Table 4.

Reactions to the BMI letter and BMI screening.

Theme	Selected quotes
Initial reactions to the letter
Provides no new information	Yeah, I mean I would look at it, but it's not telling me anything that I probably don't already know.
	I've gotten something like this . . . I was kind of upset ‘cause I said,’ Who are these people?’ I take my kids to the doctor so I already know where they stand.
Letter is helpful, acceptable	It's actually good that they do it because you get to see – back when you're younger they never did this so – you just get to see where they compare and where they should be.
	[The letter] only encouraged me to move . . . I didn't have a problem with it.
Questionable validity of BMI	The one thing that I do like about this letter is that it does say that BMI cannot tell the difference between muscle and fat.
	They're not doing the water test, they're not doing the pinching and all that. They're just doing it by their formula weight – height – here's your index, you know?
	It depends – some have taller torso, some have smaller torsos, longer legs – whatever. Where do they come up with this stuff?
Positive reactions to BMI screening
Could be helpful, motivating	This is very positive, and I think everybody should get it and get screened . . . I'm just glad the school noticed and they're out there to help the kids with their weight.
Negative reactions to BMI screening
Not a school's role	It really should be coming from a physician and not a nurse from a school.
Impact on child's self-esteem	The school nurses do . . . their little check-ups that they do in school, but they do them in groups.
	When we get those BMIs from the school . . . I don't like the fact that my son gets to see that before I can look at it . . . they don't send it home in an envelope.