The Influence of Parental Health Literacy Status on Reach, Attendance, Retention, and Outcomes in a Family-Based Childhood Obesity Treatment Program, Virginia, 2013–2015

Abstract

IntroductionFew interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose).MethodsThis pre–post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes.ResultsNo significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than $25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P < .001).ConclusionBy incorporating design features that attended to the HL needs of parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.

Maternal health literacy of ethnic Hungarian mothers in Romania

“…However, in some special settings, no disadvantage was revealed in children coming from low health literate parents. For instance, such children engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high literacy (Zoellner et al, 2017).…”

The effect of Public Health/Pediatric Obesity interventions on socioeconomic inequalities in childhood obesity: A scoping review

“… Use of parent and child workbooks developed in 6 chapters on nutrition, PA, and behavioural strategies and including module objectives, educational content, a class activity, and homework combined with newsletters mailed weekly (Zoellner, 2017) . Focus group with community residents on healthy eating and PA (Greening, 2011) . Home‐based education activities on diet and PA (Edmunson, 1996; Lytle, 1996) .…”

“…Self‐monitoring activities were incorporated (Zoellner, 2017) . Screening and consultations on diet and PA for children affected by obesity with follow up from healthcare professionals where indicated (EPIPOI‐1 and 2) (Jouret, 2009) . Consultations on diet and PA for children affected by obesity with healthcare physicians partially offered by local insurances (Taveras, 2011) or offered to families (Chomitz, 2010) .…”

Parental Translation into Practice of Healthy Eating and Active Play Messages and the Impact on Childhood Obesity: A Mixed Methods Study

“…Parents play a significant role in the development of their children by shaping physical activity and eating behaviours early in childhood [ 11 ]. Parental practices including feeding style/control [ 12 ], role modelling, using food as a reward [ 13 ], and low levels of health literacy [ 14 ] have all been associated with child physical activity and eating behaviours linked to weight status. Interventions targeting these parental behaviours have reported wide variation in effectiveness [ 15 ].…”