Addressing Health Literacy and Numeracy to Prevent Childhood Obesity

提高健康素养和算术能力以预防儿童肥胖

• 批准号: 8479459
• 负责人: ELIANA M. PERRIN
• 金额: $ 5万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-05 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8479459
• 关键词: 2 year old; Academic Medical Centers; Address; Adolescent; Adoption; Adult; Affect; Age; Age-Months; American; Attention; Beech; Behavior; Behavior Therapy; Body mass index; Breast Feeding; Cardiovascular Diseases; Caregivers; Caring; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Chronic Disease; Clinical; Clinical Research; Communication; Communities; Control Groups; Counseling; Development; Diet; Disadvantaged; Education; Educational process of instructing; Enrollment; Epidemic; Family; Food Labeling; Future; Health; Health Communication; Health behavior; Hypertension; Infant formula; Intake; Intervention; Juice; Knowledge; Latino; Life; Life Cycle Stages; Life Style; Low income; Minority; Modeling; New York; Non obese; Non-Insulin-Dependent Diabetes Mellitus; North Carolina; Nursery Schools; Obesity; Outcome; Overweight; Parenting behavior; Parents; Perception; Physical activity; Physicians; Plant Roots; Preschool Child; Prevalence; Prevention education; Prevention strategy; Preventive; Primary Care Physician; Public Health; Publishing; Randomized; Randomized Controlled Trials; Reading; Reporting; Research; Role; School-Age Population; Self Efficacy; Site; Surgeon; Television; Time; Training; United States; Universities; Visit; Weight; Weight Gain; Weight Perception; Yin; active control; base; burden of illness; clinical care; cohort; cost effective; early childhood; early onset; ethnic minority population; experience; group intervention; health literacy; high risk; improved; injury prevention; innovation; intervention effect; literacy; nutrition; obesity in children; obesity prevention; pattern perception; pediatrician; prevent; primary care setting; programs; satisfaction; skills; socioeconomics; therapy design; tool; treatment as usual

Project Summary In 2003, Surgeon General Richard Carmona stated that low health literacy was "one of the largest contributors to our nation's epidemic of overweight and obesity." This assertion is supported by recent studies which have found that low health literacy or numeracy is associated with poorer caregiver breastfeeding knowledge, incorrect mixing of infant formula, difficulty understanding food labels and portion sizes, and higher Body Mass Index (BMI) in adults and children. Of particular concern is the impact of the obesity epidemic on our youngest children. Over 26% of preschool children are now overweight (BMIe85%) or obese (BMIe95%) (based on 2007 HHS/CDC Expert Panel definitions). Rates of obesity in preschool children have doubled over the past decade, with the highest increases among low income and minority children-- the same communities most affected by low health literacy. To date, clinical efforts to prevent or treat childhood obesity have had limited efficacy. Efforts need to start early, because children who are overweight by age two are five times as likely to become overweight adolescents, and subsequently at higher risk for obesity-related complications including early-onset Type-2 Diabetes and cardiovascular disease. No published clinical studies have rigorously addressed obesity prevention prior to age 2 with a specific low-literacy and numeracy focus. Addressing caregiver health literacy in early childhood is an innovative strategy to promote healthy nutrition and activity among these families and prevent unhealthy weight gain across the child's life, which would have great public health significance by preventing both child and adult chronic illness. The proposed study is a multi-site randomized, controlled trial to assess the efficacy of a low- literacy/numeracy-oriented intervention designed to promote healthy family lifestyles and to prevent early childhood obesity. The intervention will be delivered through pediatric resident physicians in primary care settings in under-resourced communities. Four academic medical centers will be randomized: Vanderbilt University, the University of Miami, the University of North Carolina at Chapel Hill, and New York University. Two centers will receive the intervention, while the other two centers will receive an active control. At each site, a cohort of 250 English- or Spanish-speaking caregiver-child dyads will be enrolled and followed from the child's 4-6 month well-child visit through the 24-month well-child visit. The intervention will include a low- literacy-oriented toolkit for pediatric residents to use with families and clear health communication training for the pediatric residents. At control sites, pediatric residents will provide "usual care" with respect to lifestyle counseling, but they will also receive an injury-prevention education program to act as an attention control. The primary hypotheses are that the intervention will improve family dietary and physical activity behaviors and that it will reduce the rate of childhood overweight (BMIe85%) at age 24 months. Project Narrative In 2003, Surgeon General Richard Carmona suggested that low health literacy is "one of the largest contributors to our nation's epidemic of overweight and obesity." Over 26% of preschool children are now overweight or obese, and children who are overweight by age 24 months are five times as likely as non- overweight children to become overweight adolescents. The aim of the study is to assess the efficacy of a low- literacy/numeracy-oriented intervention aimed at teaching pediatric resident physicians to promote healthy family lifestyles and prevent overweight among young children (age 0-2) and their families in under-resourced communities.

