Off-campus UNL users: To download campus access dissertations, please use the following link to log into our proxy server with your NU ID and password. When you are done browsing please remember to return to this page and log out.

Non-UNL users: Please talk to your librarian about requesting this dissertation through interlibrary loan.

Parental perceptions of body mass index referrals and overweight school -age children: Planting the seeds of health

Misty M Schwartz, University of Nebraska - Lincoln


It is well documented that there is a worldwide epidemic of obesity in children. To address obesity in children, emphasis must be on factors within family, school, and community environments. Although most parents and school officials are aware of the problem of overweight children, there is little data available to guide decision making about the acceptability of school-based Body Mass Index (BMI) screening and referral programs. As states mandate BMI screening and referral, parental insight is essential to determine the efficiency and effectiveness of BMI notification.^ The purpose of this multiple case study was to explore the perceptions of parents whose school-age children received a BMI referral letter stating their child is overweight. Purposeful convenience sampling was used to obtain 21 participants. A detailed description of each case and themes was developed, followed by cross-case thematic analysis. Eight themes and corresponding sub-themes emerged. The themes regarding parental perceptions were: feelings about receiving the letter, causes of obesity, capabilities, barriers, role modeling, primary care provider response, school's role and health screening process.^ Parent's feelings were categorized into sub-themes of positive/neutral, negative, disbelief, or more than one emotion. Specific and general causes were identified. Capabilities included changes in diet and activity and support/communication. Barriers encountered were: financial, lack of time, lack of control, lack of knowledge, other children and age. Provider responses were categorized into supportive/neutral or negative. Role modeling of their own behaviors and the behaviors of others was identified as significant. Regarding the school's role, topics included education, increasing activity, responsible snacking and parties, and school lunches. Finally, the process before, during and after the health screenings was discussed.^ By receiving a BMI notification letter, parents felt a "seed of health" had been planted. The causes were "rooted" deep in the child's life. The themes and sub themes took on the form of branches and leaves. From these findings "grew" the implications for parents, schools, health care providers and communities. ^

Subject Area

Education, Elementary|Sociology, Individual and Family Studies|Education, Health

Recommended Citation

Schwartz, Misty M, "Parental perceptions of body mass index referrals and overweight school -age children: Planting the seeds of health" (2009). ETD collection for University of Nebraska - Lincoln. AAI3386558.