Abstract TU131: Agreement Between Parent-Report and Electronic Health Record Body Mass Index Among Children in the Young Hearts Study

Background: Childhood obesity is a driver of cardiovascular disease later in life. Given the importance of childhood obesity and recent advances in electronic capture of survey data, many studies have incorporated parent-proxy reports of child weight and height into their design. Here, we aimed to assess the agreement between parent-reported and electronic health record (EHR)-based BMI within a diverse, urban cohort of children, and whether the agreement varied by child age and sex. Methods: We utilized participants aged 2-17 in the Young Hearts Study with both parent-reported and EHR-based BMI data available at baseline. Parent-reported height and weight for their child were collected through electronic surveys and were used to calculate age- and sex-specific BMI percentiles. EHR-based weights, heights, and BMI percentiles were abstracted from the encounter closest in time to the survey completion date. Overweight or obesity was defined as BMI ≥85th percentile. Agreement for BMI percentile was assessed via Pearson correlation, and for classification as overweight or obese via the Kappa statistic. Results: Data from 660 children were included in this study, of whom 319 (48.3%) were female, 166 (25.2%), 263 (39.8%), and 167 (25.3%) were non-Hispanic Black, non-Hispanic White, and Hispanic, and 184 (27.9%), 234 (35.5%), and 242 (36.7%) were aged 2-7, 8-12, and 13-17 years. Overall, the mean parent-reported BMI percentile was 64.9 (SD 32.3) in girls and 63.4 (SD 34.1) in boys; these were slightly higher than the EHR at 70.5 (SD 28.8) in girls and 66.7 (SD 32.3) in boys. Agreement of parent report of BMI percentile with EHR-based BMI percentile increased with child age. For girls, age group-specific correlations were r 2-7 = 0.40, r 8-12 =0.61, and r 13-17 =0.83, and for boys they were r 2-7 = 0.53, r 8-12 =0.69, and r 13-17 =0.75. Agreement for classification as overweight or obese also increased from poor to moderate with age; for girls, age-specific agreement was k 2-7 =0.30, k 8-12 =0.63, and k 13-17 =0.67, and for boys it was k 2-7 =0.43, k 8-12 =0.62, and k 13-17 =0.72. Discussion: Our results suggest slight under-reporting of child BMI by parents overall, with agreement between parent report and EHR BMI percentile increasing with child age. Remote collection of BMI may be a valid supplement to in-clinic assessment for use in research, particularly for teenagers, which may facilitate cheaper and more timely capture of data.