title: "Greenlight study": a controlled trial of low-literacy, early childhood obesity prevention.
abstract: Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity. At 4 primary-care pediatric residency training sites across the US, 865 infant-parent dyads were enrolled at the 2-month well-child checkup and are being followed through the 24-month well-child checkup. Two sites were randomly assigned to the intervention, and the other sites were assigned to an attention-control arm, implementing the American Academy of Pediatrics' The Injury Prevention Program. The intervention consists of an interactive educational toolkit, including low-literacy materials designed for use during well-child visits, and a clinician-centered curriculum for providing low-literacy guidance on obesity prevention. The study is powered to detect a 10% difference in the number of children overweight (BMI > 85%) at 24 months. Other outcome measures include observed physician-parent communication, as well as parent-reported information on child dietary intake, physical activity, and injury-prevention behaviors. The study is designed to inform evidence-based standards for early childhood obesity prevention, and more generally to inform optimal approaches for low-literacy messages and health literacy training in primary preventive care. This article describes the conceptual model, study design, intervention content, and baseline characteristics of the study population.
authors.affiliation: Department of Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University, Stanford, California; leesanders@stanford.edu.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Sanders
authors.affiliation: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina;
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Perrin
authors.affiliation: Department of Pediatrics, School of Medicine/Bellevue Hospital Center, New York University, New York, New York; and.
authors.forename: H Shonna
authors.initials: HS
authors.lastname: Yin
authors.affiliation: Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bronaugh
authors.affiliation: Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
mesh_terms: D015992:Body Mass Index; D002662:Child Health Services; D002675:Child, Preschool; D003142:Communication; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007396:Internship and Residency; D008297:Male; D009043:Motor Activity; D010174:Pamphlets; D010287:Parent-Child Relations; D010290:Parents / Q000193:education*; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000517:prevention & control*; D010372:Pediatrics / Q000193:education*; D011203:Poverty / Q000706:statistics & numerical data*; D011320:Primary Health Care; D014481:United States; D014947:Wounds and Injuries / Q000517:prevention & control
keywords: early childhood; health literacy; injury prevention; obesity prevention; primary care; resident education