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：
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
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/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

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.

项目概要 2003 年，卫生局局长理查德·卡莫纳 (Richard Carmona) 表示，健康素养低下是“最大的问题之一”。造成我国超重和肥胖流行的罪魁祸首。”这一断言得到了最近研究的支持发现健康素养或算术能力低与护理人员母乳喂养较差有关知识、婴儿配方奶粉混合不正确、难以理解食品标签和份量大小等成人和儿童的体重指数 (BMI)。特别值得关注的是肥胖流行对健康的影响我们最小的孩子。目前超过 26% 的学龄前儿童超重 (BMIe85%) 或肥胖 (BMIe95%) （基于 2007 年 HHS/CDC 专家小组的定义）。学龄前儿童肥胖率增加了一倍过去十年，低收入儿童和少数族裔儿童的增幅最高——同一社区受健康素养低下的影响最大。迄今为止，预防或治疗儿童肥胖的临床努力效果有限。需要努力尽早开始，因为两岁时超重的儿童超重的可能性是其五倍青少年，随后出现肥胖相关并发症（包括早发 2 型）的风险更高糖尿病和心血管疾病。尚未发表的临床研究严格解决肥胖问题 2 岁之前的预防，特别关注低识字和算术能力。提高护理人员的健康素养幼儿期是一项创新战略，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，这对公共卫生具有重大意义预防儿童和成人慢性病。拟议的研究是一项多中心随机对照试验，旨在评估低- 以识字/算术为导向的干预措施，旨在促进健康的家庭生活方式并预防早期儿童肥胖症。干预措施将通过初级保健的儿科住院医生进行资源贫乏社区的环境。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、北卡罗来纳大学教堂山分校和纽约大学。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， 250 名讲英语或西班牙语的看护者-儿童二人组将被登记并从儿童 4-6 个月的健康儿童访视至 24 个月的健康儿童访视。干预措施将包括低为儿科住院医师提供与家人一起使用的以扫盲为导向的工具包，并为儿童提供清晰的健康沟通培训儿科住院医师。在控制点，儿科住院医生将提供生活方式方面的“常规护理” 咨询，但他们还将接受伤害预防教育计划作为注意力控制。这主要假设是干预措施将改善家庭饮食和身体活动行为，并且它将降低 24 个月时儿童超重率 (BMIe85%)。项目叙述 2003 年，卫生局局长理查德·卡莫纳 (Richard Carmona) 表示，健康素养低下是“最大的问题之一”。造成我们国家超重和肥胖流行的罪魁祸首。”现在超过 26% 的学龄前儿童超重或肥胖，24 个月大的儿童超重的可能性是非超重儿童的五倍超重儿童成为超重青少年。该研究的目的是评估低效药物的功效以识字/算术为导向的干预措施，旨在教导儿科住院医生促进健康家庭生活方式并防止资源贫乏地区的幼儿（0-2 岁）及其家庭超重社区。