P2.J190: Translation and Dissemination of CDC’s BMI Growth Charts to Support Pediatric Growth Monitoring, Obesity Care, and Research

Purpose/Objectives: Body mass index (BMI) z-scores and percentiles are widely used in clinical practice and research for pediatric growth monitoring. However, CDC’s 2000 BMI Growth Charts have an upper limit of the 97th percentile and other statistical limitations that limit ability to track BMI changes in children with very high BMIs. To address these limitations, in December of 2022, CDC released Extended BMI Growth Charts, which incorporated more recent nationally representative data for children with obesity. The Extended BMI Growth Charts include four additional curves above the 95th percentile; can plot BMI values up to 60 kg/m2; and can facilitate growth monitoring for millions of US children with high very BMIs.

Design/Methods: We reviewed and improved several of CDC’s resources to facilitate the integration of extended BMI z-scores and percentiles into research and clinical care. We aimed to help pediatric healthcare providers, health services researchers, epidemiologists, and others overcome numerous practical challenges, including understanding how and why new growth charts were developed, integration into clinical workflows, translation when talking to patients about growth, and application in research settings.

Results: To support translation of evidence into practice, CDC created or updated 4 public-facing resources: 1) Extended Growth Chart web pages (>14,000 views per month since release in December 2022) that include key information for healthcare providers, researchers, and the general public, 2) Child & Teen BMI Calculator (>5.7 million views per year on average since 2022) to incorporate the extended metrics into calculations and plot children with high BMIs on the Extended Growth Charts, 3) Growth Chart Trainings to improve two self-directed modules for healthcare providers who use growth charts in clinical and public health settings, and 4) statistical programs, including SAS and R codes, to facilitate integration of the extended metrics into electronic health records (EHRs) and research (50% more page views in 2023 than before the release of the Extended BMI metrics). CDC also published a manuscript comparing the new extended BMI percentiles to percent above the 95th percentile, an existing metric commonly used to indicate obesity severity.

Conclusion/Discussion: Since the release of the Extended BMI-for-Age Growth Charts in late 2022, CDC has enhanced many widely-used, publicly available resources that facilitate implementation of these growth charts in practice and research that impacts millions of US children with very high BMIs. Additional work is needed to: 1) assess uptake of the Extended Growth Charts in pediatric obesity practice and barriers to implementation, 2) better understand acceptability to patients and families, 3) examine what thresholds of Extended BMI percentiles are associated with metabolic health risks, and 4) assess how well the Extended BMI metrics track longitudinal changes.