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August 2003

Promoting Healthy Weight Among Elementary School Children via a Health Report Card Approach

Author Affiliations

From the Institute for Community Health (Drs Chomitz and Kramer and Ms Kim) and the Physical Education Department, Cambridge Public Schools (Dr McGowan), Cambridge, Mass; and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University (Ms Collins), and the Harvard School of Public Health (Ms Kim), Boston Mass.

Arch Pediatr Adolesc Med. 2003;157(8):765-772. doi:10.1001/archpedi.157.8.765

Background  As overweight continues to rise among children, schools seek effective and sensitive ways to engage parents in promoting healthy weight.

Objective  To evaluate a school-based health report card on the family awareness of and concern about the child weight status, plans for weight control, and preventive behaviors.

Design  Quasi-experimental field trial with a personalized weight and fitness health report card intervention (PI), a general-information intervention (GI), and a control group (CG). Outcomes were assessed using a postintervention telephone survey, including process and outcome measures.

Participants  The intervention included 1396 ethnically diverse students at 4 elementary schools in an urban area. Telephone surveys were completed by 399 families from an evaluation sample of 793.

Intervention  Families were randomly assigned to the PI, GI, or CG and mailed intervention materials. The CG was mailed GI materials after the survey.

Main Outcome Measures  Parent awareness of child weight status, concerns, weight-control plans, and preventive behaviors. Group effects were significantly different by the child's weight status, so results were stratified.

Results  Among overweight students, intervention parents were more likely to know their child's weight status (PI, 44%; GI, 41%; CG, 23%) (P = .02). The PI parents planned medical help (PI, 25%; GI, 7%; CG, 9%) (P = .004), dieting activities (PI, 19%; GI and CG, <5 cases) (P = .02) and physical activities (PI, 42%; GI, 27%; CG, 13%) (P<.001) for their overweight children. No group effect on concern or preventive behaviors was detected. Most parents of overweight children who read materials requested annual weight and health information on their child (PI, 91%; GI, 67%).

Conclusions  Among overweight children, the PI was associated with increased parental awareness of their child's weight status. Although parents wanted PI for their children, more research is needed to test this approach on children's self-esteem and plans for weight control.