The Massachusetts BMI letter: A qualitative study of responses from parents of obese children

Author Department

Medicine

Document Type

Article, Peer-reviewed

Publication Date

2-2014

Abstract

OBJECTIVES:

Massachusetts (MA) public schools conduct mandated body-mass index (BMI) screening and until recently, communicated results in a letter to parents/caregivers, to encourage primary care visits and provide aggregate data to the state Department of Public Health. This study assessed the letter's readability and qualitatively explored parents' responses to it.

METHODS:

Readability of the BMI letter was calculated. Audio-taped 1-h focus groups were conducted with parents/caregivers of 8- to 14-year-old obese (≥95th BMI-for-age percentile) children. A semi-structured interview guide was used to elicit responses. Qualitative content analysis was conducted on transcripts to identify emergent themes.

RESULTS:

Readability analysis showed higher grade levels than recommended. Eight focus groups consisting of two to six parents each were conducted (n=29); 83% were female, mean age 41±9years, and 65% self-identified as Hispanic/Latino. Key themes identified included usefulness of the BMI letter, concerns about utility of BMI for screening, concerns about impacting self-esteem, and failure to understand the letter.

CONCLUSIONS:

The MA BMI letter may not have been achieving its desired goal with some parents.

PRACTICE IMPLICATIONS:

Emergent themes from this study could be used to test effectiveness of similar BMI letters nationwide and develop strategies to improve communication to parents.

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