项目摘要 2003年，卫生部长理查德·卡莫纳（Richard Carmona）指出，健康素养低是“最大的问题之一， 导致我们国家超重和肥胖流行病的罪魁祸首。“这一论断得到了最近研究的支持 他们发现，低健康素养或计算能力与较差的照顾者母乳喂养有关， 知识，不正确的婴儿配方奶粉混合，难以理解食品标签和份量，以及更高的 成人和儿童的身体质量指数（BMI）。特别令人关注的是肥胖流行对 我们最小的孩子超过26%的学龄前儿童超重（BMIe85%）或肥胖（BMIe95%） （根据2007年HHS/CDC专家小组定义）。学龄前儿童的肥胖率翻了一番 在过去的十年中，低收入和少数民族儿童的增幅最高， 受健康知识普及率低的影响最大。 迄今为止，预防或治疗儿童肥胖症的临床努力效果有限。努力需要 尽早开始，因为两岁时超重的儿童超重的可能性是两岁时超重的五倍。 青少年，随后肥胖相关并发症的风险较高，包括早发性2型 糖尿病和心血管疾病。没有发表的临床研究严格解决肥胖问题 2岁之前的预防，特别关注识字和算术能力低的儿童。提高照顾者的健康知识水平 是一项创新战略，旨在促进这些家庭的健康营养和活动， 防止儿童一生中不健康的体重增加，这将具有重大的公共卫生意义， 预防儿童和成人慢性疾病。 该研究是一项多中心随机对照试验，旨在评估低剂量 旨在促进健康家庭生活方式并预防早期感染的识字/算术干预措施 儿童肥胖症干预措施将通过初级保健中的儿科住院医生提供 在资源不足的社区。四个学术医疗中心将被随机分配：范德比尔特 大学、迈阿密大学、查佩尔山的北卡罗来纳州大学和纽约大学。 两个中心将接受干预，而另外两个中心将接受主动控制。在每个站点， 将招募250名讲英语或西班牙语的双胞胎儿童， 儿童4-6个月健康儿童访视至24个月健康儿童访视。干预措施将包括低- 面向儿科住院医师的扫盲工具包，供家庭使用，并进行明确的健康沟通培训， 儿科住院医生在对照研究中心，儿科住院医师将提供关于生活方式的“常规护理” 咨询，但他们也将接受伤害预防教育计划，作为一个注意力控制。的 主要假设是，干预措施将改善家庭饮食和体育活动行为， 它将降低24个月大时儿童超重率（BMIe85%）。项目叙述 2003年，卫生部长理查德·卡莫纳（Richard Carmona）提出，健康素养低是“最大的问题之一”， 导致我们国家超重和肥胖的流行。“超过26%的学龄前儿童现在 超重或肥胖，24个月大的超重儿童的可能性是非超重儿童的五倍。 超重的孩子变成超重的青少年。该研究的目的是评估低- 以识字/算术为导向的干预措施，旨在教授儿科住院医师促进健康 家庭生活方式，防止幼儿（0-2岁）及其家庭超重， 社区.