Role of Parent Health Literacy in Early Child Obesity and Other Health Outcomes

家长健康素养在儿童早期肥胖和其他健康结果中的作用

• 批准号: 8959629
• 负责人: Alan M Delamater
• 金额: $ 23.17万
• 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 2016-04-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8959629
• 关键词: 2 year old; 5 year old; Address; Adult; Age; Age-Months; American; Attention; Award; Behavior; Body mass index; Breast Feeding; Caregivers; Child; Child Development; Child health care; Childhood; Clinic; Clinical; Cluster randomized trial; Cohort Studies; Communication; Control Groups; Cross-Sectional Studies; Data; Data Collection; Diet; Dose; Education; Educational Materials; Enrollment; Ethnic Origin; Family; Family Characteristics; Family health status; Food Labeling; Future; Grant; Growth; Health; Health Communication; Health Status; Health behavior; Health behavior outcomes; Immunization; Infant; Infant Care; Infant formula; Injury; Intervention; Intervention Studies; Interview; Length; Long-Term Effects; Measures; Mediating; Mediator of activation protein; Obesity; Outcome; Parents; Patient Self-Report; Perception; Persons; Pharmaceutical Preparations; Physical activity; Prevention program; Preventive care; Primary Health Care; Progress Reports; Protocols documentation; Provider; Race; Randomized; Role; Safety; Shapes; Site; Surveys; Time; Training; United States National Institutes of Health; Universities; Visit; Weight; Work; active control; age difference; cohort; early childhood; feeding; follow-up; group intervention; health care service utilization; health literacy; health service use; improved; injury prevention; literacy; mathematical ability; nutrition; obesity in children; obesity prevention; obesogenic; parental influence; parental role; retention rate; sedentary; skills

DESCRIPTION (provided by applicant): Over 90 million Americans have basic or below basic literacy skills, which are independently associated with poor understanding of health information, poor health behaviors and poor clinical outcomes. Prior work from our study team has demonstrated that lower health literacy or numeracy is associated with lower rates of breastfeeding, problems mixing infant formula, difficulty understanding food labels and portion sizes, difficulty understanding growth charts, higher Body Mass Index (BMI) in adults and children, and difficulties with medication dosing and other safety issues. However, to date, there has been limited study of the evolving role of parent literacy in the long-term health of young children, and most studies have only been cross-sectional. In 2009, we were awarded a 5-year NIH R01 to perform a cluster randomized trial to evaluate the impact of a health literacy/health communication intervention on early childhood obesity prevention (known as the "Greenlight Intervention Study") in four academic primary care clinics. Two clinics received a health literacy sensitive intervention for obesity prevention, while two active control sites received education in injury prevention. English- and Spanish-speaking parents and their infants were enrolled at the child's routine 2 month-old preventive care visit and are followed until the child is 2 years old. Throughout the study, multiple measures of child health status are collected, including clinical indicators (e.g., child weight and length, immunization status, health-care utilization), behaviora indicators (e.g., dietary and physical activity, injury prevention behaviors), and health communication-related assessments (e.g., parent health literacy/numeracy, perceived provider communication). Recruitment of 865 families was completed September 1, 2012. Retention rates have been promising to date, with >90 percent of eligible families completing their 2 year visits. Cross-sectional analyses of data from the baseline 2 month well-child visit demonstrated significant associations between low literacy and increased "obesogenic" behaviors and worse injury prevention behaviors. Preliminary results at 4 and 6 months suggest that the intervention improved dietary and physical activity-related infant care behaviors. Through this competing renewal, we propose to continue to follow this unique child cohort, which we call the "Greenlight Cohort Study," with data collection through phone surveys and in-person interviews every six months until children are 5 years old. This will allow us to assess the long-term effects of the original intervention. In addition, this longitudinal cohort will provide us the opportunity to examine the relationship between parent literacy and early childhood health-related outcomes, including family health behaviors, child obesity, injury, and child development. This study will also contribute new information on the validity of parent literacy measures over time in the context of child health. The proposed study will provide the most robust understanding to date of the role and importance of parent health literacy in early childhood obesity prevention and other child health-related issues and shape future interventions to curb obesity and improve child health.

描述（由申请人提供）：超过 9000 万美国人具有基本或低于基本的识字技能，这些技能与对健康信息理解不足、健康行为不良和临床结果不良独立相关。我们的研究团队之前的研究表明，较低的健康素养或算术能力与较低的母乳喂养率、混合婴儿配方奶粉的问题、难以理解食品标签和份量大小、难以理解生长图表、成人和儿童较高的体重指数 (BMI) 以及用药剂量困难和其他安全问题有关。然而，迄今为止，关于父母识字率对幼儿长期健康的不断变化的作用的研究还很有限，而且大多数研究只是横断面的。 2009 年，我们获得了为期 5 年的 NIH R01 资格，在四个学术初级保健诊所进行了一项整群随机试验，以评估健康素养/健康沟通干预对儿童早期肥胖预防的影响（称为“绿灯干预研究”）。两个诊所接受了预防肥胖的健康素养敏感干预措施，两个主动控制点接受了健康素养教育 伤害预防。讲英语和西班牙语的父母及其婴儿参加了孩子 2 个月大的例行预防性护理就诊，并接受跟踪直至孩子 2 岁。在整个研究过程中，收集了儿童健康状况的多种衡量标准，包括临床指标（例如，儿童体重和身长、免疫状况、医疗保健利用）、行为指标（例如，饮食和体力活动、伤害预防行为）和健康沟通相关评估（例如，家长健康素养/计算能力、感知的提供者沟通）。 865 个家庭的招募已于 2012 年 9 月 1 日完成。迄今为止，保留率一直很高，超过 90% 的合格家庭完成了两年的访问。对 2 个月健康儿童就诊基线数据的横断面分析表明，识字率低与“肥胖”行为增加以及伤害预防行为恶化之间存在显着关联。 4 个月和 6 个月时的初步结果表明，干预措施改善了与饮食和身体活动相关的婴儿护理行为。 通过这种竞争性的更新，我们建议继续跟踪这个独特的儿童队列，我们​​称之为“绿光队列研究”，每六个月通过电话调查和面对面访谈收集数据，直到孩子们年满 5 岁。这将使我们能够评估原始干预措施的长期影响。此外，这个纵向队列将为我们提供机会来研究父母识字率与幼儿健康相关结果之间的关系，包括家庭健康行为、儿童肥胖、伤害和儿童发育。这项研究还将提供有关儿童健康背景下家长识字措施随着时间推移的有效性的新信息。拟议的研究将提供迄今为止对父母健康素养在儿童早期肥胖预防和其他儿童健康相关问题中的作用和重要性的最有力的了解，并制定未来遏制肥胖和改善儿童健康的干预措施。