Published online August 31, 2009
PEDIATRICS Vol. 124 Supplement September 2009, pp. S50-S62 (doi:10.1542/peds.2008-3586H)
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SUPPLEMENT ARTICLE


The Role of Culture in the Context of School-Based BMI Screening

Marian L. Fitzgibbon, PhDa,b and Bettina M. Beech, DrPH, MPHc

a Department of Medicine, University of Illinois, Chicago, Illinois
b Center for Management of Complex Chronic Care, Jesse Brown VA Medical Center, Chicago, Illinois
c Division of General Internal Medicine and Public Health, Vanderbilt University School of Medicine, Nashville, Tennessee

The high prevalence of overweight and obesity is a significant public health concern in the United States. Minority populations are disproportionately affected, and the impact of obesity on minority children is especially alarming. In this article we discuss school-based BMI reporting, which is intended to increase parental awareness of their children's weight status. This information could potentially lead parents of overweight and obese children to carefully examine and possibly change their children's diet and activity patterns. However, any program related to child weight status must consider culturally defined aspects of body size and shape. In other words, the cultural context in which information on child BMI is presented to and received by parents must be considered. In this article we review parental perceptions of child weight. Multiple studies have shown that parents of overweight or obese children often fail to correctly perceive their children as overweight. Possible reasons for, and implications of, this misperception of child weight status among minority parents are then explored within a cultural framework. The PEN-3 model is used to examine influences on health behaviors and could help inform the development of a culturally sensitive BMI-notification program for minority parents. Reporting materials congruent with the social and cultural values and practices of the target audience are likely to maximize program effectiveness. A culturally based BMI-notification program should be conceptualized as a small step in a comprehensive plan to reduce childhood obesity and improve the current and future health of minority children.

Key Words: weight status • weight perception • minorities • overweight • African Americans • Latinos • PEN-3 model

Abbreviations: NHANES—National Health and Nutrition Examination Survey • WIC—Supplemental Nutrition Program for Women, Infants, and Children

Accepted Apr 29, 2009.


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