Remote Assessment of Pediatric Anthropometrics

To assess the reliability and fidelity of caregiver- and examiner-administered anthropometric measurements in English- and Spanish-speaking children aged 0-17 years.

Participants (N = 199; median age, 4.69 years; interquartile range, 1.58-10.37; 46.7% male) were recruited in 6 sites across the United States in May-August 2023. Examiners were trained by a pediatric nurse; caregivers received well-developed administration materials. The key anthropometric outcomes assessed were infant length/child height, weight, percent body fat (PBF), head size, and waist circumference. Concordance between caregiver/examiner measurements was assessed using interrater reliability estimates, technical error of measurement (TEM), and mean absolute difference (MAD). Secondary outcomes included reported ease of use and language used.

High concordance was observed between caregivers and examiners, with reliability coefficients ranging from 0.91 to >0.99 and intraclass correlation coefficient values from 0.92 to >0.99 across all assessments and age groups. The TEM was low (height = 2.10 cm, weight = 0.39 kg, PBF = 2.33%; head circumference = 0.73 cm, waist circumference = 3.65 cm) as were MAD estimates (height = 2.12 cm, 95% confidence interval [CI], 1.82-2.42; weight = 0.35 kg, 95% CI, 0.29-0.41; PBF = 2.39%, 95% CI, 1.89-2.88; head size = 0.71 cm, 95% CI, 0.54-0.89; waist circumference = 3.15 cm, 95% CI, 2.41-3.88).

Across multiple metrics, there was high concordance between caregiver- and examiner-administered measurements, providing evidence of interchangeability between remote and in-person assessments of anthropometric outcomes. Remote anthropometric assessment appears feasible and low burden and has comparably high validity and reliability to in-person methods.