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: 2.6). 09/2009; 79(1):43-8. DOI: 10.1016/j.pec.2009.07.035
Source: PubMed

ABSTRACT 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.

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    • "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] "
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    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 · 2.60 Impact Factor
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    • "(Sharif & Blank, 2010 "
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    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).
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    • "Promoting HL is necessary since low HL is associated with a higher risk of health-related impairments, e.g. a lower health-related status (Baker et al. 1997; Wolf et al. 1946–1952; von Wagner et al. 2007), higher prevalence rates of cardiovascular diseases (Gazmararian et al. 2006), diabetes (Schillinger et al. 2002), asthma (Mancuso and Rincon 2006) and obesity (Hawthorne 1997; Goodman 1999; Sharif and Blank 2010), and a higher rate of tobacco and alcohol consumption (Conwell et al. 2003; von Wagner et al. 2007). Low HL is also associated with many healthrelated costs (Robert Koch-Institut 2009a). "
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    ABSTRACT: Aim Health literacy (HL) is a key outcome of health education. Low HL is associated with a higher risk of health-related impairments and high health-related costs. This article therefore describes the contents and evaluation of the school-based programme "Health literacy in school-aged children" (GeKo KidS) and its acceptance by teachers. A second focus of the study is the description of methods to increase the response of schools, students and parents as a crucial condition for the validity and generalizability of results from epidemiologic prevention studies. Subjects and methods The evaluation of the prevention program GeKo KidS included 5th grade students aged 9–13 years in schools in the region of Greifswald and East Pomerania [longitudinal randomised control group pre-post design (RCT)]. Data collections took place within the extended school dentist examination visits at the beginning of the 2007/2008 school year and at the beginning of the second half term of the 2008/2009 school year. This included medical examinations and self-completion ques-tionnaires of students, parents and teachers. The study was authorised by the data protection commissioner of Mecklenburg-West Pomerania, the Ministry of Education, Science and Culture of Mecklenburg-West Pomerania and the Ethics Commitee of the Ernst Moritz Arndt University Greifswald. Based on the authorisation of the data protection concept and concerns about selective response, parents were not granted a consent but rather a right to refuse participation. In order to attain a high participation rate of the schools, the school principals were informed about the research project by an invitation letter, telephone calls and personal visits. Additionally an agreement on participation was handed out to all schools as a binding criterion for participation. By signing this agreement schools committed to using the offered teaching material, to participate in teacher training and evaluation, and to provide resources with respect to time and space. At the beginning of the 2007/2008 school year, all parents of 5th grade students were informed about the research project, the prevention programme and aspects of data protection. In order to increase the response rate parents also received a supporting letter from the Minister of Education, Science and Culture of Mecklenburg-West Pomerania, which mainly provided information about the importance of the research project and asked for support of this study. Results In Greifswald/East Pomerania, 19 of 22 schools with 5th year classes participated in GeKo KidS (response M. Franze (*) : K. Fendrich : J. rate: 86.3%). Out of 914 eligible students in the participat-ing schools, 882 children (96.4%) took part in the school dentist examinations. A total of 863 children (94.4%) participated in the extended school dentist examination; 852 children (93.2%) took part in the student survey. In the parental survey 721 parents participated (response rate: 78.8%). A high level of acceptance referring to teacher training and the appropriateness of the GeKo KidS programme was achieved. Conclusion As shown by the low rate of refusal, the programme and the evaluation study were well accepted. Possible reasons for these results could be the chosen procedure of establishing contact with schools before sending the questionnaires and the parent's right to refuse their child's participation instead of giving an active confirmation. Because of this high response rate, the database enables comprehensive conclusions to be reached on the health-related state of students in Greifswald/East Pomerania.
    Journal of Public Health 08/2011; 19(4):339-347. DOI:10.1007/s10389-011-0421-7 · 2.30 Impact Factor
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