Randomized controlled trial of a mailed toolkit to increase use of body mass index percentiles to screen for childhood obesity.
BACKGROUND
Despite epidemic increases in childhood obesity rates, many providers fail to diagnose obesity. Body mass index (BMI)-for-age percentiles are the recommended screening test. We evaluated whether mailing a toolkit to physicians would increase use of sex-specific BMI-for-age percentiles to screen for childhood obesity.


METHODS
We assigned a random sample of family physicians and pediatricians from New York State's medical licensing database to either intervention or control groups in the summer of 2004. At baseline and at follow-up, we sent physicians a survey that asked how often they used various screening methods to identify childhood obesity. Between the surveys, we sent physicians in the intervention group a toolkit that consisted of professional guidelines for childhood obesity screening, a tool for calculating BMI, BMI-for-age growth charts, and educational information.


RESULTS
At follow-up, more physicians in the intervention group than in the control group reported using BMI percentiles to screen for childhood obesity. Compared with physicians in the control group, physicians in the intervention group had a larger increase in their routine use of BMI percentiles to screen children aged 2 to 5, 6 to 11, and 12 to 20 years, although the differences in the older 2 groups did not attain statistical significance.


CONCLUSIONS
Directly mailing an educational toolkit to physicians can have a small but positive effect on clinical practice.
Dennison
Barbara A
BA
New York State Department of Health and State University of New York at Albany, Albany, New York, USA. bad10@health.state.ny.us
Nicholas
Joseph
J
de Long
Rachel
R
Prokorym
Megan
M
Brissette
Ian
I
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004502:Education, Medical, Continuing; D006801:Humans; D008403:Mass Screening; D009518:New York; D009765:Obesity / Q000175:diagnosis*; D010372:Pediatrics; D010820:Physicians; D055815:Young Adult