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Updated: Jul 26, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Does the use of color coding facilitate parents' understanding of body mass index curves?
Coralie Barbe1, Marie Boiteux-Chabrier2, Leïla Bouazzi3
1Comité Universitaire de Ressources pour la Recherche en Santé, Université de Reims Champagne-Ardenne UFR Médecine, 51 rue Cognacq Jay, 51100, REIMS, France; Laboratoire C2S (Cognition, Santé, Société), EA 6291, Université de Reims Champagne-Ardenne, France.
Insights
Color-coded body mass index (BMI) curves significantly improved parents' understanding of their child's weight status compared to standard curves. This visual aid enhances parental engagement in childhood obesity management.
Area of Science:
- Pediatric Health
- Public Health Nutrition
- Health Communication
Background:
- National guidelines in France emphasize early detection of childhood overweight and obesity.
- Systematic generation of children's body mass index (BMI) curves is standard practice in primary care.
- Parental comprehension of BMI curves is crucial for effective involvement in child health management.
Purpose of the Study:
- To compare parental understanding of body mass index (BMI) curves presented with color coding versus those without.
- To evaluate the impact of visual aids on parental interpretation of pediatric weight status.
Main Methods:
- An observational, cross-sectional study involving parents of primary school children.
- Two questionnaires assessed understanding of BMI curves: one color-coded, one standard.
- McNemar test and mixed logistic regression analyzed differences in fully correct responses.
Main Results:
- Parents demonstrated significantly higher understanding with color-coded BMI curves (86.0%) compared to standard curves (54.2%).
- Color coding was strongly associated with achieving fully correct responses (OR: 5.9).
- The response rate was 45.4% with 109 participants completing 214 questionnaires.
Conclusions:
- Color coding enhances parental understanding of children's BMI curves.
- Further research is needed on the benefits and risks of using colored BMI curves for managing childhood overweight and obesity, including mental health considerations.
Background:
In France, national guidelines recommend early detection and management of overweight and obesity in children, with multi-year systematic generation of children's body mass index (BMI) curves in primary care. It is important for the parents to understand the BMI curves displayed in the child's health notebook and to become involved in the care with health professionals.
Objective:
The aim of the current study was to compare parents' understanding of a BMI curve displayed using color coding versus their understanding of the same curve displayed without color coding.
Methods:
An observational, cross-sectional, comparative study was performed between February 1, 2021 and November 15, 2021. Adult parents with at least one child attending primary school were included. Two questionnaires testing parents' understanding were completed: one showing BMI curves without color coding (five questions) and one showing BMI curve with color coding (five questions). The primary endpoint was the proportion of parents achieving fully correct answers. Comparisons of endpoints between the color-coded and non-color-coded curve were performed using the McNemar test. Factors associated with the primary endpoint were investigated by mixed logistic regression models with the subject as a random effect.
Results:
The 109 participants (45.4% response rate) had an average age of 39.4 ± 6.6 years; 81.7% were women. A total of 214 complete questionnaires were compared: The proportion of participants with fully correct responses was significantly higher using the BMI curve with color coding compared to the curve without color coding (86.0% vs. 54.2%, p<0.0001). In multivariate analysis, the use of color coding was significantly associated with a higher likelihood of achieving fully correct responses (odds ratio: 5.9, 95% CI: 3.0-11.2, p<0.0001).
Conclusion:
The use of color coding improved parents' understanding of BMI curves. Further research should explore equally the benefits and risks associated with weight loss and mental health when using a colored BMI curve for the detection and management of overweight and obese children.
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