Feasibility Of Using Caregiver Obtained Muac Z-score Measurement In Monitoring Malnutrition In The Pediatric Patient
Presenter Status
Early Career Investigator
Abstract Type
Clinical Research
Primary Mentor or Principal Investigator
Michelle Roach, MSN, RN, CPNP-PC
Presentation Type
Poster
Start Date
20-5-2026 11:00 AM
End Date
20-5-2026 12:00 PM
Abstract Text
Background: Pediatric feeding disorder (PFD) affects 1 in 37 children under 5 and increases the risk of malnutrition. Rising telehealth visits improve access but make monitoring growth challenging, creating a need for alternatives to in‑clinic height and weight measurements. Mid-upper arm circumference (MUAC) insertion tape is an effective, low‑cost tool that provides a single-point assessment of nutritional status. While MUAC insertion tape training has been studied in non‑medical caregivers internationally, no U.S. studies have evaluated teaching U.S. caregivers to use MUAC insertion tape.
Objectives/Goal: This study aims to determine the accuracy of caregiver-obtained MUAC Z-scores and assess socioeconomic factors and feasibility.
Methods/Design: Prospective cohort-based study. Participants were 2 months to 16 years old, recruited from an interdisciplinary feeding and swallowing program, and English- or Spanish‑speaking. At the first visit, a registered dietitian (RD) taught caregivers how to select the correct side of the MUAC tape for age, find the arm midpoint, position the arm, feed and tighten the tape properly, and read the correct age line. Families received a MUAC kit if enrolled. At the next clinic visit (2–6 months later), caregivers measured their child’s MUAC independently twice; incorrect technique prompted reteaching and repeat measurement. A dietitian then obtained a comparison measurement. Caregivers completed a survey on feasibility and acceptability. For second visits done via telehealth, only observation was possible; no RD measurement was obtained.
Results: All 44 participants used the MUAC tape correctly and matched the RD’s color designation after initial teaching. Families were primarily White (69%), followed by Hispanic (23.8%), Black (12%), Asian (2%), and Native Hawaiian/Pacific Islander (2%); 86% spoke English and 14% Spanish. Half had Medicaid (52%) and 38% were WIC‑eligible. Fifteen families completed the second visit; 84% required reteaching, after which all accurately reported color designation and MUAC measurements to the nearest tenth. Ten families completed the feasibility survey: most reported no or some difficulty (91%), one could not use the tape at home, 64% needed help holding the child still, and nearly all were willing to continue MUAC use.
Conclusions: This was the first U.S. study since 2001 to evaluate whether parents can accurately obtain MUAC measurements and the first to assess U.S. caregivers’ ability to use the MUAC insertion tape tool to monitor child nutritional status. In a diverse sample, caregivers found MUAC measurement highly feasible and acceptable. Although most required re‑teaching, nearly all demonstrated accurate measurement skills 2–6 months after initial instruction. Some families needed a second adult to help hold the child, but nearly all were willing to continue using the tape. These findings support MUAC insertion tape as a practical method for home‑based nutritional monitoring, including during telehealth visits or between clinic appointments.
Disclaimer - AI was used in the preparation of the abstract such as to create text, but not in the analysis.
Feasibility Of Using Caregiver Obtained Muac Z-score Measurement In Monitoring Malnutrition In The Pediatric Patient
Background: Pediatric feeding disorder (PFD) affects 1 in 37 children under 5 and increases the risk of malnutrition. Rising telehealth visits improve access but make monitoring growth challenging, creating a need for alternatives to in‑clinic height and weight measurements. Mid-upper arm circumference (MUAC) insertion tape is an effective, low‑cost tool that provides a single-point assessment of nutritional status. While MUAC insertion tape training has been studied in non‑medical caregivers internationally, no U.S. studies have evaluated teaching U.S. caregivers to use MUAC insertion tape.
Objectives/Goal: This study aims to determine the accuracy of caregiver-obtained MUAC Z-scores and assess socioeconomic factors and feasibility.
Methods/Design: Prospective cohort-based study. Participants were 2 months to 16 years old, recruited from an interdisciplinary feeding and swallowing program, and English- or Spanish‑speaking. At the first visit, a registered dietitian (RD) taught caregivers how to select the correct side of the MUAC tape for age, find the arm midpoint, position the arm, feed and tighten the tape properly, and read the correct age line. Families received a MUAC kit if enrolled. At the next clinic visit (2–6 months later), caregivers measured their child’s MUAC independently twice; incorrect technique prompted reteaching and repeat measurement. A dietitian then obtained a comparison measurement. Caregivers completed a survey on feasibility and acceptability. For second visits done via telehealth, only observation was possible; no RD measurement was obtained.
Results: All 44 participants used the MUAC tape correctly and matched the RD’s color designation after initial teaching. Families were primarily White (69%), followed by Hispanic (23.8%), Black (12%), Asian (2%), and Native Hawaiian/Pacific Islander (2%); 86% spoke English and 14% Spanish. Half had Medicaid (52%) and 38% were WIC‑eligible. Fifteen families completed the second visit; 84% required reteaching, after which all accurately reported color designation and MUAC measurements to the nearest tenth. Ten families completed the feasibility survey: most reported no or some difficulty (91%), one could not use the tape at home, 64% needed help holding the child still, and nearly all were willing to continue MUAC use.
Conclusions: This was the first U.S. study since 2001 to evaluate whether parents can accurately obtain MUAC measurements and the first to assess U.S. caregivers’ ability to use the MUAC insertion tape tool to monitor child nutritional status. In a diverse sample, caregivers found MUAC measurement highly feasible and acceptable. Although most required re‑teaching, nearly all demonstrated accurate measurement skills 2–6 months after initial instruction. Some families needed a second adult to help hold the child, but nearly all were willing to continue using the tape. These findings support MUAC insertion tape as a practical method for home‑based nutritional monitoring, including during telehealth visits or between clinic appointments.
Disclaimer - AI was used in the preparation of the abstract such as to create text, but not in the analysis.
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Poster Board Number: 23