Beyond the BMI: An Educational, Family-Centered Approach to Identifying Risk for Childhood Obesity

Abstract

Category/Date

Evidence-Based Practice Poster presented at NAPNAP’s 46^th National Conference on Pediatric Health Care, Posters on the Move, March 12, 2025

Background & Significance

In the United States, the increasing prevalence of obesity has caused public health concerns. From 2017 to 2020, 14.7 million children were considered obese. Obesity is defined as a body mass index (BMI) at or above the 95th percentile on the growth chart. Pediatric patients with obesity have a 70% likelihood of becoming obese in adulthood and can develop associated cardiometabolic complications. Additionally, they can spend $310 more for healthcare annually than their healthy weight counterparts.

Purpose/Aims

The Family Nutrition and Physical Activity (FNPA) screening tool can be implemented in pediatric primary care clinics to address lifestyle habits and risk for childhood obesity. The purpose of this project was to determine if the FNPA tool can identify more obesogenic behaviors than the standard of care, and if counseling using motivational interviewing (MI) improves FNPA score.

Methods

Thirty-three families with children aged 4 to 18 presenting for their well-child visits filled out the FNPA tool and the standard of care. Counseling was performed with MI and a handout of AAP-endorsed recommendations. After three months, 27 families participated in a follow-up via phone call where the tool was administered again.

Results

92.6% of participants (25/27) improved their score, signifying that family lifestyle changes were implemented. A paired sample t-test showed that scores significantly increased from the pre-intervention score (mean = 64.67, SD = 5.903) to the post-intervention score (mean = 70.67, SD = 5.407); t(26) = -7.109, p< 0.001. Additionally, the FNPA tool identified more obesogenic risk factors than the standard of care.

Discussion

In using the FNPA screening tool, the provider can better counsel on lifestyle behaviors than the standard of care. Improved screening will identify more children at risk for obesity and begin weight management interventions. Children with improved lifestyle behaviors will have lower obesity risk factors. In turn, reduced rates of childhood obesity will have large cost savings.

Conclusions

Families that were screened using the FNPA tool and counseled with MI techniques had a mean improvement of 9% (six points) in their score and demonstrated improved lifestyle behaviors over three months. Future studies may be necessary with extended follow-up periods to see long-term lifestyle changes.