Health Literacy as a Vehicle to Reduce Obesogenic Behaviors Among Adolescents: A Pilot Intervention
概览
- 阶段
- 不适用
- 干预措施
- Obesity Prevention
- 疾病 / 适应症
- Obesity, Adolescent
- 发起方
- City University of New York, School of Public Health
- 入组人数
- 36
- 试验地点
- 2
- 主要终点
- Reductions in participants' unhealthy eating behaviors as assessed by the Dietary Screener Questionnaire
- 状态
- 已完成
- 最后更新
- 昨天
概览
简要总结
The prevalence of adolescent behaviors that can lead to obesity are alarming, and reduced life expectancy is the future of America's youth if behavioral changes are not implemented to improve health and reduce the obesity burden. Researchers have argued that health literacy is a precursor to health knowledge and is necessary for translating knowledge about healthy choices into behavior, with low health literacy being associated with reduced preventive health behaviors in adults. Given the lack of health literacy-specific interventions addressing adolescents' obesogenic behaviors, the purpose of this study is to examine the preliminary effectiveness of adding a health literacy module to an obesity prevention intervention that addresses adolescents' obesogenic behaviors.
详细描述
The rates of pediatric obesity (\~19%) and diabetes (0.24%) in the US are alarming and behaviors implicated in obesity and type 2 diabetes are highly prevalent. Approximately 69% and 73% of adolescents consume less than two fruits and vegetables daily respectively, while 53% engage in insufficient physical activity. These behaviors magnify adolescents' immediate and long-term risks for obesity and obesity-related chronic illnesses, as well as complicate the treatment of obesity-related chronic illnesses. Children and adolescents who are obese are four times more likely to be diagnosed with type 2 diabetes than normal weight children, with serious short and long-term consequences impacting quality of life. Reduced life expectancy is the future of America's youth if behavioral changes are not implemented to improve health and reduce the obesity burden. Reversing current national trends in obesity and type 2 diabetes require novel and sustainable prevention strategies to address children and adolescents' obesogenic behaviors. Adolescence is marked by increased autonomy in decision-making, yet data suggest that adolescents are not equipped with all the skills to make effective health-related behavioral decisions. While health knowledge works in conjunction with motivation and behavioral skills to predict behavior, most existing adolescent interventions target these variables in isolation with modest success. Researchers have argued that health literacy (HL) - the ability to access, understand, and use health information to make informed health decisions - is a precursor to health knowledge and is necessary for translating health knowledge into behavior. Low HL among adults is associated with poor ability to interpret health messages, and results in reduced preventive health behaviors. Further, parent and adolescent HL is negatively related to adolescents' obesity status. Thus, while research on adding HL to existing behavior interventions to improve adolescents' obesity prevention behaviors is lacking, it is expected that the inclusion of HL into existing interventions will increase intervention effectiveness and positive behavior outcomes. The long-term goal of this line of research is to reduce the incidence of obesity in adolescents and by extension reduce the risk for obesity-related chronic illnesses using interventions that address individual and contextual factors related to long-term health decision-making and behavior change. The goal of the proposed study is to examine the effect of adding a HL component to an obesity prevention intervention that addresses adolescents' obesogenic behavior-related health knowledge, motivation, and behavioral skills. The central hypothesis is adolescents receiving HL training as part of an obesity prevention intervention will have higher rates of prevention behaviors than those in the obesity prevention only condition. Study goals will be achieved through the following specific aims: Aim 1: Modify successful components of existing obesity prevention interventions into an interactive digital platform with and without HL for acceptability and usability in adolescents. Approach: Use successful components of existing interventions, our completed preliminary research, and our research teams' expertise to develop an interactive digital intervention including HL, and obesogenic behavior-related health knowledge, motivation, and behavioral skills. Assess and modify the intervention for usability and acceptability among 14-16-year-olds through an iterative process. Aim 2: Determine if the addition of HL training to an interactive digital obesity prevention intervention will improve adolescents' obesity prevention behaviors over the obesity intervention alone. Hypothesis: Adolescents in the obesity prevention plus HL intervention will have higher rates of obesity prevention behaviors at posttest and follow-up compared to the obesity prevention only group. Approach: Conduct a two-arm randomized controlled trial (RCT) intervention (obesity prevention only, obesity prevention/HL) and estimate the intervention's effects on obesogenic behaviors. Adolescents (n = 36; 14-16-year-olds) will be randomly assigned to each condition (18/condition). Conduct pretest, posttest, and 1- month assessments of HL, obesogenic behaviors, and obesogenic behavior-related motivation, behavioral skills, and knowledge. Outcomes: Intervention completion will result in effect size estimates of improvements in obesity prevention behaviors, health knowledge, motivation, and behavioral skills for both groups with greater improvements for the HL group at posttest and follow-up. The obesity prevention/HL intervention group will also have higher HL at posttest and follow-up. Retention, recruitment, completion and treatment fidelity rates will be established. Innovation \& Impact: This study incorporates HL, an understudied but potentially critical factor in adolescents' health behaviors. The intervention will be developed and implemented in a digital format which will increase reach and impact. This is the first study examining the effect of including HL in adolescents' obesity prevention interventions. This study sets the groundwork for a full scale, RCT to assess the benefit of HL training added to an obesity prevention intervention to address adolescents' obesogenic behaviors.
