This paper provides an analysis of the usefulness and operational feasibility of an indicator to monitor both obesity in children and young people, and the effectiveness of the collective strategies and interventions used to prevent and manage childhood obesity. The work uses a ‘Leading for Outcomes’ approach, which is a systems-level framework employed by the Clinical Services Directorate of the Ministry of Health, with an initial focus on chronic disease prevention and management.
This paper was written by Dr Nikki Blair, as part of her advanced training in paediatrics, during a six-month attachment to the Ministry of Health’s Clinical Services Directorate under the supervision of Dr Pat Tuohy, Chief Advisor Child and Youth Health.
Section 1 of this paper identifies candidate indicators of obesity in childhood. From the candidate indicators, including anthropometric and direct measures of adiposity, the single best indicator will be identified by reviewing the literature and consulting experts whom work in obesity research and management. Criteria considered for this analysis included reliability, reproducibility and acceptability to the individual, along with the ability of the indicator to detect differences and trends in populations and subgroups. It will show that age-related BMI percentile to be the best indicator of obesity in childhood and adolescence.
Section 2 assesses the best age in childhood to apply the selected indicator (BMI) for the purpose of population monitoring. Criteria used in this analysis are accessibility, prevalence of obesity and consequently the ability to measure change and minimisation of potential harm. Analysis will draw on research, current practices and expert opinion.
Section 3 discusses the ethical considerations such as consent, privacy, psychosocial risks and costs. These issues will be specifically assessed for the proposed population collection of BMI in childhood. These discussions will rely on formal documents, the Health Information Privacy Code and the Code of Health and Disability Services Consumers’ Rights, expert opinion and current practices.
Section 4 describes the practical issues including the setting, the personnel requirements and the data collection process. This discussion mostly relies on expert opinion and experience.
Section 5 looks at how the introduction of a systems performance indicator of obesity in childhood will contribute to the overall goal of reducing the prevalence of childhood and thus adulthood obesity, and the associated chronic disease burden. This analysis will use research where available, and expert opinion and existing practice where it is not.
Disclaimer: The content of this paper does not necessarily represent the Ministry of Health’s viewpoint, but is intended to guide policy and funding decisions regarding childhood obesity prevention and management. The intended audience for this paper includes policy makers within the Ministry of Health and other relevant government departments, and District Health Board funders and planners.