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.

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Available from: Iman Sharif, Sep 04, 2015
    • "Low health literacy has been recognized as an independent and clear risk factor for poor health (Volandes & Paasche-Orlow, 2007). In addition, it has been seen as explaining inequalities in health and health behavior (Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011; Brown, Teufel, & Birch, 2007; Sharif & Blank, 2010; Sun et al., 2013). Since school can reach the children at an age when many health habits are developed, it is not surprising that schools are viewed as a context for learning many health-related competencies (St Leger, 2001; World Health Organization, 1998). "
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    • "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]. "
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