2010 Assessment:2010 Assessment:Measuring Height and WeightMeasuring Height and Weight

Catherine Lillehoj, Ph.D.Catherine Lillehoj, Ph.D.

Xia Chen, D.D.S., M.S.Xia Chen, D.D.S., M.S.

BMI Surveillance ProjectBMI Surveillance Project

WhyWhy– PurposePurpose– How data will be usedHow data will be used

HowHow– Confidentiality Confidentiality – Taking accurate measurementsTaking accurate measurements– Using equipmentUsing equipment– Role of the person doing the measurementsRole of the person doing the measurements

Current Data SourcesCurrent Data Sources

Pediatric Nutrition Surveillance SystemPediatric Nutrition Surveillance System Children 0-5 years of age Children 0-5 years of age Participating in WICParticipating in WIC Less than 40% of all children in IowaLess than 40% of all children in Iowa

Youth Risk Behavior SurveyYouth Risk Behavior Survey Self reported height and weightSelf reported height and weight Self reported Self reported perception perception of weightof weight High school ageHigh school age Scanty school participation Scanty school participation

Pilot Intervention Project/CDC Nutrition & Physical Pilot Intervention Project/CDC Nutrition & Physical Activity GrantActivity Grant 12 schools (312 schools (3rdrd, 4, 4thth, 5, 5thth graders) graders)

Setting-up Examination AreaSetting-up Examination Area

Establish privacy by using dividers or Establish privacy by using dividers or having other children wait outside the having other children wait outside the examination area.examination area.

Privacy is important for weighing and Privacy is important for weighing and measuring. Even young children are measuring. Even young children are sensitive about weight and being teased.sensitive about weight and being teased.

Other ways to establish privacy?Other ways to establish privacy?

Height/Weight Measurement Height/Weight Measurement Equipment and MaterialsEquipment and Materials

Child/Adult Portable Stadiometer (measure Child/Adult Portable Stadiometer (measure height) height) Flat Electronic Scale with Cable for Remote Flat Electronic Scale with Cable for Remote DisplayDisplayHard surface for scale Hard surface for scale Clipboard or portable writing surfaceClipboard or portable writing surface

Using the StadiometerUsing the Stadiometer

PlatformPlatformMeasuring BoardMeasuring BoardMoveable head board - Rigid Moveable head board - Rigid right angle – moves up & down right angle – moves up & down in groove to rest on headin groove to rest on headUse only the stadiometer for Use only the stadiometer for height measurementheight measurementAssemble by sliding the Assemble by sliding the backboard sections togetherbackboard sections togetherCheck to make sure section Check to make sure section are in correct sequenceare in correct sequenceLock sections togetherLock sections togetherPosition the stadiometer on a Position the stadiometer on a level surfacelevel surface

Standing HeightStanding Height

1.1. Remove shoes, hats and Remove shoes, hats and bulky clothing.bulky clothing.

2.2. Position child with shoulders Position child with shoulders level, hands at sides, feet flat level, hands at sides, feet flat on foot piece.on foot piece.

3.3. Heels, buttocks, shoulders & Heels, buttocks, shoulders & head should touch board.head should touch board.

4.4. Position child’s head into the Position child’s head into the Frankfort plane (line of sight).Frankfort plane (line of sight).

5.5. Lower head piece until it Lower head piece until it firmly touches the crown of firmly touches the crown of the head.the head.

6.6. Read measurement to the Read measurement to the nearest 1/8 inch.nearest 1/8 inch.

Reviewing TechniqueReviewing Technique

Frankfort plane Frankfort plane – an – an imaginary line through the imaginary line through the eyes. Position child so eyes. Position child so that it is parallel to the that it is parallel to the floor when the child is floor when the child is looking straight aheadlooking straight aheadFour points Four points will touch will touch the measuring boardthe measuring board– back of head back of head – shoulders shoulders – buttocksbuttocks– heels heels

Review of Placement for HeightReview of Placement for Height MeasurementMeasurement

•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

Reading & Recording Height MeasurementReading & Recording Height MeasurementWhen the child is correctly positioned ask the child to “take a When the child is correctly positioned ask the child to “take a deep breath and stand-up straight.”deep breath and stand-up straight.”

Make sure they do not lift heels off base plate.Make sure they do not lift heels off base plate.

Lower the head plate so it rests firmly on the child’s head.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 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 the measurement at the bottom edge of the head plate. head plate.

