What do you do with your BMI results?

[PattyB RN]

I am an elementary school nurse in CT. It is state mandated that we weigh, measure and calculate BMI on our 3rd grade students. The problem is, once we have the result, we aren't allowed to anything with it but chart it in the health record. In my school, for the past several years, the results have been that 50% of the students are considered overweight. 50% of those are actually off the chart obese:o. My results are typical for all the schools in my district. With today's trend of increased obesity at a younger age, wouldn't it be helpful to send a letter home simply stating that the facts? We do for vision & hearing. We've discussed this at our staff meetings to no conclusion so we leave it as it is. How do other schools handle this? Does anyone else do this and if so what do you do with the information?

[SchoolNurseBSN]

Do you also screen for the Acanthosis marker? If marker is present - a referral is sent that also includes BMI and 2 B/P readings.

[bergren]

Patty

Unfortunately, the research out of Arkansas has shown that telling parents their child's BMI level does not result in any changes in nutrition or physical activity.

Why don't you approach using the data from the public health / population approach rather than the individual child family approach? At 50% this is not longer an individual child or family problem - it is a school community problem.

Have you compared your BMI rate to the other schools in your district or the state numbers? Did you share with PE teachers and Wellness Committee? PTA? The School Wellness Goals legislated by the 2004 School Wellness Act should be in the implementation stage now. Engage with your fitness and nutrition partners and champions in the school to identify areas that the group can change the environment to not contribute to the overweight obesity rate. DO you have undergranduate nursing students assigned to you? Ask them to use the School Helath Index to do a needs assessment on physical educaiton and nutrition to highlight the areas most in need. There are a lot of evidence based school wide programs out there that the committee could choose from.

Once the school wide obesity rate is shared, you might find parents coming to you for assistance. You could publish the BMI calculator in the school newsletter for parents to calculate their own and their kids.

[Aneroo, LPN]

We send a letter home. I sent a letter home to everyone I screen, since I am doing vision at the same time.

If you're not allowed to do anything, at least save the data. Use it to show the need in schools for more exercise and healthier snacks and lunch.

[luvschoolnursing, LPN]

In Pennsylvania we wend home the BMI's K-12. In my school district we also send home a letter with what the numbers mean and some resource information. My experience is the parents either throw them away or call and complain about how it is none of my business. It is VERY time consuming and expensive since they are all mailed and I'm not really sure what the benefit is.

[Flare, ASN, BSN]

For BMI's I check height and weight at their first PE class of the school year. The charting program we have calculates BMI, but unfortunately also rounds up height. This doesn't throw the gross number off too much so i can still use that list to see who is at an extreme BMI - either high (over 95% for age) or low (under 5%) and then check it a bit more exact with the CDC BMI calculator: http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx

Students falling into those ranges are then rechecked 5 months later (half a school year) then if they are still out of range, i send a letter home. Fortunately, a good number of the children grow into their bodies within that time.

[PattyB RN]

No, we don't screen for acanthosis. I think it's a good idea. Makes you wonder if the parent even notices the furry darkness of their child's neck! Thanks for the thought.