The Arkansas Assessment of Childhood and Adolescent Obesity – Tracking Progress ONLINE STATE REPORT Year 3 (Fall 2005–Spring 2006) Acknowledgments ACHI recognizes and thanks the dedicated and hardworking school personnel— nurses, teachers, PE instructors, principals, superintendents, clinicians, and others—who recognize the importance of continuing this ground-breaking work in combating childhood and adolescent obesity. In particular, we applaud the vision of school administrators who encouraged nurses to be trained in the pilot web-based system and we thank those nurses for agreeing to learn a new task while continuing to carry out their daily work. ACHI also gratefully acknowledges the Robert Wood Johnson Foundation for its financial support of the BMI data analysis. Copyright © September 2006 by the Arkansas Center for Health Improvement. All rights reserved. Suggested citation: Arkansas Center for Health Improvement. The Arkansas Assessment of Childhood and Adolescent Obesity—Tracking Progress: Online Report Year 3 (Fall 2005–Spring 2006). Little Rock, AR: ACHI, August 2006. Table of Contents Overview & Highlights of the Arkansas BMI Assessments . 1 BMI Data Collection Efforts . .2 Process . .2 Definition of BMI . .3 Student and School Participation in the BMI Initiative . 3 Data Collected and Reasons Students Could Not Be Assessed . 4 Special Circumstances for Reporting . 5 BMI Reports . .6 Child Health Reports . .6 School Reports . .6 School District Reports . .6 Statewide Report . .6 Statewide Results of the Arkansas BMI Assessments . 7 Overall State Results for 2005–2006 . 7 School District Results . 11 Conclusion—Comprehensive Efforts Yield Results . 13 Appendices . .14 Appendix A: BMI Classifications by School (2005–2006) . 14 Appendix B: BMI Classifications by School District (2005–2006) . 26 Appendix C: BMI Classifications by County (2005–2006) . 31 Appendix D: Student BMI Assessment Rates (2005–2006) . 33 List of Tables and Figures Table 1. School Districts Using ACHI’s Web-based BMI Data Entry System . 2 Table 2. Statewide Participation in BMI Assessments . 3 Figure 1. Reasons Students Could Not Be Assessed (2005–2006) . 4 Table 3. Trends in BMI Classifications for Arkansas Public School Students . 7 Figure 2. BMI Classifications for Arkansas Public School Students (2005–2006) . 7 Figure 3. BMI Classifications by Gender (2005–2006) . 8 Table 4. BMI Classifications by Ethnic Group (2005–2006) . 8 Figure 4. Percentage of Students Classified as Overweight or At Risk for Overweight by Gender and Ethnic Group (2005–2006) . 9 Figure 5. Percentage of Students Classified as Overweight or At Risk for Overweight by Grade (2005–2006) . .9 Figure 6. Percentage of Students Classified as Overweight or At Risk for Overweight by Gender and Grade (2005–2006) . 10 Figure 7. Percentage of Students Classified as Overweight or At Risk for Overweight by Gender, Ethnicity, and Grade (2005–2006) . 10 Figure 8: Percentage of Students Classified as Overweight or At Risk for Overweight by Arkansas Public School District (2005–2006) . 12 Tracking Progress: Online State Report (Year 3) Overview and Highlights of the Arkansas BMI Assessments Analysis of the third annual BMI assessments of public school students reveals that the progression of the childhood obesity epidemic has been halted in Arkansas. Despite these results, almost 38 percent of children and adolescents in the state continue to face an obesity problem and associated health risks. hildhood obesity is a leading public health As a result of its size and methodological rigor, threat in the United States. More than ACHI’s BMI database provides the broadest and most 9 million children over the age of six are precise single-state profile of the childhood obesity Caffected by the obesity epidemic, with minorities and epidemic in the nation. children living in low-income communities facing Building on new actions by the Arkansas State Board the greatest risk. Obese children face an increased risk of Education, ACHI worked closely with public of developing hypertension, diabetes, heart disease, school personnel and community health nurses and other life-threatening illnesses as they age. If the during the last school year to improve and streamline epidemic grows unchecked, obesity-related illnesses the BMI assessment and reporting process. A new may cause today’s young people—for the first time web-based data entry system was used to assess BMIs in U.S. history—to have a lower life expectancy than for about one-fourth of public school students, or their parents’ generation. 130,000 individuals, during the 2005–2006 school Arkansas leaders year. Overall, BMI recognized the danger assessment forms were of the obesity epidemic As a result of its size and methodological rigor, completed for nearly and took aggressive ACHI’s BMI database provides the broadest and 434,000 Arkansas public action long before many most precise single-state profile of the childhood school students in states had focused on obesity epidemic in the nation. 