1. 2010 Assessment: Measuring Height and Weight Catherine Lillehoj, Ph.D. Xia Chen, D.D.S., M.S.

2. BMI Surveillance Project Why –Purpose –How data will be used How –Confidentiality –Taking accurate measurements –Using equipment –Role of the person doing the measurements

3. Current Data Sources  Pediatric Nutrition Surveillance System  Children 0-5 years of age  Participating in WIC  Less than 40% of all children in Iowa  Youth Risk Behavior Survey  Self reported height and weight  Self reported perception of weight  High school age  Scanty school participation  Pilot Intervention Project/CDC Nutrition & Physical Activity Grant  12 schools (3 rd, 4 th, 5 th graders)

4. Setting-up Examination Area Establish privacy by using dividers or having other children wait outside the examination area. Privacy is important for weighing and measuring. Even young children are sensitive about weight and being teased. Other ways to establish privacy?

5. Height/Weight Measurement Equipment and Materials Child/Adult Portable Stadiometer (measure height) Flat Electronic Scale with Cable for Remote Display Hard surface for scale Clipboard or portable writing surface

6. Using the Stadiometer Platform Measuring Board Moveable head board - Rigid right angle – moves up & down in groove to rest on head Use only the stadiometer for height measurement Assemble by sliding the backboard sections together Check to make sure section are in correct sequence Lock sections together Position the stadiometer on a level surface

7. Standing Height 1. Remove shoes, hats and bulky clothing. 2. Position child with shoulders level, hands at sides, feet flat on foot piece. 3. Heels, buttocks, shoulders & head should touch board. 4. Position child’s head into the Frankfort plane (line of sight). 5. Lower head piece until it firmly touches the crown of the head. 6. Read measurement to the nearest 1/8 inch.

8. Reviewing Technique Frankfort plane – an imaginary line through the eyes. Position child so that it is parallel to the floor when the child is looking straight ahead Four points will touch the measuring board –back of head –shoulders –buttocks –heels

9. Review of Placement for Height Measurement Points of Contact with Stadiometer: Head* Shoulder blades Buttocks Heels Check Frankfort Plane *Occasionally, body shape will not permit the child’s head to touch the board when standing in a natural position. Do not ask child to tip head backward to touch the board. Head plate Ruler placement for line of sight - Frankfort Plane Base plate

10. Reading & Recording Height Measurement When the child is correctly positioned ask the child to “take a deep breath and stand-up straight.” Make sure they do not lift heels off base plate. Lower the head plate so it rests firmly on the child’s head. Bend your knees so that your line of site is level with the head plate. Read the measurement at the bottom edge of the head plate. Read measurement to the nearest 1/8 th inch. Read only the marks you can see without adjusting your position. Record the height measurement to the nearest 1/8 inch on the form. Recheck the measurement to ensure you have recorded it correctly, then release the head plate. Note any difficulties in obtaining an accurate measurement.

11. Using the Scale Turn the display on. Wait for the display to read 0.0 kilograms before weighing the child. Wait for the display to reset before weighing the next child. the next child. 00

12. Operating the Scale 76.2 KgSTART kg Turn scale on START; 88888 will flash momentarily and the display will register 0.0 Set the unit of display by pressing the kg/lb button to set the mark to kilograms

13. Weight Measurement Equipment and Placement Weight will be measured using the Seca electronic scale. Use this scale only. Look at the scale to verify that it is set to measure kilograms. Place scale on a hard level surface. Center the scale on the surface. 00

14. Preparing to Measure Weight Ask the child to remove: –shoes –outer clothing such as a coat, jacket, sweater/vest, or heavy belt sweater/vest, or heavy belt –purse, fanny pack, or heavy jewelry Empty pockets of change and heavy items

15. Weighing Children Ask child to step on the scale. Set scale at “0”. Read & record the number shown on the digital reader. It will not be necessary to touch children during the weighing & measuring process. Reset scale at “0”.

16. Review of Placement for Weighing Ask the child to stand on the center of the scale, as shown. The child’s posture is important: –Arms should be hanging loosely at sides. –Ask the child to look straight ahead. –Standing off-center, looking down, or shifting weight can adversely affect accuracy.

17. Taking the Weight Measurement When the scale stabilizes, the child’s weight will be displayed. The child may step off. Record the weight on the form exactly as displayed. Read the display again to ensure the correct weight is recorded. Reset the scale.

18. If Child Expresses Concern Ensure confidentiality Do not make a “diagnosis” –A single measurement is not useful in making judgments about a child’s weight status. –Growth spurts, body build are some factors that can influence weight in children.

19. How Will Data Be Used? Height & weight will be used to calculate BMI BMI is related to age. –BMI for children varies with age. Percentiles will be calculated Data will be grouped by school. Data will be reported back.

20. Sharing Results After a school is completed, the data will be entered into a database with no identifiable information. After all schools are completed, the data will be analyzed using statistical software to generate statewide data Promote the surveillance system in all counties in Iowa Communication via Website, newsletter, reports is being developed

21. What mistakes do you see?

25. Please Contact: Catherine Lillehoj 515 242 5913 clilleho@idph.state.ia.us Questions?