The Influence of Child and Parent Health Literacy Status on Health Outcomes from a Childhood Obesity Treatment Program
Lowery, Kamilan Aurielle
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While limited health literacy has been associated with poorer health decisions and poorer health outcomes, there remains a gap in the literature related to the influence of health literacy on weight and weight-related behaviors. The primary aim of this study is to examine the influence of child and parent health literacy status on childs body mass index (BMI) and health behaviors, within an adapted evidence-based family-based childhood obesity intervention, iChoose, implemented in the medically underserved Dan River Region (DRR). Previously developed measures were used to assess health literacy and health behaviors. iChoose consisted of 101-parent-child dyads. Using the New Vital Sign (NVS), 46% of children and 13% of parents had low to limited health literacy levels at baseline. Younger children and parents who were African American, had no high school diploma, and earned <$25,000/year were significantly more likely to have low health literacy when compared to their counterparts. Health literacy levels for these individuals ranged between 0 to 3, which is considered low to limited health literacy. Health literacy levels were further examined between health outcomes. However, BMI, fruit and vegetable intake, sugar-sweetened beverages (SSB), minutes of moderate to vigorous physical activity, and screen time did not differ by health literacy levels at baseline. Among children, improvements in the NVS was significantly correlated with decreases in SSB consumption (r = -.275, p < .05), but with no other outcomes. There were no significant correlations among changes in parent NVS score and changes in child health behaviors. Results from this study fill a gap in understanding the associations in health literacy and weight and weight-related behavioral outcomes in children. It also provides insights into the opportunities and challenges in measuring health literacy among children. Future research is needed to explore further health literacy measurement issues among children and the influence of both child and parent health literacy in family-based childhood obesity treatment efforts. Additional efforts are also needed to assist community and health care providers in finding more effective strategies to guide children with low health literacy to better health outcomes.
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