# Acceptability and Feasibility of Health Measures in Preteens: Findings From the ROLO Longitudinal Birth Cohort Study

## TL;DR

This study found that preteens find health research methods acceptable and that neck and arm circumference can be used as simple indicators of body fat.

## Contribution

The study introduces feasible, less invasive alternatives to traditional health measures in preteens.

## Key findings

- No preteens found the study measurements or questionnaires unacceptable.
- Neck and mid-upper arm circumference were strongly associated with body fat and BMI.
- Blood pressure and fitness tests were not strongly linked to blood biomarkers.

## Abstract

Limited research has investigated young people's opinions on health measures that are used in clinical and research settings. This study aimed to describe young people's views on research methods utilised in a longitudinal birth cohort. It also aimed to explore the feasibility of (i) blood pressure and a fitness assessment as a substitute for blood biomarkers; (ii) foot length as a substitute for maternal‐reported stage of puberty and (iii) neck and mid‐upper arm circumference as a substitute for body composition analysis in preteens (9–11‐year‐olds).

This is a mixed‐methods analysis of preteens (n = 408) who were born into the ROLO longitudinal birth cohort study. Weight, height, skinfold thickness, circumferences, body composition, blood pressure, fitness (shuttle run test score), blood biomarkers, stage of puberty and foot length were obtained at 9–11 years of age. A subgroup completed a Likert‐style acceptability questionnaire after their study visit and took part in public and patient involvement to gain further insight into opinions of health measures utilised. Statistical comparisons and linear regression models explored associations in the total group and stratified by child sex. Results were adjusted for multiple testing.

Of 50 preteens who completed an acceptability questionnaire after their study visit, no participants rated the study measurements, exercises or questionnaires as unacceptable research methods, and only 5% rated providing a blood sample as unacceptable. Blood pressure percentiles and fitness scores were not strongly associated with blood biomarkers. In the total group, after adjustment for multiple testing, neck and mid‐upper arm circumference were positively associated with body mass index z‐score (Beta [B] = 0.42, 95% confidence interval [CI] = 0.34,0.49, p < 0.001, q = 0.015; B = 0.32, 95% CI = 0.29, 0.35, p < 0.001, q = 0.005), waist circumference (cm) (B = 2.83, 95% CI = 2.22, 3.45, p < 0.001, q = 0.016; B = 2.10, 95% CI = 1.78, 2.41, p < 0.001, q = 0.010) and body fat (%) (B = 2.26, 95% CI = 1.66, 2.87, p < 0.001, q = 0.018; B = 2.05, 95% CI = 1.80, 2.30, p < 0.001, q = 0.008), respectively.

Research methods were acceptable to preteens. Neck and mid‐upper arm circumference may serve as simple and less burdensome indicators of adiposity. Future research should explore minimally invasive blood sampling techniques.

Preteens contributed to the manuscript analysis by sharing their insights and ideas related to health measurements used in a longitudinal birth cohort study. Their input provided important perspectives on the acceptability of health measures in this age group that may have important implications for researchers and clinicians conducting health research with youth.