P88 Is it Just a Measurement? Collecting, Tracking, and Reporting BMI in Head Start

Background Head Start (HS) is required to collect height and weight data of preschoolers each year and report aggregate rates of BMI. However, limited research has been conducted to understand this process. Objective This study explored the processes HS programs in Ohio and North Carolina use to measure, track, and report children's weight status. Study Design, Setting, Participants This qualitative study utilized a phenomenological approach. Twenty-nine semi-structured interviews were conducted with Head Start Health and Nutrition Managers across Ohio (n = 14) and North Carolina (n = 15). Interviews were conducted until saturation was achieved. Measurable Outcome/Analysis Interviews were recorded and transcribed verbatim. Transcripts were independently reviewed and significant statements were identified, describing what participants experienced. Patterns of meaning across interviews were assigned codes and described. Codes were compared, agreed upon, and organized into themes. Results Analysis yielded 5 themes: perceptions of BMI, measurement processes, reporting/tracking, training and resources, and additional support. Managers described a variety of concerns with the usefulness of BMI. Differences were identified in the staff responsible for measurements, as well as their expertise and training. Equipment used for measuring height and weight also varied across and within programs. Most managers reported utilizing computer programs where height and weight were entered, BMI calculated, and weight status classifications generated for reporting to parents and on the Program Information Report. Managers acknowledged inconsistencies in the persons responsible for data collection, training of collectors, and variability in the data collection process may impact accuracy of reporting. Furthermore, no consistent process was identified for the reporting and referral of at-risk children. Conclusion Training on collection of height and weight measurements is needed, as most programs described limited availability of training opportunities, resources, and time to implement internal training on growth and assessment. Additionally, clarification and standardization of the process for tracking, reporting and referring at-risk children is warranted.