Development and validation of a Weight Literacy Scale in English and Spanish

Health literacy and obesity: A systematic scoping review

Obesity is a preventable global health epidemic that has serious health consequences. Health literacy has been identified as an underlying and modifiable factor in the development and maintenance of obesity. Adequate levels of health literacy have been shown to significantly impact on weight loss, weight loss maintenance, and associated health outcomes.

OBJECTIVE

The aim of the current study was to systematically review extant literature to evaluate the way in which health literacy is measured for individuals with obesity and to identify the key areas of health literacy that are commonly assessed.

METHOD

This systematic scoping review was conducted over five databases and yielded 12 papers (Nparticipants = 15,393) that represented our search strategy and inclusion and exclusion criteria.

RESULTS

The review highlighted there are currently multiple measures that exist that assess independent or dual domains of health literacy; however, there were no studies that specifically utilized a measure that holistically assessed the three maintaining and modifiable domains of health literacy of obesity (psychological knowledge, nutritional knowledge, and knowledge about physical activity).

CONCLUSION

Given the dearth of targeted health literacy measures for obesity, our findings highlighted a critical need to develop a distinct measure of health literacy for obesity to guide policy, research, education, and intervention.

Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health

OBJECTIVES

To assess the efficacy of a community-based childhood obesity prevention intervention targeting Sugar-sweetened beverage (SSB) consumption on self-rated oral health among children and their parents/caregivers.

METHODS

This study is a secondary analysis of data from a pilot site-randomized intervention (H₂ GO!) targeting SSB consumption and obesity risk among children. The 6-week SSB behavioural intervention was implemented in two Massachusetts Boys and Girls Club sites that were matched for size and racial/ethnic composition. Children ages 9-12 years and their parents/caregivers were eligible to participate. Data on self-rated oral health and sociodemographics were obtained via self-report surveys at baseline, 2 and 6 months. Generalized linear mixed regression models were used to estimate 2- and 6-month change in oral health associated with the intervention.

RESULTS

Data are from 100 child participants (46% female; 38% Black, 20% Hispanic, 13% White, 12% Multiracial, 11% Asian) and 87 parent participants (78.2% female; 37.9% Hispanic, 29.9% Black, 14.9% Asian, 10.3% White). At baseline, 47% of child participants rated their oral health as good, followed by very good (32%), fair (11%) and excellent (10%). Among parents, 46.3% rated their oral health as good, followed by very good (29.3%), excellent (9.8%), fair (9.7%) and poor (4.9%). The intervention was associated with 2- and 6-month improvements in child participants' mean self-rated oral health scores (β = 0.78; 95% CI: 0.48, 1.087; P < .001; β = 0.98; 95% CI: 0.61, 1.34; P < .001, respectively) and with 2-month improvements in parent participants' mean self-rated oral health (β = 0.42; 95% CI: 0.016, 0.82; P = .042).

CONCLUSION

Short-term improvements in oral health among children and their parents/caregivers were observed among those participating in a SSB behavioural intervention. Community-based behavioural programmes targeting SSB consumption may be a promising approach to promote oral health as well as prevent childhood obesity.

Development and psychometric properties of maternal health literacy inventory in pregnancy

Background

Pregnancy is one of the most sensitive and important stages of women's life. Maternal health literacy is the key to achieving a healthy pregnancy. It also affects pregnancy outcomes by improving the quality of health care in this period. The aim of this study was to develop and evaluate the psychometric properties of maternal health literacy inventory in pregnancy (MHELIP).

Methods

This sequential, exploratory and mixed study was carried out in two parts (qualitative study and psychometric evaluation of the tool) in Tehran in 2016–18. The first part involved a qualitative content analysis with a traditional approach using in-depth, semi-structured and personal interviews with 19 eligible pregnant women. Then, the pool of items extracted from the qualitative part was completed by reviewing the existing literature and tools. In the second part, the overlapping items were summarized and the tool was validated. In order to evaluate the construct validity, a cross-sectional study was conducted with the participation of 320 pregnant women. Data analysis was performed by SPSS-19 software using exploratory factor analysis and reliability tests (Cronbach's alpha and ICC).

Results

Findings of qualitative part produced a pool of 120 items that reached to 124 items after reviewing the literature. After confirming face and content validity by calculating CVI and CVR for each item, 53 items remained in the pool. Finally, the results of exploratory factor analysis confirmed a tool with 48 items in four factors, explaining 46.49% of the variance of total variables of the tool. Reliability of the tool was approved by Cronbach's alpha = 0.94 and test-retest with 2-weeks intervals, indicating an appropriate stability for the scale (ICC = 0.96). Finally, the tool was finalized with 48 items in 4 dimensions, including "Maternal Health Knowledge", "Maternal Health Information Search", "Maternal Health Information Assessment" and "Maternal Health Decision Making and Behavior".

Conclusion

The designed tool is a multidimensional, reliable and validated scale for assessing maternal health literacy during pregnancy. This tool can be used to evaluate different aspects of maternal health literacy in pregnant women, which was prepared based on their experiences during a qualitative study.

Reducing sugary drink intake through youth empowerment: results from a pilot-site randomized study

BACKGROUND

Efficacious strategies to reduce sugar-sweetened beverage (SSB) consumption among youth are needed. This pilot study assessed the feasibility and preliminary efficacy of a community-based youth empowerment intervention to reduce SSB consumption and obesity risk among a low-income, ethnically diverse sample of youth.

METHODS

The H2GO! intervention was pilot-tested in an afterschool setting (Boys and Girls Clubs (BGC)) in Massachusetts, USA. One site was randomized to receive the intervention; the other site received standard programming. Youth ages 9-12 years and their parents/caregivers were eligible to participate. A total of N = 110 parent-child pairs (N = 55 parent-child pairs per site) were recruited. The 6-week intervention consisted of group-based weekly sessions delivered by trained BGC staff and youth-led activities that engaged parents. Child outcomes included self-reported SSB and water intake and measured body mass index z scores (zBMI). Parent outcomes included self-reported SSB and water intake, SSB purchasing, and availability of SSBs at home. Outcomes were measured at baseline, 2 months, and 6 months. Generalized linear and logistic regression models were used to estimate intervention effects over time.

RESULTS

The final analytic study sample consisted of 100 child participants (38% Black, 20% Hispanic, 13% White, 12% Multiracial, 11% Asian) and 87 parent participants (78.2% female; 78.2% reporting eligibility for the free-or-reduced price lunch program). 6-month retention rates were ≥ 82%. Intervention attendance rates among intervention child participants (N = 51) averaged 78.1% (SD = 10.3). Over half (56.0%) of child participants were overweight or obese at baseline. Relative to the comparison site, intervention site child participants had decreased SSB intake (β = - 1.64; 95% CI: 2.52, - 0.76), increased water intake (β = 1.31; 95% CI: 0.38, 2.23), and decreased zBMI (- 0.23 units; 95% CI: - 0.31, - 0.14) over 6 months (p < 0.001). Intervention parent participants also reported decreased SSB intake (β = - 1.76; 95% CI: - 2.56, - 0.96) and increased water intake (β = 1.75; 95% CI: 1.11, 2.40) than comparison parent participants at 6 months (p < 0.001).

CONCLUSIONS

Findings demonstrate the potential of a youth empowerment intervention on reducing SSB intake and zBMI among a diverse sample. Findings will guide a larger cluster-randomized controlled trial to test intervention efficacy on preventing childhood obesity, as well as inform future interventions that aim to target additional diet and physical activity behaviors through youth empowerment.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02890056 . Registered 31 August 2016.