Skip to main content
Top
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Recruitment into diabetes prevention programs: what is the impact of errors in self-reported measures of obesity?

Authors: Andrea Hernan, Benjamin Philpot, Edward D Janus, James A Dunbar

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Error in self-reported measures of obesity has been frequently described, but the effect of self-reported error on recruitment into diabetes prevention programs is not well established. The aim of this study was to examine the effect of using self-reported obesity data from the Finnish diabetes risk score (FINDRISC) on recruitment into the Greater Green Triangle Diabetes Prevention Project (GGT DPP).

Methods

The GGT DPP was a structured group-based lifestyle modification program delivered in primary health care settings in South-Eastern Australia. Between 2004–05, 850 FINDRISC forms were collected during recruitment for the GGT DPP. Eligible individuals, at moderate to high risk of developing diabetes, were invited to undertake baseline tests, including anthropometric measurements performed by specially trained nurses. In addition to errors in calculating total risk scores, accuracy of self-reported data (height, weight, waist circumference (WC) and Body Mass Index (BMI)) from FINDRISCs was compared with baseline data, with impact on participation eligibility presented.

Results

Overall, calculation errors impacted on eligibility in 18 cases (2.1%). Of n = 279 GGT DPP participants with measured data, errors (total score calculation, BMI or WC) in self-report were found in n = 90 (32.3%). These errors were equally likely to result in under- or over-reported risk. Under-reporting was more common in those reporting lower risk scores (Spearman-rho = −0.226, p-value < 0.001). However, underestimation resulted in only 6% of individuals at high risk of diabetes being incorrectly categorised as moderate or low risk of diabetes.

