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Am J Hum Biol. 2016 May;28(3):364-71. doi: 10.1002/ajhb.22796. Epub 2015 Oct 12.

Anthropometric measurement standardization in the US-affiliated pacific: Report from the Children's Healthy Living Program.

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Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, Hawai'i.
Cancer Center, University of Hawai'i at Mānoa, Honolulu, Hawai'i.
School of Nursing and Health Sciences, University of Guam, Mangilao, Guam.
Land Grant Program, Northern Marianas College, Saipan, Northern Mariana Islands.
Department of Alaska Native Health, University of Alaska, Fairbanks, Alaska.
Land Grant Program, American Samoa Community College, Pago Pago, American Samoa.
Department of Tropical Plants and Soil Science, University of Hawai'i at Mānoa, Honolulu, Hawai'i.



Anthropometric standardization is essential to obtain reliable and comparable data from different geographical regions. The purpose of this study is to describe anthropometric standardization procedures and findings from the Children's Healthy Living (CHL) Program, a study on childhood obesity in 11 jurisdictions in the US-Affiliated Pacific Region, including Alaska and Hawai'i.


Zerfas criteria were used to compare the measurement components (height, waist, and weight) between each trainee and a single expert anthropometrist. In addition, intra- and inter-rater technical error of measurement (TEM), coefficient of reliability, and average bias relative to the expert were computed.


From September 2012 to December 2014, 79 trainees participated in at least 1 of 29 standardization sessions. A total of 49 trainees passed either standard or alternate Zerfas criteria and were qualified to assess all three measurements in the field. Standard Zerfas criteria were difficult to achieve: only 2 of 79 trainees passed at their first training session. Intra-rater TEM estimates for the 49 trainees compared well with the expert anthropometrist. Average biases were within acceptable limits of deviation from the expert. Coefficient of reliability was above 99% for all three anthropometric components.


Standardization based on comparison with a single expert ensured the comparability of measurements from the 49 trainees who passed the criteria. The anthropometric standardization process and protocols followed by CHL resulted in 49 standardized field anthropometrists and have helped build capacity in the health workforce in the Pacific Region. Am. J. Hum. Biol. 28:364-371, 2016. © 2015 Wiley Periodicals, Inc.

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