![]() ![]() Most studies among school-children require opt-in (active consent) from parents or guardians and achieve participation rates (PRs) between 30–60%. ![]() Several authors have made the case for routine, population-level surveillance/monitoring of anthropometric data among children, stressing the importance of sampling that accurately reflects the characteristics of the population under investigation. Prevalence, monitoring and community intervention studies on childhood obesity should move to opt-out consent processes for better scientific outcomes.ĭifficulties in obtaining accurate and timely estimates of prevalence, trends and intervention effectiveness present challenges to informed policy and service delivery. Conclusions: Opt-in consent underestimated prevalence of childhood obesity, particularly in girls. Significant underestimation was seen in girls, but not for boys. The opt-in strategy underestimated the overall population prevalence of overweight/obesity and obesity by −5.4 and −4.5 percentage points respectively ( p < 0.001 for both). Results: The results demonstrate strong evidence of non-participation bias for mean BMI-z overall (Std bias = −4.5, p < 0.0001) and for girls (Std bias = −5.4, p < 0.0001), but not for boys (Std bias = −1.1, p = 0.15). Standardized bias (Std bias) estimates defined as bias/standard error are reported for BMI-z. Outcomes: differences between opt-in and opt-out sample estimates (bias) for mean BMI-z, prevalence of overweight/obesity and obesity (alone). For the opt-out wave N = 47 schools (RR 32%) and N = 2557 students participated (RR 86.4%). For the opt-in wave N = 38 schools (recruitment rate (RR) 24.3%) and N = 856 students participated (RR 36.3%). 9–12 years) were invited to participate via opt-in consent (2013) and opt-out consent (2014). Primary schools were randomly selected in 20 and all Grades 4 and 6 students (aged approx. Methods: Data arose from all Local Government Areas (LGAs) participating in the Healthy Together Victoria Childhood Obesity Study, Australia. This study quantified the magnitude of non-participation bias for mean Body Mass Index-z scores and overweight/obesity prevalence associated with low (opt-in) compared to high (opt-out) participation consent methodologies. Background: Tracking population trends in childhood obesity and identifying target areas for prevention requires accurate prevalence data.
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