What exactly is to be measured, what common terms are to be used and where is there interesting and available data for analysis in the work of preventing childhood obesity?
These issues are raised in three new reports from Ending Childhood Obesity’s fourth work package Measurement, follow-up and data. The reports are based on an extensive literature search and inventory of terms and measurement indicators as well as data sources and databases.
-What we see is that today there are shortcomings, both in terms of data availability and consensus on which indicators should be measured and which terms we use. In addition, we see a great need to find legal solutions for data sharing, says Jovanna Dahlgren, Professor and chief physician, University of Gothenburg and the Västra Götaland region, who led the work with the reports.
Data sources and databases
Easily accessible national analysis and data access are needed for a better overview of the current situation and the trends around childhood obesity before school age. The report “Measurement, follow-up and data for early prevention of childhood obesity” makes an inventory of the available data sources and databases. In addition, it is cataloged which principals these belong to and how open the data sources are for downloading data.
Four levels for data search
The report highlights four different levels at which data should be sought:
nationally by gaining access to real-time population databases,
regionally in terms of both health data and healthcare data,
at municipality level about the local environment and available municipal service,
as well as everything that concerns the individual and its family.
In the work of inventorying available databases, it has become clear that there is a great need for better coordination and more uniform data infrastructure nationally. Different databases need harmonization for automatic extraction.
Another important issue raised in the report is the requirement for nationwide connection to the major quality registers such as BHVQ for child health care and the corresponding quality register for school health care / student health.
Legal solutions for data sharing
The legal basis for data exchange and access is not sufficiently defined, but an investigation has been initiated and the report “Legal solutions for data sharing” examines this and presents a summary of the advantages and disadvantages of different solutions.
The dialogue needs to be extended to actors such as municipalities, where the focus should be on the municipalities’ need for IT solutions for an inventory of the current situation and evaluation of initiatives.
-We also see that it is important that available data is repackaged in accordance with a national standard. When we want to build an infrastructure for data sharing in the future, it is important to use accepted terms and units, says Jovanna Dahlgren.
Indicators of childhood obesity
The third report “Indicators of childhood obesity” is based on a literature search of indicators of childhood obesity, or medically expressed childhood obesity, and its sequelae. The results show that certain variables are obvious to be followed because they are important indicators. This is, for example, height and weight to calculate BMI and convert this to standard deviations to take into account age and gender given that you are following a growing child. At birth, you need to correct if the baby was born prematurely.
In addition, waist measurements is recommended, but this is not implemented in the national health programs within BVC or school health care. The report states that it is remarkable that there does not seem to be a coherent picture in international literature of what should be measured.
Fast food, soft drinks and snacks
Indicators that have also proven to be of great importance are proximity to fast food chains, local sales of soft drinks (eg in schools), special convenience stores that mainly offer snacks, and breakfast serving at preschool / school. The report therefore emphasizes that these indicators are important to include in future inventories of data in society.
National measurement data register
One of the most important results in the literature search is that there is no national measurement data register (0-18 years) to be able to draw correct conclusions. It is of great importance to identify the disease as early as possible. Therefore, it is important to measure and weigh preschool children regularly in order to be able to offer preventive, health-promoting and treatment interventions as well as investigation and assessment before obesity has been established.
The report emphasizes that the starting point during the preschool years should be patients’ right to have their obesity identified, but that it is important to address the issue of weight in a respectful and non-stigmatizing way. For identification, there is a great need to develop tools, for example to be able to measure eating behaviors or other obesity-related behaviors early in life and then tools that cover several domains.