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Using EMRALD to assess baseline body mass index among children living within and outside communities participating in the Ontario, Canada Healthy Kids Community Challenge


Objectives — The Healthy Kids Community Challenge is a large-scale, centrally-coordinated, community-based intervention in Ontario, Canada that promotes healthy behaviours towards improving healthy weights among children. With the goal of exploring tools available to evaluators, we leveraged electronic medical records from primary care physicians to assess child weights prior to launch of the Healthy Kids Community Challenge. This study compares the baseline (i.e. pre-intervention) prevalence of overweight and obesity in children 1–12 years of age living within and outside Healthy Kids Community Challenge communities.

Design — Cross-sectional analysis of a primary care patient cohort.

Setting — Electronic Medical Record Administrative data Linked Database (EMRALD) in Ontario, Canada.

Participants — A cohort of 19 920 Ontario children who are rostered to an EMRALD physician. Children were 1–12 years of age at a primary care visit with recorded measured height and weight, between January 1, 2014 and December 31, 2015.

Outcome Measure — Overweight and obesity as determined by age- and sex-standardized body mass index using World Health Organization’s Growth Standards.

Results — In Healthy Kids Community Challenge communities, 25.6% (95% CI 24.6–26.6%) of children had zBMI above normal (i.e. >1) compared to 26.7% (95% CI 25.9–27.5%) for children living outside of Healthy Kids Community Challenge communities.

Conclusions — Despite some differences in sociodemographic characteristics, zBMI of children aged 1–12 years were similar inside and outside of Healthy Kids Community Challenge community boundaries prior to program launch.



Orr SK, Tu K, Carsley S, Chung H, Holder L, Jabbari S, Harrington DW, Manson H. PLoS One. 2019; 14(4):e0213443. Epub 2019 Apr 11.

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