Relationship between child health literacy and body mass index in overweight children

General Pediatrics, Thomas Jefferson University, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA.
Patient Education and Counseling (Impact Factor: 2.2). 09/2009; 79(1):43-8. DOI: 10.1016/j.pec.2009.07.035
Source: PubMed


To test the relationship between child health literacy and body mass index (BMI) Z-score in overweight children.
Cross-sectional survey of overweight children and parents. Parent and child health literacy was measured by the Short Test of Functional Health Literacy (STOFHLA). Linear regression tested for predictors of childhood BMI Z-score, adjusting for confounders.
Of 171 total children, 107 (62%) participated, of whom 78 (73%) had complete data for analysis. Mean child BMI Z-score (SD) was 2.3 (0.40); median child age (interquartile range) was 11.5 (10-16); 53% were female; 80% were Medicaid recipients. Mean child STOFHLA was 22.9 (9.0); mean parental STOFHLA was 29.1 (8.6). Child STOFHLA correlated negatively with BMI Z-score (r=-0.37, p=0.0009) and positively with child eating self-efficacy (r=0.40, p<0.0001). After adjusting for confounders, child STOFHLA was independently associated with child BMI Z-score (standardized B=-0.43, p<0.0001). Overall adjusted r-squared for the regression model was 38%. Child STOFHLA contributed 13% to the overall model.
Child health literacy was negatively correlated with BMI Z-scores in overweight children, suggesting the need to consider health literacy in the intersection between self-efficacy and behavior change when planning interventions that aim to improve child BMI.

Download full-text


Available from: Iman Sharif, Sep 04, 2015
18 Reads
  • Source
    • "The results suggested that most studies were flawed with methodological problems, particularly few had included potential confounding factors to be controlled for in the examination of the relationship [27]. Moreover, some of these studies were not focusing on the health literacy children or adolescents and their body weight, but the health literacy levels of the mother or the study was conducted in a specific patient group such as overweight children and not in the community [28,29]. In the small scale study by Sharif and Blank, it was found that child health literacy correlated negatively with the Body Mass Index (BMI) with a correlation coefficient of -0.37 (p < 0.001) among 78 overweight children [29]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The problem of overweight and obesity in children and adolescents is considered an epidemic in both developed and developing world by the WHO. There has been little study on the relationship between health literacy and body weight among adolescents.This epidemiological study aims to investigate the association between low health literacy and overweight and obesity among a population of Chinese adolescents aged 12-16 years in the city of Nanning, China in 2012. This study was a population-based cross-sectional health survey utilising a two-stage random cluster sampling design. The sample consisted of high school students aged between 12-16 years with the total student population attending high schools in a large city as the sample frame. Health literacy was measured by the Chinese version of the short form of the Test of Functional Health Literacy translated for and validated among Taiwanese adolescents. Overweight and obesity were assessed in accordance to the recommendation of the World Health Organization (WHO) Global Database of Body Mass Index classification methods. Data were analysed using logistic regression modelling techniques with adjustment to the cluster sampling effect. A total of 1035 students responded to the survey providing usable information with 628 (48.1%) respondents classified as high, 558 (42.8%) moderate, and 119 (9.1%) low levels of health literacy. After adjusting for potential confounding factors and the cluster sampling effect, low health literacy was significantly associated with overweight and obesity (OR = 1.84, 95% C.I. = 1.13-2.99). Results suggested that low health literacy level was associated with many aspects of adolescence health including their body weight. These results have public health implications on an important global problem of adolescence body weight. Enhancing the health literacy should be considered as part of the strategies in combating adolescence weight problem.
    Archives of Public Health 04/2014; 72(1):11. DOI:10.1186/2049-3258-72-11
  • Source
    • "Median (IQR) child BMI percentile was 82 (55–95); 65 (27%) were obese. Median (IQR) parent BMI was 27.5 [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] "
    [Show abstract] [Hide abstract]
    ABSTRACT: We tested the association between child and parental health literacy (HL) and odds of child and adolescent obesity. We conducted an anonymous cross-sectional survey of a convenience sample of English-speaking child-parent dyads. Newest Vital Sign (NVS) measured HL. We used multivariable logistic regression to test adjusted association between child and parental NVS and obesity. Analyses were stratified for school-aged children (aged 7-11) vs. adolescents (aged 12-19). We surveyed 239 child-parent dyads. Median child age was 11 [inter-quartile range 9-13]; 123 (51%) were male; 84% Medicaid recipients; 27% obese. For children, the odds of obesity [adjusted odds ratio (95% confidence interval)] decreased with higher parent NVS [0.75 (0.56,1.00)] and increased with parent obesity [2.53 (1.08,5.94)]. For adolescents, odds of obesity were higher for adolescents with the lowest category of NVS [5.00 (1.26, 19.8)] and older parental age [1.07 (1.01,1.14)] and lower for Medicaid recipients [0.21 (0.06,0.78)] and higher parental education [0.38 (0.22,0.63)]. Obesity in school-aged children is associated with parental factors (obesity, parental HL); obesity in adolescents is strongly associated with the adolescent's HL. Strategies to prevent and treat obesity should consider limited HL of parents for child obesity and of adolescents for adolescent obesity.
    Patient Education and Counseling 09/2013; 94(1). DOI:10.1016/j.pec.2013.09.006 · 2.20 Impact Factor
  • Source
    • "(Sharif & Blank, 2010 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: Improving public capability to obtain, understand, and use health information is important for decision-making and communication. This study attempts to measure adults' literacy of the information provided by a public health institution. Factors affecting different health literacy level are also investigated. The relation between public risk perception and health literacy is examined as well. Methods: A total of 800 korean adults were surveyed. To provide the participants health literacy questions, health messages of heavy metals released by KFDA as well as literacy questions developed by NIKL were used. A total of eight questions were developed to measure health literacy. The dimensions of risk perception proposed by Brewer et al.(2008) were modified to measure risk perception. Results: The average percentage of correct answer for all literacy questions was only 65.57%. Individuals at the older age, and with lower education/ income level were more likely to be low literate. In addition, health literacy was strongly associated with risk perception. Conclusions: Public literacy of health information is influenced by socio demographic factors. This study suggested a possibility that low health literacy may affect unrealistically high risk perception. Further studies with sophisticated methodologies to measure health literacy need to be developed.
    01/2012; 29(3).
Show more