title: A health literate approach to the prevention of childhood overweight and obesity.
abstract: OBJECTIVE
  To describe a systematic assessment of patient educational materials for the Growing Right Onto Wellness (GROW) trial, a childhood obesity prevention study targeting a low health literate population.
  
  
  METHODS
  Process included: (1) expert review of educational content, (2) assessment of the quality of materials including use of the Suitability Assessment of Materials (SAM) tool, and (3) material review and revision with target population.
  
  
  RESULTS
  12 core modules were developed and assessed in an iterative process. Average readability was at the 6th grade reading level (SMOG Index 5.63 ± 0.76, and Fry graph 6.0 ± 0.85). SAM evaluation resulted in adjustments to literacy demand, layout & typography, and learning stimulation & motivation. Cognitive interviews with target population revealed additional changes incorporated to enhance participant's perception of acceptability and feasibility for behavior change.
  
  
  CONCLUSIONS
  The GROW modules are a collection of evidence-based materials appropriate for parents with low health literacy and their preschool aged children, that target the prevention of childhood overweight/obesity.
  
  
  CONCLUSIONS
  Most trials addressing the treatment or prevention of childhood obesity use written materials. Due to the ubiquitous prevalence of limited health literacy, our described methods may assist researchers in ensuring their content is both understood and actionable.
authors.affiliation: Department of Community Internal Medicine, Mayo Clinic, Jacksonville, USA; Department of Family Medicine, Mayo Clinic, Jacksonville, USA. Electronic address: white.richard@mayo.edu.
authors.forename: Richard O
authors.initials: RO
authors.lastname: White
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Thompson
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
authors.forename: Amanda M
authors.initials: AM
authors.lastname: McDougald Scott
authors.forename: William J
authors.initials: WJ
authors.lastname: Heerman
authors.forename: Evan C
authors.initials: EC
authors.lastname: Sommer
authors.forename: Shari L
authors.initials: SL
authors.lastname: Barkin
mesh_terms: D002648:Child; D002675:Child, Preschool; D032882:Comprehension; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D008297:Male; D050177:Overweight / Q000517:prevention & control*; D010174:Pamphlets; D010290:Parents / Q000193:education*; D063766:Pediatric Obesity / Q000517:prevention & control*; D016730:Program Development; D015397:Program Evaluation; D013664:Teaching Materials / Q000592:standards*
keywords: Childhood obesity; Education; Evaluation; Health literacy; Intervention development