研究者
Sasha Fleary
Associate Professor
City University of New York, School of Public Health
入排标准
入选标准
- •Adolescents 13-16 years old at time of enrollment (may turn age 17 during the study
- •Must have parental consent
- •All weight classifications
排除标准
- •Adolescents younger than 13 years or older than 16 years at time of enrollment
- •No parental consent
- •Medical conditions preventing engagement in physical activity
- •Medical conditions resulting in extremely restricted diets (e.g., ketogenic diet)
- •Already participating in an intervention related to healthy eating, physical activity and/or obesity prevention or treatment
研究组 & 干预措施
Vaping and Obesity Prevention Only
Obesity prevention and vaping 1. Vaping: * Factual information about vaping devices and vaping * Beliefs and attitudes about nicotine products * Refusing and avoiding vaping * Recognizing addiction and getting help 2. Health information: • Factual information about healthy eating and activity (PA) 3. Motivation: * Personal: Create positive attitudes toward engagement in healthy eating and PA * Social: Enlisting social support to increase healthy eating and PA * Social: Identification of community resources that promote and support healthy eating and PA 4. Behavioral Skills * Tips for engaging in prevention behaviors and avoiding risk behaviors in the context of existing barriers * Skills for social situations around behaviors * Skills for making behavior part of routine * Build autonomy, self-efficacy and model good health decision-making for health behaviors
干预措施: Obesity Prevention
Health Literacy and Obesity Prevention
Obesity prevention and health literacy (HL). 1. Health Literacy * Functional HL: skills for reading/understanding nutrition labels and medication instructions. * Interactive HL: verbal skills for interacting with others on health issues. * Critical HL: connections between advocacy and health * Media HL: skills for accessing and identifying reliable source of media. 2. Health information: • Factual information about healthy eating and activity (PA) 3. Motivation: * Create positive attitudes toward engagement in healthy eating and PA * Enlisting social support to increase healthy eating and PA * Identification of community resources that promote and support healthy eating and PA 4. Behavioral Skills * Tips for engaging in prevention behaviors and avoiding risk behaviors * Skills for social situations around behaviors * Skills for making behavior part of routine * Build autonomy, self-efficacy and good health decision-making for health behaviors
干预措施: Obesity Prevention
Health Literacy and Obesity Prevention
Obesity prevention and health literacy (HL). 1. Health Literacy * Functional HL: skills for reading/understanding nutrition labels and medication instructions. * Interactive HL: verbal skills for interacting with others on health issues. * Critical HL: connections between advocacy and health * Media HL: skills for accessing and identifying reliable source of media. 2. Health information: • Factual information about healthy eating and activity (PA) 3. Motivation: * Create positive attitudes toward engagement in healthy eating and PA * Enlisting social support to increase healthy eating and PA * Identification of community resources that promote and support healthy eating and PA 4. Behavioral Skills * Tips for engaging in prevention behaviors and avoiding risk behaviors * Skills for social situations around behaviors * Skills for making behavior part of routine * Build autonomy, self-efficacy and good health decision-making for health behaviors
干预措施: Health Literacy
结局指标
主要结局
Reductions in participants' unhealthy eating behaviors as assessed by the Dietary Screener Questionnaire
时间窗: 5 months
Recall of unhealthy eating (sugary and salty foods, fast foods, sugar-sweetened beverages, saturated fats) behaviors
Improvement in participants' healthy eating behaviors as assessed by the National Youth Physical Activity and Nutrition Study
时间窗: 5 months
Recall of healthy eating (e.g., fruits and vegetables, whole grain, fiber, calcium) behaviors
Reductions in participants' unhealthy eating behaviors as assessed by the National Youth Physical Activity and Nutrition Study
时间窗: 5 months
Recall of unhealthy eating (sugary and salty foods, fast foods, sugar-sweetened beverages, saturated fats) behaviors
