title: Reliability and criterion validity of self-measured waist, hip, and neck circumferences.
abstract: Waist, hip, and neck circumference measurements are cost-effective, non-invasive, useful markers for body fat distribution and disease risk. For epidemiology and intervention studies, including body circumference measurements in self-report surveys could be informative. However, few studies have assessed the test-retest reliability and criterion validity of a self-report tool feasible for use in large scale studies.
  
  
  
  At home, mothers of young children viewed a brief, online instructional video on how to measure their waist, hip, and neck circumferences. Afterwards, they created a homemade paper measuring tape from a downloaded file with scissors and tape, took all measurements in duplicate, and entered them into an online survey. A few weeks later, participants visited an anthropometrics lab where they measured themselves again, and trained technicians (n = 9) measured participants in duplicate using standard equipment and procedures. To assess differences between self- and technician-measured circumferences, duplicate measurements for participant home self-measurements, participant lab self-measurements, and technician measurements each were averaged and Wilcoxon signed-rank tests conducted. Agreement between all possible pairs of measurements were examined using Intraclass Correlations (ICCs) and Bland-Altman plots.
  
  
  
  Participants (n = 41; aged 38.05 ± 3.54SD years; 71 % white) were all mothers that had at least one child under the age of 12 yrs. Technical error of measurements for self- and technician- duplicate measurements varied little (0.08 to 0.76 inches) and had very high reliability (≥0.90). Intraclass Correlations (ICC) comparing self vs technician were high (0.97, 0.96, and 0.84 for waist, hip, and neck). Comparison of self-measurements at home vs lab revealed high test-retest reliability (ICC ≥ 0.87). Differences between participant self- and technician measurements were small (i.e., mean difference ranged from -0.13 to 0.06 inches) with nearly all (≥93 %) differences within Bland-Altman limits of agreement and <10 % exceeding the a priori clinically meaningful difference criterion.
  
  
  
  This study has demonstrated a simple, inexpensive method for teaching novice mothers of young children to take their own body circumferences resulting in accurate, reliable data. Thus, collecting self-measured and self-reported circumference data in future studies may be a feasible approach in research protocols that has potential to expand our knowledge of body composition beyond that provided by self-reported body mass indexes.
authors.affiliation: Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Barrios
authors.affiliation: Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Martin-Biggers
authors.affiliation: Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA. gingermquick@gmail.com.
authors.forename: Virginia
authors.initials: V
authors.lastname: Quick
authors.affiliation: Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ, 08901, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Byrd-Bredbenner
mesh_terms: D000328:Adult; D050218:Body Fat Distribution; D003951:Diagnostic Errors; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D050177:Overweight / Q000175:diagnosis*; D015203:Reproducibility of Results; D055105:Waist Circumference
keywords: Body circumferences; Criterion validity; Hip; Measurements; Neck; Reliability; Waist