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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

基本信息

批准号：
8207253
负责人：
ELIANA M. PERRIN
金额：
$ 57.7万
依托单位：
VANDERBILT UNIVERSITY
依托单位国家：
美国
项目类别：
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/8207253
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

项目摘要

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.

项目总结