title: Parent health literacy and "obesogenic" feeding and physical activity-related infant care behaviors.
abstract: OBJECTIVE
  To examine the relationship between parent health literacy and "obesogenic" infant care behaviors.
  
  
  METHODS
  Cross-sectional analysis of baseline data from a cluster randomized controlled trial of a primary care-based early childhood obesity prevention 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.
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, NY. Electronic address: yinh02@med.nyu.edu.
authors.forename: H Shonna
authors.initials: HS
authors.lastname: Yin
authors.affiliation: Department of Pediatrics and Center for Health Policy, Stanford University, Stanford, CA.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Sanders
authors.affiliation: Department of Internal Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, NY.
authors.forename: Rachel
authors.initials: R
authors.lastname: Shustak
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Svetlana K
authors.initials: SK
authors.lastname: Eden
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shintani
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, NY.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Cerra
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, NY.
authors.forename: Evelyn F
authors.initials: EF
authors.lastname: Cruzatte
authors.affiliation: Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine and Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC.
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Perrin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D057220:Health Literacy; D006801:Humans; D007223:Infant; D007224:Infant Care; D041943:Infant Formula / Q000008:administration & dosage; D016015:Logistic Models; D008297:Male; D008895:Milk, Human; D009043:Motor Activity; D016487:Parenting; D010290:Parents; D063766:Pediatric Obesity / Q000517:prevention & control; D013690:Television