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Updated: Jul 6, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Validation of remote anthropometric measurements in a rural randomized pediatric clinical trial in primary care
E Zhang1, Ann M Davis2, Elizabeth Yakes Jimenez3
1Department of Occupational Therapy Education, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA. ezhang@kumc.edu.
Insights
Remote measurements of child height and weight via video are a valid solution for pediatric weight management trials in rural areas. This approach improves accessibility and accuracy, overcoming barriers of in-person visits.
Area of Science:
- Pediatric Health
- Obesity Research
- Telemedicine
Background:
- Childhood obesity disproportionately affects rural populations.
- In-person visits for pediatric weight management trials pose accessibility challenges for rural families.
- Remote assessments can enhance the accuracy of self-reported health data.
Purpose of the Study:
- To validate a low-cost, scalable video-assisted protocol for remote height and weight measurements in children and caregivers.
- To assess the feasibility of remote measurements for pediatric clinical trials in rural settings.
Main Methods:
- Thirty-three child-caregiver dyads participated in remote and in-person measurements.
- Low-cost digital scales and tape measures were provided to families.
- Videoconferencing was used for remote observations, with comparisons to in-person measurements using paired t-tests and Bland-Altman plots.
Main Results:
- No significant overall mean differences were found between remote and in-person measurements for child/caregiver weight, height, BMI, and child BMIaz.
- Limits of agreement were established for all measured parameters.
- Absolute mean differences were significant, and age was associated with height measurement discrepancies.
Conclusions:
- Remotely observed measurements using non-research grade equipment are feasible and valid for pediatric trials in rural communities.
- Researchers must consider measurement precision needs and intervention effect size when implementing remote measurements.
- This method offers a viable alternative to overcome geographical barriers in pediatric obesity research.
Abstract:
Rural children are more at risk for childhood obesity but may have difficulty participating in pediatric weight management clinical trials if in-person visits are required. Remote assessment of height and weight observed via videoconferencing may provide a solution by improving the accuracy of self-reported data. This study aims to validate a low-cost, scalable video-assisted protocol for remote height and weight measurements in children and caregivers. Families were provided with low-cost digital scales and tape measures and a standardized protocol for remote measurements. Thirty-three caregiver and child (6-11 years old) dyads completed remote (at home) height and weight measurements while being observed by research staff via videoconferencing, as well as in-person measurements with research staff. We compared the overall and absolute mean differences in child and caregiver weight, height, body mass index (BMI), and child BMI adjusted Z-score (BMIaz) between remote and in-person measurements using paired samples t-tests and one sample t-tests, respectively. Bland-Altman plots were used to estimate the limits of agreement (LOA) and assess systematic bias. Simple regression models were used to examine associations between measurement discrepancies and sociodemographic factors and number of days between measurements. Overall mean differences in child and caregiver weight, height, BMI, and child BMIaz were not significantly different between remote and in-person measurements. LOAs were - 2.1 and 1.7 kg for child weight, - 5.2 and 4.0 cm for child height, - 1.5 and 1.7 kg/m2 for child BMI, - 0.4 and 0.5 SD for child BMIaz, - 3.0 and 2.8 kg for caregiver weight, - 2.9 and 3.9 cm for caregiver height, and - 2.1 and 1.6 kg/m2 for caregiver BMI. Absolute mean differences were significantly different between the two approaches for all measurements. Child and caregiver age were each significantly associated with differences between remote and in-person caregiver height measurements; there were no significant associations with other measurement discrepancies. Remotely observed weight and height measurements using non-research grade equipment may be a feasible and valid approach for pediatric clinical trials in rural communities. However, researchers should carefully evaluate their measurement precision requirements and intervention effect size to determine whether remote height and weight measurements suit their studies.Trial registration: ClinicalTrials.gov NCT04142034 (29/10/2019).
