Obesity and Overweight Assessment Instruments

Body Mass Index

Body Mass Index (BMI) is a person's weight in kilograms divided by the square of height in meters. For children and teens, BMI is age-and-sex specific and is often referred to as BMI-for-age. A high BMI can be an indicator of high level of fat in the body. BMI does not measure body fat directly, but research has shown that BMI correlates with more direct measures of body fat, such as skinfold thickness measurements, bioelectrical impedance, densitometry (underwater weighing), dual energy x-ray absorptiometry (DXA) and other methods. BMI can be considered an alternative to direct measures of body fat. In general, BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems.

Nuttall, F. Q. (2015). Body mass index: Obesity, BMI, and health: A critical review. Nutrition Today, 50(3), 117-128. https://doi.org/10.1097/NT.0000000000000092

Dietz, W. H. & Bellizzi, M. C. (1999) Introduction: The use of body mass index to assess obesity in children. The American Journal of Clinical Nutrition, 70(1), 123S-125S. https://doi.org/10.1093/ajcn/70.1.123sopens in new window

Pediatric Quality of Life Inventory^TM (PedsQL)

The PedsQL Quality of Life Inventory^TM is made up of nine different questionnaires, for children, adolescents and young adults ranging in age from 2-25 years. For children and adolescents, there are seven questionnaires: Teens (13-18), Children (8-12), Young Children (5-7), and Toddlers (2-4). All measures include both a parent report and a self-report, except for only a parent report for toddlers. In addition, the Young Children self-report (and older, if needed) is administered verbally by an interviewer. These questionnaires measure health-related quality of life in both healthy children and adolescents and those with acute and chronic health conditions. It integrates general quality of life scales with disease-specific modules into one measurement system. The scales measure physical, emotional, social and school functioning, with summary scores given for psychosocial and physical health, as well as a total scale score. There are 23 items, but the inventory takes less than 4 minutes to complete. 

Varni, J. W., Seid, M., & Rode, C. A. (1999) The PedsQ^TM: Measurement model for the pediatric quality of life inventory. Medical Care, 37(2), 126-139. 

Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQ^TM 4.0: Reliability and validity of the pediatric quality of life inventory^TM version 4.0 generic core scales in healthy and patient populations. Medical Care, 39(8), 800-812.

Child Feeding Questionnaire (CFQ)

The CFQ is a 31-item self-report measure for assessing parental beliefs, attitudes and practices regarding child feeding, with a focus on obesity proneness in children. The seven-factor model is measured using a five-point Likert-type scale. The CFQ is designed for use with parents of children ranging in age from 2 to 11 years old.

Birch, L. L., Fisher, J. O., Grimm-Thomas, K., Markey, C. N., Sawyer, R., & Johnson, S. L. (2001) Confirmatory factor analysis of the child feeding questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite, 36 (3), 201-210. https://doi.org/10.1006/appe.2001.0398opens in new window

Child Health Questionnaire (CHQ)

The CHQ are a group of patient-reported outcome measures to assess health-related quality of life for children and adolescents. There are both parent-reported (for ages 4 – 18) and child self-completed (for ages 13 – 17) versions of varying lengths. Clinicians can choose the version most suitable to their clinical population. The average completion time across measures for school-age children is 11 minutes.

Landgraf, J. M., Abetz, L., & Ware, J. E. (2002). Child health questionnaire (CHQ): A user's manual . Boston, Mass.: Author.

Raat, H., Botterweck, A. M., Landgraf, J. M., Hoogeveen, W. C., & Essink-Bot, M. L. (2005). Reliability and validity of the short form of the child health questionnaire for parents (CHQ-PF28) in large random school based and general population samples. Journal of Epidemiology & Community Health, 59 (1), 75-82. https://dx.doi.org/10.1136/jech.2003.012914opens in new window

Ruperto, N., Ravelli, A., Pistorio, A., Malattia, C., Cavuto, S., Gado-West, L., ... & Martini, A. (2001). Cross-cultural adaptation and psychometric evaluation of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ) in 32 countries: Review of the general methodology. Clinical and Experimental Rheumatology , 19 (4 Suppl 23), S1-9.

Child Behavior Checklist (CBCL)

The Child Behavior Profiles were designed for a child and adolescent population from ages 6-18 years. The Child Behavior Checklist (CBCL) is a standardized questionnaire administered to parents to obtain reports of their children's social competence and behavioral problems. It takes parents between 5 and 10 minutes to complete the questionnaire. Additional versions are available, including the Teacher's Report Form and Youth Self-Report. The CBCL has been replicated and translated into various languages.

Achenbach, T. M. (1978). The child behavior profile: An empirically based system for assessing children's behavioral problems and competencies. International Journal of Mental Health, 7(3-4), 24-42. https://doi.org/10.1080/00207411.1978.11448806opens in new window

Kariuki, S. M., Abubakar, A., Murray, E., Stein, A., & Newton, C. R. J. C. (2016). Evaluation of psychometric properties and factorial structure of the pre-school child behaviour checklist at the Kenyan Coast. Child and Adolescent Psychiatry and Mental Health, 10 , Article ID 1. https://dx.doi.org/10.1186/s13034-015-0089-9opens in new window

Children’s Depression Inventory (CDI)

The Children's Depression Inventory is a modification of the Beck Depression Inventory for adults. The CDI is now on its second edition. It assesses depression severity in children and adolescents, aged 7-17. Two scales measure emotional problems and functional problems. Three separate rater forms are available: one for parents (17 items), one for teachers (12 items), and a self-report (28 items). Administration time is between 5-15 minutes.

Kovacs, M. (1981). Rating scales to assess depression in school-aged children. Acta Paedopsychiatrica: International Journal of Child & Adolescent Psychiatry, 46(5-6), 305-315. https://dx.doi.org/10.1037/t00788-000opens in new window

Sun, S., & Wang, S. (2015). The children's depression inventory in worldwide child development research: A reliability generalization study. Journal of Child and Family Studies, 24 (8), 2352-2363. https://doi.org/10.1007/s10826-014-0038-xopens in new window

Rosenberg Self-Esteem Scale (RSE)

The Rosenberg Self-Esteem Scale consists of 10 items designed to measure the self-esteem of adolescents. The RSE requires respondents to rate five positively worded and five negatively worded items on a Likert scale. The scale is now used across the population and takes very little time to administer.

Rosenberg, M. (1965). Society and the adolescent self-image . Princeton, NJ: Princeton University Press.

Rosenberg, M. (1979). Conceiving the self. New York, NY: Basic Books.

Huang, C., & Dong, N. (2012). Factor structures of the Rosenberg self-esteem scale. European Journal of Psychological Assessment, 28 (2) , 132-128. https://doi.org/10.1027/1015-5759/a000101opens in new window

Self-Perception Profile for Children (SPPC)

The Perceived Competence Scale for Children is a 28-item self-report measure for school-age children. It includes three subscales for cognitive, physical and social functioning, and measures a child's perceived competence and general self-worth. A fourth subscale, independent of any particular skill domain, of general self-worth, is included. The Self-Perception Profile for Children (SPCC) was created out of the latter measure and includes 36-items and includes five domains. It measures self-perception and self-esteem in children ages 8 and older.

Harter, S. (1985). The self-perception profile for children manual. Denver, CO: University of Denver.

Muris, P., Meesters, C., & Fijen, P. (2003). The self-perception profile for children: Further evidence for its factor structure, reliability, and validity. Personality and Individual Differences, 35 (8), 1791-1802. https://doi.org/10.1016/S0191-8869(03)00004-7opens in new window