Associations Between Health Literacy and Child Weight Control Strategies Among Parents of Preschoolers
Method: Data were drawn from the first wave of a state funded 5-year panel study on childhood obesity prevention among preschoolers and their parents. Parents (n=497; 90% female) were 6% Hispanic, 71% White, 19% African American, and 8% Asian. About one-third (36%) reported receiving WIC. Health Literacy was measured using two standardized scales including the nutrition-oriented Newest Vital Signs. Parent endorsement of weight loss strategies for children and for adults was assessed by checklist. Parent concern about their child’s weight was measured by a subscale of the Child Feeding Questionnaire. Descriptive, correlational, and multivariate regression analyses were performed to assess relationships between constructs.
Results: Nearly a third (29%) of parents had limited health literacy. Very few parents (2%) endorsed any of the 10 unsafe weight loss methods for preschool children; however, those who did selected an average of 3.5 unsafe strategies such as the use of laxatives, diuretics, and skipping meals; and 28% endorsed these and other unsafe strategies for adults. The most common type of child weight control strategy endorsed involved calorie restriction. Most parents (83%) endorsed one or more of the 10 dietary restraint strategies for young children; and two-thirds endorsed 3 or more. Linear regressions showed that higher health literacy was associated with fewer unsafe child weight loss strategies (β = -.162, R2 = .053, p = .002), but more child dietary restraint strategies (β = .210, R2 = .028, p= .000) after controlling for parent age, education, and race/ethnicity.
Implications: Parents concerned about child obesity hold misconceptions about safe and effective weight management strategies, suggesting targets for intervention to improve weight-related health literacy. Health Social Workers are needed to educate and empower parents to develop the knowledge, skills, and strategies to successfully promote healthy weight and eating among their children.