Improvement in participants' healthy eating behaviors as assessed by the Dietary Screener Questionnaire
时间窗: 5 months
Recall of healthy eating (e.g., fruits and vegetables, whole grain, fiber, calcium) behaviors
Reductions in participants' sedentary activity as assessed by the Youth Activity Profile
时间窗: 5 months
Recall of sedentary activity behaviors
Improvements in participants' physical activity as assessed by the Godin and Shephard Leisure-Time Physical Activity Questionnaire
时间窗: 5 months
Recall of moderate and vigorous physical activity behaviors
Improvements in participants' physical activity as assessed by the Youth Activity Profile
时间窗: 5 months
Recall of moderate and vigorous physical activity behaviors
Improvement in Participants' Healthy Eating Behaviors as Assessed by the Dietary Screener Questionnaire and the National Youth Physical Activity and Nutrition Study
时间窗: 5 months
Percent of participants improved healthy eating (e.g., fruits and vegetables) behaviors
Reductions in Participants' Unhealthy Eating Behaviors as Assessed by the Dietary Screener Questionnaire and the National Youth Physical Activity and Nutrition Study
时间窗: 5 months
Percent of participants reduce unhealthy eating (sugary and salty foods, junk foods) behaviors
Improvements in Participants' Physical Activity as Assessed by the Youth Activity Profile
时间窗: 5 months
Percent of participants increase number of days with 60 minutes of more of physical activity
Improvements in Participants' Physical Activity as Assessed by the Godin and Shephard Leisure-Time Physical Activity Questionnaire
时间窗: 5 months
Percent of participants in weekly leisure activity score
Reductions in Participants' Sedentary Activity as Assessed by the Youth Activity Profile
时间窗: 5 months
Percent of participants with increase in number of days with less than 2 hours of sedentary behaviors
Reduction in Participants' Sugar-sweetened Beverage Consumption as Measured by the Dietary Screener Questionnaire and the National Youth Physical Activity and Nutrition Study
时间窗: 5 months
Percent of participants with reduced sugar-sweetened beverage intake
次要结局
- Participants' physical activity knowledge will be assessed using the knowledge and understanding subscale of the Canadian Assessment of Physical Literacy(5 months)
- Participants' functional health literacy will be assessed using the Newest Vital Signs(5 months)
- Participants' nutrition knowledge will be assessed using a modified General Nutrition Knowledge Questionnaire for Adults(5 months)
- Participants' interactive and critical health literacy will be assessed using the Assesments of Adolescent Health Literacy Scales(5 months)
- Participants' media health literacy will be measured using the Adolescent Media Health Literacy Scale and eHeals(5 months)
- Participants' personal motivation will be assessed using the Regulation of Eating Behaviors Scale(5 months)
- Participants' self-efficacy for physical activity will be assessed using the Psychosocial Constructs for Adolescent Physical Activity and Sedentary Behaviors(5 months)
- Participants' social motivation for physical activity will be assessed using the decisional balance, family influences, and peer influences subscales of the Psychosocial Constructs for Adolescent Physical Activity and Sedentary Behaviors(5 months)
- Participants' social motivation for diet will be assessed using the decisional balance, family influences, and peer influences subscales of the Psychosocial Constructs for Adolescent Fruit and Vegetables and Dietary Fat Intake Questionnaire(5 months)
- Participants' self-efficacy for diet will be assessed using the Psychosocial Constructs for Adolescent Fruit and Vegetables and Dietary Fat Intake(5 months)
- Participants' Functional Health Literacy Will be Assessed Using the Assessments of Adolescent Health Literacy Scales(5 months)
- Participants' Interactive Health Literacy Assessed Using the Assessments of Adolescent Health Literacy Scales(5 months)
- Participants' Critical Health Literacy Will be Assessed Using the Assesments of Adolescent Health Literacy Scales(5 months)
- Participants' Media Health Literacy Will be Measured Using the Adolescent Media Health Literacy Scale and eHeals(5 months)
- Participants' Overall Health Literacy Will be Assessed Using the Assessments of Adolescent Health Literacy Scales(5 months)