Conclusions

Overall FINDRISC was found to be an effective tool to screen and recruit participants at moderate to high risk of diabetes, accurately categorising levels of overweight and obesity using self-report data. The results could be generalisable to other diabetes prevention programs using screening tools which include self-reported levels of obesity.
Appendix
Available only for authorised users
Literature
1.
go back to reference Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, Hsu RT, Khunti K: Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 2007, 334 (7588): 299-302. 10.1136/bmj.39063.689375.55.CrossRefPubMedPubMedCentral Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, Hsu RT, Khunti K: Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 2007, 334 (7588): 299-302. 10.1136/bmj.39063.689375.55.CrossRefPubMedPubMedCentral
2.
go back to reference Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, et al: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344 (18): 1343-1350. 10.1056/NEJM200105033441801.CrossRefPubMed Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, et al: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001, 344 (18): 1343-1350. 10.1056/NEJM200105033441801.CrossRefPubMed
3.
go back to reference Absetz P, Valve R, Oldenberg B, Heinonen H, Nissinen A, Fogelholm M, Ilvesmaki V, Talja M, Uutela A: Type 2 diabetes prevention in the “Real World” - One-year results of the GOAL implementation trial. Diabetes Care. 2007, 30 (10): 2465-2470. 10.2337/dc07-0171.CrossRefPubMed Absetz P, Valve R, Oldenberg B, Heinonen H, Nissinen A, Fogelholm M, Ilvesmaki V, Talja M, Uutela A: Type 2 diabetes prevention in the “Real World” - One-year results of the GOAL implementation trial. Diabetes Care. 2007, 30 (10): 2465-2470. 10.2337/dc07-0171.CrossRefPubMed
4.
go back to reference Laatikainen T, Dunbar J, Chapman A, Kilkkinen A, Vartiainen E, Heistaro S, Philpot B, Absetz P, Bunker S, O'Neil A, et al: Prevention of type 2 diabetes by lifestyle intervention in an Australian primary health care setting: Greater Green Triangle (GGT) Diabetes Prevention Project. BMC Public Health. 2007, 7 (1): 249-10.1186/1471-2458-7-249.CrossRefPubMedPubMedCentral Laatikainen T, Dunbar J, Chapman A, Kilkkinen A, Vartiainen E, Heistaro S, Philpot B, Absetz P, Bunker S, O'Neil A, et al: Prevention of type 2 diabetes by lifestyle intervention in an Australian primary health care setting: Greater Green Triangle (GGT) Diabetes Prevention Project. BMC Public Health. 2007, 7 (1): 249-10.1186/1471-2458-7-249.CrossRefPubMedPubMedCentral
5.
go back to reference Lindstrom J, Tuomilehto J: The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003, 26 (3): 725-731. 10.2337/diacare.26.3.725.CrossRefPubMed Lindstrom J, Tuomilehto J: The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003, 26 (3): 725-731. 10.2337/diacare.26.3.725.CrossRefPubMed
6.
go back to reference Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS: Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003, 289 (1): 76-79. 10.1001/jama.289.1.76.CrossRefPubMed Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS: Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003, 289 (1): 76-79. 10.1001/jama.289.1.76.CrossRefPubMed
7.
go back to reference Stevens J, McClain JE, Truesdale KP: Selection of measures in epidemiologic studies of the consequences of obesity. Int J Obes. 2008, 32 (S3): 60-66.CrossRef Stevens J, McClain JE, Truesdale KP: Selection of measures in epidemiologic studies of the consequences of obesity. Int J Obes. 2008, 32 (S3): 60-66.CrossRef
8.
go back to reference Janssen I, Katzmarzyk PT, Ross R: Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004, 79 (3): 379-384.PubMed Janssen I, Katzmarzyk PT, Ross R: Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004, 79 (3): 379-384.PubMed
9.
go back to reference Dekkers J, van Wier M, Hendriksen I, Twisk J, van Mechelen W: Accuracy of self-reported body weight, height and waist circumference in a Dutch overweight working population. BMC Med Res Methodol. 2008, 8 (1): 69-10.1186/1471-2288-8-69.CrossRefPubMedPubMedCentral Dekkers J, van Wier M, Hendriksen I, Twisk J, van Mechelen W: Accuracy of self-reported body weight, height and waist circumference in a Dutch overweight working population. BMC Med Res Methodol. 2008, 8 (1): 69-10.1186/1471-2288-8-69.CrossRefPubMedPubMedCentral
10.
go back to reference Merrill R, Richardson J: Validity of self-reported height, weight, and body mass index: findings from the National Health and Nutrition Examination Survey, 2001–2006. Prev Chronic Dis. 2009, 6 (4): 1-10. Merrill R, Richardson J: Validity of self-reported height, weight, and body mass index: findings from the National Health and Nutrition Examination Survey, 2001–2006. Prev Chronic Dis. 2009, 6 (4): 1-10.
11.
go back to reference Stommel M, Schoenborn C: Accuracy and usefulness of BMI measures based on self-reported weight and height: findings from the NHANES & NHIS 2001–2006. BMC Public Health. 2009, 9 (1): 421-10.1186/1471-2458-9-421.CrossRefPubMedPubMedCentral Stommel M, Schoenborn C: Accuracy and usefulness of BMI measures based on self-reported weight and height: findings from the NHANES & NHIS 2001–2006. BMC Public Health. 2009, 9 (1): 421-10.1186/1471-2458-9-421.CrossRefPubMedPubMedCentral
12.
go back to reference Park JY, Mitrou PN, Keogh RH, Luben RN, Wareham NJ, Khaw KT: Effects of body size and sociodemographic characteristics on differences between self-reported and measured anthropometric data in middle-aged men and women: the EPIC-Norfolk study. Eur J Clin Nutr. 2011, 65 (3): 357-367. 10.1038/ejcn.2010.259.CrossRefPubMed Park JY, Mitrou PN, Keogh RH, Luben RN, Wareham NJ, Khaw KT: Effects of body size and sociodemographic characteristics on differences between self-reported and measured anthropometric data in middle-aged men and women: the EPIC-Norfolk study. Eur J Clin Nutr. 2011, 65 (3): 357-367. 10.1038/ejcn.2010.259.CrossRefPubMed
13.
go back to reference Gorber SC, Tremblay M, Moher D, Gorber B: A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev. 2007, 8 (4): 307-326. 10.1111/j.1467-789X.2007.00347.x.CrossRefPubMed Gorber SC, Tremblay M, Moher D, Gorber B: A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev. 2007, 8 (4): 307-326. 10.1111/j.1467-789X.2007.00347.x.CrossRefPubMed
