The Journal of the Arkansas Medical Society Med Journal May 2019 Final 2 - Page 15

Table 1. Participants HRQoL Score Range for Weight Classification HRQoL Score Range BMI z-Score Weight Classification 25-49% Healthy Weight Overweight 50-74% 75-100% Total 0 4 11 15 % Within Weight Class 0% 26.7% 73.3% 100% % Within HRQoL Score Range 0% 44.4% 52.4% 48.4% % of Total 0% 12.9% 35.5% 48.4% 1 1 4 6 Count Count Figure 1. Stunkard’s Visual Figures Scale % Within Weight Class 16.7% 16.7% 66.7% 100% Statistical Analysis % Within HRQoL Score Range 100% 11.1% 19% 19.4% % of Total 3.2% 3.2% 12.9% 19.4% 0 4 6 10 % Within Weight Class 0% 40% 60% 100% % Within HRQoL Score Range 0% 44.4% 28.6% 32.3% % of total 0% 12.9% 19.4% 32.3% 1 9 21 31 % Within Weight Class 3.2% 29% 67.7% 100% % Within HRQoL Score Range 100% 100% 100% 100% % of total 3.2% 29% 67.7% 100% Data was analyzed using descriptives and fre- quencies, bivariate correlations, one-way ANOVA, and independent samples t-test using the Statistical Package for the Social Sciences (SPSS). Obese RESULTS Of the sample (n=35), the minimum VFL was a level 1 (n=4) and the maximum VFL was a level 20 (n=1). Majority (77%, n=27) of participants scored within healthy recommendations (VFL<10) and 22% (n=8) scored an excessive VFL (VFL>10). All participants who classified as healthy weight and overweight also had a healthy VFL, while only three participants who were classified as obese had a healthy VFL. The minimum BMI z-score was 19 (n=1) and the maximum was 99 (n=1). Approximately half (49%, n=17) of participants were within healthy BMI z-score, whereas 20% (n=7) were classified over- weight, and 31% (n=11) were classified as obese. The minimum HRQoL was 32 and the maximum was 100 (M=80.9, SD=1508). Participants who scored less than 75% on the HRQoL were mostly of a healthy weight (n=11, 73.3%) see Table 1. As predicted, positive correlations were exhib- ited between PBF and BMI z-score and VFL (r=.851, p<.000; r=.937, p<.000, respectively). A positive correlation was also seen between VFL and BMI z- score (r=.745, p<.000, respectively)—see Table 2. BID (M=.967, SD=.982) and HRQoL (M=80.90, SD=15.08) were significantly, negatively related (r=- .451, p=.012), and those who were obese had the highest levels of BID (M=1.8, SE=.29)—see Figure Total Count Count 3. Obese participants (n=11) were more likely than overweight (n=7) or healthy weight (n=17) partici- pants to report body-image dissatisfaction (p=.002 and p=.001, respectively)—see Figure 4. Males had a greater BID (M=1.33) than females (M=.625), a greater BMI z-score (M=82.53) than females (M=67.5), and a higher VFL (M=7.59) than females (M=4.67)—see Figure 5. HRQoL’s only correlation was to BID—see Figure 6. Children of this age group may not yet be expe- riencing problems with teasing and bullying, or the children may not have mentally matured enough to identify adverse social conditions like many studies suggest. Another possibility is that due to the vast population of elevated BMI individuals in Arkansas, an elevated BMI z-score may appear to be consid- ered “normal” to many of the children, so teasing may not occur. DISCUSSION & FUTURE STUDIES Limitations include small sample size which may impact results, data collection from one school, and collecting data once in a school year. Further research will need to be conducted with the same participants as they continue into adolescence and until they graduate from secondary school. As stu- dents age, HRQoL will most likely change. Observing changes over time may provide more information about how to address BID, which often leads to other mental stressors. Establishing greater rapport with students and faculty may encourage greater par- ticipation in the next study. A major gap in literature pertaining to VFL cut-offs in adolescence made the present study of defining appropriate VFL challeng- ing. Currently, there are not any VFL reference ranges for children or adolescents in the U.S. Due to this limitation, the adult threshold of 100 cm 2 was used. Although BMI z-score and VFL were closely related, the data for some participants presented anomalies. Many students who were classified as obese by BMI z-score were within acceptable VFL ranges. Elevated levels of BID were seen in every weight group. Some participants who were of healthy weight classification scored low HRQoL, while other participants of obese weight classification scored high HRQoL. In general, HRQoL was inversely related to BID, so higher levels of BID indicated lower levels of HRQoL. Table 2. Pearson’s Product-Moment Correlation Results PBF VFL BMI z-score BID HRQoL *p<.05, **p<.01 PBF VFL BMI z-score BID HRQoL 1 .937** .851** .577** -.155 1 .745** .531** -.147 1 .473** -.185 1 -.450* 1 Future studies to be carried out should work to resolve the following factors: 1) Having a larger sample, adding additional schools or increasing participation within schools. Having a larger sample will aid in NUMBER 11 > Continued on page 256. MAY 2019 • 255