2005–2006. the problem. Three years Researchers at ACHI ago, Arkansas passed Act 1220 of 2003, a uniquely analyzed the results of three consecutive years of comprehensive approach to combating childhood BMI screenings for Arkansas public school students. obesity in public schools and local communities. The data reveal that the percentage of students Among other provisions, the Act called for improved classified as overweight decreased from 20.9 percent access to healthier foods in schools, creation of during the first year to 20.4 percent this year. It also local committees to promote physical activity and shows that the percentage of students at risk for nutrition, and confidential reporting of each student’s overweight—the category between “healthy weight” body mass index (BMI) to his or her parents. and “overweight”—declined slightly over the same To help implement Act 1220 and gauge its period from 17.2 percent to 17.1 percent. Although effectiveness over time, the Arkansas Center for obesity among children and adolescents remains a Health Improvement (ACHI) worked with Arkansas major public health threat with almost 38 percent of policymakers and school personnel to develop Arkansas students categorized as at risk for overweight a system for weighing and measuring students, or overweight, it’s clear that Arkansas’s efforts are calculating BMI levels, and collecting and analyzing yielding positive results for the state’s children and data on a school, school district, and statewide basis. families. Tracking Progress: Online State Report (Year 3) 1 BMI Data Collection Efforts Process Since Arkansas began collecting BMI data in the health staff to merge future BMI reports with other 2003–2004 school year, ACHI has worked closely health assessments, such as vision, hearing, and other with public school personnel and community health screenings. nurses to develop and subsequently improve and Districts that did not participate in pilot tests of the streamline the BMI assessment and reporting process. web-based data entry system received student labels The success of and positive response to in September 2005 so the assessment last year’s small pilot of new web-based Table 1. School Districts process could begin early in the school technology encouraged ACHI to expand a Using ACHI’s Web-based year. Student data were collected web-based data entry system to 16 school BMI Data Entry System by school nurses and other school districts (216 schools) during the 2005– • Bentonville personnel. Paper records were sent to the • Cabot 2006 school year (Table 1). This new • Fayetteville University of Arkansas at Fayetteville’s web-based data entry system allowed data • Greene County Technical Survey Research Center for data entry. to be collected in a streamlined paperless • Lake Hamilton School personnel were then able to fashion. Approximately 130,000 students, • Lisa Academy print confidential reports for parents by • Little Rock or one-fourth of the Arkansas student • North Little Rock accessing ACHI’s secure website. population, were assessed using the web- • Nettleton ACHI intends to expand the web- based system in 2005–2006. • Pine Bluff • Rogers based entry system to all districts in Working with the Arkansas Educational • Springdale the 2006–2007 school year. Training Cooperatives, which gave school • Texarkana sessions for Community Health Nurses • Van Buren personnel and ACHI staff access to • Watson Chapel will be scheduled during the 2006–2007 computer labs and IT specialists, • White Hall school year with assistance from the participating school districts’ personnel Educational Cooperatives. Community completed training on the web-based Health Nurses will then be able to train system by January 2006. Pilot schools entered student school personnel, who will begin data collection at BMI data into computers with Internet connectivity their convenience and enter data into a pre-populated either from paper records kept while weighing and system. This cost-effective method of collection only measuring students or by directly entering data into requires schools to have Internet connectivity; they do the web-based system at the time of assessments. The not have to purchase software or to print assessment web-based system enabled schools to immediately forms or student labels. No longer will schools have generate individual, confidential Child Health to package and ship forms to a data entry center or Reports for parents after data were entered. wait for reports to be created. Schools will be able to Nurses using the web-based system evaluated it weigh and measure students, enter the data directly and provided valuable feedback to ACHI. Most into the web-based program, and print off reports participants noted how easy the system was to use.