Parent Health Literacy and "Obesogenic" Feeding

J Pediatr. 2013 Dec 24. pii: S0022-3476(13)01423-6. doi: 10.1016/j.jpeds.2013.11.014. [Epub ahead of print]

Parent Health Literacy and "Obesogenic" Feeding and Physical Activity-Related Infant Care Behaviors.

Yin HS1, Sanders LM2, Rothman RL3, Shustak R4, Eden SK5, Shintani A5, Cerra ME4, Cruzatte EF4, Perrin EM6.

Author information

• 1Department of Pediatrics, New York University School of Medicine, New York, NY. Electronic address: yinh02@med.nyu.edu.
• 2Department of Pediatrics and Center for Health Policy, Stanford University, Stanford, CA.
• 3Departments of Internal Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
• 4Department of Pediatrics, New York University School of Medicine, New York, NY.
• 5Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
• 6Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine and Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC.

Abstract

OBJECTIVE:

To examine the relationship between parent health literacy and "obesogenic" infant care behaviors.

STUDY DESIGN:

Cross-sectional analysis of baseline data from a cluster randomized controlled trial of a primary care-based early childhood obesityprevention program (Greenlight). English- and Spanish-speaking parents of 2-month-old children were enrolled (n = 844). The primary predictor variable was parent health literacy (Short Test of Functional Health Literacy in Adults; adequate ≥23; low <23). Primary outcome variables involving self-reported obesogenic behaviors were: (1) feeding content (more formula than breast milk, sweet drinks, early solid food introduction), and feeding style-related behaviors (pressuring to finish, laissez-faire bottle propping/television [TV] watching while feeding, nonresponsiveness in letting child decide amount to eat); and (2) physical activity (tummy time, TV). Multivariate logistic regression analyses (binary, proportional odds models) performed adjusting for child sex, out-of-home care, Women, Infants, and Children program status, parent age, race/ethnicity, language, number of adults/children in home, income, and site.

RESULTS:

Eleven percent of parents were categorized as having low health literacy. Low health literacy significantly increased the odds of a parent reporting that they feed more formula than breast milk, (aOR = 2.0 [95% CI: 1.2-3.5]), immediately feed when their child cries (aOR = 1.8 [1.1-2.8]), bottle prop (aOR = 1.8 [1.002-3.1]), any infant TV watching (aOR = 1.8 [1.1-3.0]), and inadequate tummy time (<30 min/d), (aOR = 3.0 [1.5-5.8]).

CONCLUSIONS:

Low parent health literacy is associated with certain obesogenic infant care behaviors. These behaviors may be modifiable targets for low health literacy-focused interventions to help reduce childhood obesity.