Childhood obesity has become a global public health priority. Obesity leads to increased risk of several co-morbid health conditions such as hypertension, type 2 diabetes, and mental health problems. Growth monitoring is the long-standing child health practice to identify children who fall outside healthy growth parameters. It has been proposed as a key activity for prevention of obesity in children. Growth data is now predominantly stored in primary care electronic medical records (EMRs). However concerns about data quality have limited its use for public health and research. Five inter-related studies were conducted to better understand the feasibility of using routinely collected anthropometric data from primary care EMRs for childhood obesity surveillance and outcomes. In our survey on current growth monitoring practices, only 21% of primary care providers reported using a length board to measure length in infants less than two years of age. Growth measurements were reported to be performed most often during scheduled well-baby/child visits, but rarely during sick visits. Encouragingly, intra- and inter-observer reliability of height/length, and weight was found to be acceptable when using appropriate equipment and measurement methods. Body mass index z-score data in EMRs was found to be 90% complete and 97% accurate. The main inaccuracies were due to recording measurements with inconsistent units and data entry errors. Using reliable data from EMRs, it was found that preschool-aged children (2 toPh.D
