The nurse is planning a community-based project to reduce obesity in school-aged population. Which outcome statement best supports the goal for this population?

• A. Within 2 years, the students body mass index greater than 95th percentile will be reduced by 50%
• B. Within 1 year, the percentage of students who are physically active at least 60 minutes daily will increase by 20 percentage points
• C. Within 2 years, the proportion of school meals meeting nutritional guidelines will increase by 30%
• D. Within 2 years, the students body mass index percentile will be reduced by 25%

Answer: (A)

Measuring the impact of an obesity-reduction effort in school-aged children should use a direct, population-level indicator of obesity status that can be tracked over time. The best choice targets the proportion of students whose body mass index is above the 95th percentile. This is a clear, standard metric for obesity in children, and setting a time-bound goal (such as a 50% reduction within two years) provides a concrete, measurable target that directly reflects changes in obesity prevalence.

Other options describe valuable supportive changes but don’t quantify the obesity outcome itself. Increasing daily physical activity or improving the nutritional quality of school meals are important factors that can lead to obesity reduction, yet they are intermediate or process outcomes rather than the actual prevalence of obesity. Reducing BMI percentile across all students by a certain percentage is less precise because percentiles shift with growth and age, and a percentage change isn’t as interpretable as changes in the obesity threshold (BMI above the 95th percentile).