.6）。
BMI 报告在提高儿童体重感知准确性方面效果有限。虽然探索性分析表明特定亚组变得更准确，但应设计未来的前瞻性研究来证实这些结果。
