June 27, 2017

The Association of BMI Status With Adolescent Preventive Screening

OBJECTIVE: To examine the relationship between BMI status (normal, overweight, and obese) and preventive screening among adolescents at their last checkup.

METHODS: We used population-based data from the 2003–2007 California Health Interview Surveys, telephone interviews of adolescents aged 12 to 17 years with a checkup in the past 12 months (n  9220). Respondents were asked whether they received screening for nutrition, physical activity, and emotional distress. BMI was calculated from self-reported height and weight: (1) normal weight or underweight (85th percentile); (2) overweight (85th–94th percentile); and (3) obese (95th percentile). Multivariate logistic regression models tested how screening by topic differed according to BMI status, adjusting for age, gender, income, race/ethnicity, and survey year.

RESULTS: Screening percentages in the pooled sample (all 3 years) were higher for obese, but not overweight, adolescents for physical activity (odds ratio: 1.4; P  .01) and nutrition (odds ratio: 1.6; screening did not differ P  .01). Stratified analysis by year revealed higher screening for obese (versus normal-weight) adolescents for nutrition and physical activity in 2003 and for all 3 topics in 2005. However, by 2007, screening did not differ according to BMI status. Overall screening between 2003 and 2007 declined for nutrition (75%–59%; P  .01), physical activity (74%–60%; P  .01), and emotional distress (31%– 24%; P  .01).

CONCLUSIONS: Obese adolescents receive more preventive screening versus their normal-weight peers. Overweight adolescents do not report more screening, but standards of care dictate increased attention for this group. These results are discouraging amid a rise in pediatric obesity and new guidelines that recommend screening by BMI status.

The Association of BMI Status With Adolescent Preventive Screening; Carolyn Bradner Jasik, Sally H. Adams, Charles E. Irwin, Jr, and Elizabeth Ozer; Pediatrics 2011; 128:2 e317-e323; published ahead of print July 18, 2011, doi:10.1542/peds.2010-2559