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：
8403591
负责人：
ELIANA M. PERRIN
金额：
$ 55.32万
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 2013-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8403591
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.

项目摘要 2003年，外科医生理查德·卡莫纳（Richard Carmona）表示，低健康素养是“最大的素养之一对我们国家超重和肥胖流行的贡献。”最近的研究支持了这一主张发现低健康素养或算术与较差的护理人员母乳喂养有关知识，婴儿配方奶粉不正确的混合，难以理解食品标签和份量以及更高的成人和儿童的体重指数（BMI）。特别关注的是肥胖症流行的影响我们最小的孩子。现在超过26％的学龄前儿童超重（BMIE85％）或肥胖（BMIE95％）（基于2007 HHS/CDC专家面板定义）。学龄前儿童的肥胖率翻了一番过去十年，低收入和少数民族儿童的增长最高 - 相同的社区大多数受健康素养的影响。迄今为止，预防或治疗儿童肥胖的临床努力的疗效有限。努力需要早点开始，因为按二岁的孩子超重的孩子超重的可能性是五倍青少年，随后面临与肥胖相关并发症（包括早发2型）的风险更高糖尿病和心血管疾病。没有公开的临床研究严格解决肥胖症在2岁之前预防特定的低数字和算术重点。解决护理人员健康素养在幼儿期是一种创新策略，旨在促进这些家庭中健康的营养和活动防止儿童生活中不健康的体重增加，这将具有很大的公共健康意义防止儿童和成人慢性病。拟议的研究是一项多站点随机对照试验，以评估低 - 素养/面向算术的干预措施，旨在促进健康的家庭生活方式并防止早期儿童肥胖。干预将通过小儿居民在初级保健中进行资源不足社区的设置。四个学术医疗中心将被随机分解：范德比尔特大学，迈阿密大学，北卡罗来纳大学教堂山大学和纽约大学。两个中心将接受干预，而其他两个中心将获得主动控制。在每个站点，将招收250个英语或西班牙语的男孩二元组的队列，然后从儿童的4-6个月夫妇访问了24个月的夫妇访问。干预将包括低 - 小儿居民以识字为导向的工具包与家人一起使用，并清除健康传播培训小儿居民。在控制地点，儿科居民将在生活方式方面提供“通常的护理” 咨询，但他们还将获得一项预防伤害的教育计划，以作为注意力控制。这主要的假设是干预将改善家庭饮食和体育锻炼行为，并且它将降低24个月大的童年超重（BMIE85％）。