Surveillance | Methods

The WV CARDIAC Project has two types of screening methods: Passive Consent and Active Consent. This page describes the purpose, design, procedures and confidentiality associated with each screening type.

Passive Consent screenings will be completed for Kindergarten, 2nd, and 5th graders in all participating counties.

Active Consent screenings will only be offered to 5th graders on a limited basis, in select counties.

Passive Consent

Design

This project is designed to provide a body mass index (BMI) screening to children enrolled in targeted grades upon approval by the superintendent of the school(s). Families have the opportunity to opt-out of this study by informing study or school personnel in writing of their request to not participate. The child may also opt-out at any time during screening procedures. Screening will consist of height and weight assessments. Screening staff will also look at the back of the children’s necks for Acanthosis Nigricans (AN), a dark pigmentation that, if present, could indicate insulin resistance. The height and weight information will be used to calculate the student’s BMI and BMI percentile. Screening results (via sealed health report) will be sent to children and their families. Parents whose children are identified as overweight or obese or have the AN marker on the back of their necks are asked to talk to their physicians/pediatrician about these risks and recommended lifestyle changes.

Procedures

  1. Opt out letters are furnished to school personnel for distribution during the school year.
  2. Screening day: Separate stations (for confidentiality and privacy) are set up at the school for: Height, weight, and AN check.
  3. After screening day: WV CARDIAC Project central office staff calculates BMI and BMI percentile based on student’s height and weight. A health report is generated, placed in a sealed envelope, sent to the school to be sent home to the parents/guardians.

Confidentiality

What information will be used or disclosed?

Height and weight will be used to calculate body mass index (BMI) and BMI percentile for each participant. BMI and BMI percentile and presences of AN will be returned to the family of the participating child and to the school nurse so medical follow-up can be completed if needed.

Who will have access to, or use of, the health information?

WV CARDIAC Project staff and the child's school nurse.

How will the health information be used or disclosed?

The health information is maintained in a password-protected system. A CARDIAC ID number is used for all correspondence and linkage purposes. Student BMI, BMI percentiles and AN will be included in the health report that goes to the families and school nurse following the screening.

De-identified, aggregate data is shared with schools, county boards of education, and other local and state-level stakeholders at the end of the screening year.

Active Consent

Design

Through this procedure, the parent/guardian will complete demographic, health and family history questions, and provide signature on an Active Consent form. The child will sign the form as well. The parent/guardian may also choose for the WV CARDIAC Project to share the results with the child’s pediatrician or primary care physician. Completion of this form, including signatures, is required to collect blood pressure readings from a child on screening day. Weight, height, and AN status are still screened as part of the Active Consent process. In addition, assent of the child still applies, meaning that the child must be in agreement to screen, and should not be forced to screen if they express that they do not want to.

Procedures

  1. Prior to screening day, students are introduced to WV CARDIAC Project by teachers, school nurses, and Health Educators and they are given a consent package.
  2. The consent brochure consists of a letter detailing the project and a brief demographic and family history questionnaire related to coronary heart disease, diabetes, high blood pressure, weight-related concerns, as well as a health behavior survey about physical activity, nutrition, screen time, and sleep habits. Students for who consent and assent have been given participate in the WV CARDIAC Project screening.
  3. The added screening component for the active consent WV CARDIAC Project screening is a blood pressure measurement.
  4. Following the screening, parents and the participating child receive a health report describing the results of the screening process. If the parent elected, the health report will also be mailed to the child’s physician.

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