Prediction of BMI Change in Young Children with the Family Nutrition and Physical Activity (FNPA) Screening Tool

  • Michelle A. Ihmels
  • Gregory J. Welk
  • Joey C. Eisenmann
  • Sarah M. Nusser
  • Esther F. Myers
Original Article



Youth obesity prevention practices would be enhanced if modifiable risk factors can be identified before children become overweight.


This study evaluated the predictive validity of the Family Nutrition and Physical Activity (FNPA) screening tool, a behaviorally based screening tool designed to assess family environments and behaviors that may predispose youth to becoming overweight.


Parents from a large urban school district completed the FNPA screening when children were in first grade. One-year change in measured body mass index (BMI) was used as the primary outcome, and this was computed using the relative change in distance from the BMI value at the 50th percentile. Descriptive, correlation, and mixed modeling analyses were used for survey validation.


Over half of the participants exhibited an increase in BMI percentile over the 1-year follow-up with an average change of 0.51 ± 11.5% which is indicative of trends to overweight. Although baseline BMI predicted BMI at follow-up, the FNPA total score explained unique variance in child BMI at follow-up after accounting for baseline BMI, parent BMI, and other demographic variables (p = 0.049).


This study demonstrates the potential validity of a simple, easy-to-use screening tool for identifying children that may be at risk for becoming overweight.


Childhood obesity Screening tool Physical activity Nutrition 



The development of the FNPA tool evolved from an ongoing research partnership with the American Dietetic Association (ADA). The Ann Hertzler Fund of the ADA Foundation provided support for the Evidence Analyses and vision to guide the development of the tool. We would like to acknowledge the key members of the FNPA planning group: Patricia Crawford, PhD, RD; Lorene Ritchie, PHD, RD; and Karen Peterson, PhD, RD as well as the original American Dietetic Association Foundation strategic group that identified the need for a family nutrition and physical activity screening tool. The project was completed with collaborative support from the Des Moines Independent School District. The project was funded through a grant from the Center for Designing Foods to Improve Human Nutrition (CDFIN), a United States Department of Agriculture (USDA)-funded research program at Iowa State University.


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Copyright information

© The Society of Behavioral Medicine 2009

Authors and Affiliations

  • Michelle A. Ihmels
    • 1
  • Gregory J. Welk
    • 1
  • Joey C. Eisenmann
    • 2
  • Sarah M. Nusser
    • 3
  • Esther F. Myers
    • 4
  1. 1.Department of KinesiologyIowa State UniversityAmesUSA
  2. 2.Department of KinesiologyMichigan State UniversityEast LansingUSA
  3. 3.Department of StatisticsIowa State UniversityAmesUSA
  4. 4.American Dietetic AssociationChicagoUSA

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