Read measurement to the nearest 1/8Read measurement to the nearest 1/8thth inch. Read only the inch. Read only the marks you can see without adjusting your position.marks you can see without adjusting your position.

Record the height measurement to the nearest 1/8 inch on Record the height measurement to the nearest 1/8 inch on the form.the form.

Recheck the measurement to ensure you have recorded it Recheck the measurement to ensure you have recorded it correctly, then release the head plate. correctly, then release the head plate.

Note any difficulties in obtaining an accurate measurement.Note any difficulties in obtaining an accurate measurement.

Using the ScaleUsing the ScaleTurn the display on.Turn the display on.

Wait for the display to read 0.0 kilograms Wait for the display to read 0.0 kilograms before weighing the child.before weighing the child.

Wait for the display to reset Wait for the display to reset before weighing before weighing

the next child. the next child. 00

Operating the ScaleOperating the Scale

76.276.2

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

Weight Measurement Weight Measurement Equipment and PlacementEquipment and Placement

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

00

Preparing to Measure WeightPreparing to Measure Weight

Ask the child to remove: Ask the child to remove: – shoes shoes – outer clothing such as a coat, jacket, outer clothing such as a coat, jacket,

sweater/vest, or heavy belt sweater/vest, or heavy belt – purse, fanny pack, or heavy jewelrypurse, fanny pack, or heavy jewelry

Empty pockets of change and heavy Empty pockets of change and heavy itemsitems

Weighing ChildrenWeighing Children

Ask child to step on the Ask child to step on the scale.scale.

Set scale at “0”.Set scale at “0”.

Read & record the Read & record the number shown on the number shown on the digital reader. digital reader.

It will not be necessary to It will not be necessary to touch children during the touch children during the weighing & measuring weighing & measuring process. process.

Reset scale at “0”.Reset scale at “0”.

Review of Placement for WeighingReview of Placement for Weighing

00Ask the child to stand on the Ask the child to stand on the center of the scale, as center of the scale, as shown.shown.

The child’s posture is The child’s posture is important: important: – Arms should be hanging loosely Arms should be hanging loosely

at sides. at sides.

– Ask the child to look Ask the child to look straight ahead. straight ahead.

– Standing off-center, looking Standing off-center, looking down, or shifting weight can down, or shifting weight can adversely affect accuracy.adversely affect accuracy.

Taking the Weight MeasurementTaking the Weight MeasurementWhen the scale stabilizes, the When the scale stabilizes, the child’s weight will be displayed. child’s weight will be displayed. The child may step off. The child may step off.

Record the weight on the form Record the weight on the form exactly as displayed. Read the exactly as displayed. Read the display again to ensure the display again to ensure the correct weight is recorded.correct weight is recorded.

Reset the scale.Reset the scale.

If Child Expresses ConcernIf Child Expresses Concern

Ensure confidentialityEnsure confidentiality

Do not make a “diagnosis”Do not make a “diagnosis”– A single measurement is not useful in making A single measurement is not useful in making

judgments about a child’s weight status.judgments about a child’s weight status.– Growth spurts, body build are some factors that can Growth spurts, body build are some factors that can

influence weight in children. influence weight in children.

How Will Data Be Used?How Will Data Be Used?

Height & weight will be used to calculate Height & weight will be used to calculate BMIBMI

BMI is related to age. BMI is related to age. – BMI for children varies with age.BMI for children varies with age.

Percentiles will be calculated Percentiles will be calculated

Data will be grouped by school. Data will be grouped by school.

Data will be reported back. Data will be reported back.

Sharing ResultsSharing Results

After a school is completed, the data will be After a school is completed, the data will be entered into a database with no identifiable entered into a database with no identifiable information.information.

After all schools are completed, the data will be After all schools are completed, the data will be analyzed using statistical software to analyzed using statistical software to generate statewide datagenerate statewide data

Promote the surveillance system in all Promote the surveillance system in all counties in Iowacounties in Iowa

Communication via Website, newsletter, Communication via Website, newsletter, reports is being developedreports is being developed

What mistakes do you see?What mistakes do you see?

What mistakes do you see?What mistakes do you see?

What mistakes do you see?What mistakes do you see?

Please Contact:Please Contact:

Catherine LillehojCatherine Lillehoj

515 242 5913515 242 5913

clilleho@idph.state.ia.usclilleho@idph.state.ia.us

Questions?