Abstract
Background: Current evidence demonstrates that, while a widely used tool for childhood obesity prevention, school-based BMI reports do not effectively reduce pediatric obesity. The purpose of this study was to examine the presumed mechanisms by which BMI reporting might impact child weight by assessing parents': (1) recall of BMI reports, (2) accuracy in recalling child overweight status, and (3) reactions to BMI reports. Methods: Mailed surveys were completed by 2205 racially/ethnically diverse parents of third- to seventh-grade students participating in the Fit Study who had either been exposed to 1 year of child BMI reporting (one report) or 2 years (two reports). Results: After 1 year of BMI reporting, parents of children with overweight were less likely [odds ratio (OR) = 0.7, 95% confidence interval (CI): 0.5-0.9] to recall receiving a BMI report and less likely (OR = 0.2, 95% CI: 0.1-0.3) to accurately recall their child's weight status from the BMI report, compared with parents of children with healthy weight. Differences in accuracy of child weight status recall persisted after 2 years of BMI reporting exposure. Only 22% of parents of children at risk for overweight and with overweight reported being surprised by the results. Conclusions: Parents' recall of receiving a school-based BMI report is low, as is the accuracy of recall of child's overweight status. Additionally, parents' surprise at, and concern for, BMI results is limited. Current BMI reports may be ineffective at reducing pediatric obesity due to their lack of salience and ability to compel meaningful behavior change among parents.