14.
go back to reference Bolton-Smith C, Woodward M, Tunstall-Pedoe H, Morrison C: Accuracy of the estimated prevalence of obesity from self reported height and weight in an adult Scottish population. J Epidemiol Community Health. 2000, 54 (2): 143-148. 10.1136/jech.54.2.143.CrossRefPubMedPubMedCentral Bolton-Smith C, Woodward M, Tunstall-Pedoe H, Morrison C: Accuracy of the estimated prevalence of obesity from self reported height and weight in an adult Scottish population. J Epidemiol Community Health. 2000, 54 (2): 143-148. 10.1136/jech.54.2.143.CrossRefPubMedPubMedCentral
15.
go back to reference Quiles I, Vioque J: Validity of notified anthropometric data for determining the prevalence of obesity. Med Clin (Barc). 1996, 106 (19): 725-729. Quiles I, Vioque J: Validity of notified anthropometric data for determining the prevalence of obesity. Med Clin (Barc). 1996, 106 (19): 725-729.
16.
go back to reference Bigaard J, Spanggaard I, Thomsen BL, Overvad K, Tjonneland A: Self-reported and technician-measured waist circumferences differ in middle-aged men and women. J Nutr. 2005, 135 (9): 2263-2270.PubMed Bigaard J, Spanggaard I, Thomsen BL, Overvad K, Tjonneland A: Self-reported and technician-measured waist circumferences differ in middle-aged men and women. J Nutr. 2005, 135 (9): 2263-2270.PubMed
17.
go back to reference Spencer EA, Roddam AW, Key TJ: Accuracy of self-reported waist and hip measurements in 4492 EPIC - Oxford participants. Public Health Nutr. 2004, 7 (06): 723-727.CrossRefPubMed Spencer EA, Roddam AW, Key TJ: Accuracy of self-reported waist and hip measurements in 4492 EPIC - Oxford participants. Public Health Nutr. 2004, 7 (06): 723-727.CrossRefPubMed
18.
go back to reference Saaristo T, Peltonen M, Lindstrom J, Saarikoski L, Sundvall J, Eriksson J, Tuomilehto J: Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome. Diab Vasc Dis Res. 2005, 2 (2): 67-72. 10.3132/dvdr.2005.011.CrossRefPubMed Saaristo T, Peltonen M, Lindstrom J, Saarikoski L, Sundvall J, Eriksson J, Tuomilehto J: Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome. Diab Vasc Dis Res. 2005, 2 (2): 67-72. 10.3132/dvdr.2005.011.CrossRefPubMed
19.
go back to reference World Health Organization Expert Consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004, 363 (9403): 157-163.CrossRef World Health Organization Expert Consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004, 363 (9403): 157-163.CrossRef
20.
go back to reference Lean MEJ, Han TS, Morrison CE: Waist circumference as a measure for indicating need for weight management. BMJ. 1995, 311 (6998): 158-161. 10.1136/bmj.311.6998.158.CrossRefPubMedPubMedCentral Lean MEJ, Han TS, Morrison CE: Waist circumference as a measure for indicating need for weight management. BMJ. 1995, 311 (6998): 158-161. 10.1136/bmj.311.6998.158.CrossRefPubMedPubMedCentral
21.
go back to reference Tolonen H, Kuulasmaa K, Laatikainen T, Wolf H: European Health Risk Monitoring Project. Recommendation for indicators, international collaboration, protocol and manual of operations for chronic disease risk factor surveys. 2002, Helsinki: Finnish National Public Health Institute Tolonen H, Kuulasmaa K, Laatikainen T, Wolf H: European Health Risk Monitoring Project. Recommendation for indicators, international collaboration, protocol and manual of operations for chronic disease risk factor surveys. 2002, Helsinki: Finnish National Public Health Institute
22.
go back to reference Rossouw K, Senekal M, Stander I: The accuracy of self-reported weight by overweight and obese women in an outpatient setting. Public Health Nutr. 2001, 4 (01): 19-26.CrossRefPubMed Rossouw K, Senekal M, Stander I: The accuracy of self-reported weight by overweight and obese women in an outpatient setting. Public Health Nutr. 2001, 4 (01): 19-26.CrossRefPubMed
23.
go back to reference Kuczmarski MF, Kuczmarski RJ, Najjar M: Effects of age on validity of self-reported height, weight, and body mass index: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994. J Am Diet Assoc. 2001, 101 (1): 28-34. 10.1016/S0002-8223(01)00008-6.CrossRefPubMed Kuczmarski MF, Kuczmarski RJ, Najjar M: Effects of age on validity of self-reported height, weight, and body mass index: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994. J Am Diet Assoc. 2001, 101 (1): 28-34. 10.1016/S0002-8223(01)00008-6.CrossRefPubMed
24.
go back to reference Lawlor DA, Bedford C, Taylor M, Ebrahim S: Agreement between measured and self-reported weight in older women. Results from the British Women's Heart and Health Study. Age Ageing. 2002, 31 (3): 169-174. 10.1093/ageing/31.3.169.CrossRefPubMed Lawlor DA, Bedford C, Taylor M, Ebrahim S: Agreement between measured and self-reported weight in older women. Results from the British Women's Heart and Health Study. Age Ageing. 2002, 31 (3): 169-174. 10.1093/ageing/31.3.169.CrossRefPubMed
25.
go back to reference Smith SC, Haslam D: Abdominal obesity, waist circumference and cardiometabolic risk: awareness among primary care physicians, the general population and patients at risk - the Shape of the Nations survey. Curr Med Res Opin. 2007, 23 (1): 29-47. 10.1185/030079906X159489.CrossRefPubMed Smith SC, Haslam D: Abdominal obesity, waist circumference and cardiometabolic risk: awareness among primary care physicians, the general population and patients at risk - the Shape of the Nations survey. Curr Med Res Opin. 2007, 23 (1): 29-47. 10.1185/030079906X159489.CrossRefPubMed
26.
go back to reference Schwarz P, Li J, Lindstrom J, Tuomilehto J: Tools for predicting the risk of type 2 diabetes in daily practice. Horm Metab Res. 2009, 41 (2): 86-97. 10.1055/s-0028-1087203.CrossRefPubMed Schwarz P, Li J, Lindstrom J, Tuomilehto J: Tools for predicting the risk of type 2 diabetes in daily practice. Horm Metab Res. 2009, 41 (2): 86-97. 10.1055/s-0028-1087203.CrossRefPubMed
Metadata
Title
Recruitment into diabetes prevention programs: what is the impact of errors in self-reported measures of obesity?
Authors
Andrea Hernan
Benjamin Philpot
Edward D Janus
James A Dunbar
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-510

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue