ABSTRACT
Background and Aims
Remote healthcare is expanding, with accurate growth data essential for nutritional care. Guidance for routine caregiver-led measurements is limited and largely untested. This study evaluated the feasibility and accuracy of caregiver-led child growth measurements at home, compared to ‘gold-standard’ measurements in the hospital.
Methods
Caregivers of children attending outpatient appointments completed a survey on their access to weighing scales and tape measures at home. Those with suitable equipment were consented to participate in a home measurement study. Using provided instructions, caregivers measured their child twice within 48 h of a hospital appointment, where two healthcare professionals (HCPs) repeated measurements. Caregiver experiences were explored through short interviews. Agreement between methods was assessed using Bland–Altman analysis.
Results
Of 677 survey respondents (49% response), 61% owned both scales and tape measure, with ownership more likely in relatively affluent postcodes. One hundred and forty participants consented to the home measurement study but due to low recruitment in the 0–2-age group (n = 18), analysis was restricted to 122 2–15-year-olds with median age 8.5 [IQR 5,12]. Participants were predominantly white British (88%) from relatively affluent areas (78% IMD 5–10). LOA between caregivers and HCP were −3.46% to 3.79% (height) and −4.91% to 4.36% (weight), demonstrating reasonable caregiver accuracy. LOA between the two caregiver measurements were −0.97% to 0.99% (weight) and −1.04% to 0.80% (height), demonstrating consistency, and LOA between two HCPs were −0.48% to 0.53% (weight) and −0.61% to 0.55% (height), demonstrating good inter-observer agreement. The majority found the process straightforward, with greater confidence in weighing than in measuring, despite achieving lower accuracy. Most were willing to routinely provide measurements before remote appointments.
Conclusions
Caregiver-led measurements appear feasible and reasonably accurate for children aged 2–15 years, although they may be more suitable to monitor trends, rather than in situations needing precision. Equipment access may be limited in less affluent areas, but generally, caregivers are willing to monitor weight and height at home.
Journal of Human Nutrition and Dietetics, Volume 39, Issue 5, October 2026. Read More