Background

Preschool-aged Latino children suffer marked disparity in obesity prevalence. Their parents are less likely to perceive weight problems or to be satisfied with weight counseling. This study aims to identify ways health communication might be tailored to improve readiness for healthy lifestyle change among Latino parents of: 1. preschoolers with obesity (treatment frame), and 2. preschoolers with high-normal BMI (prevention).

Methods

A validated measure of readiness to change diet and activity for healthy child weight was administered to Latino parents of preschoolers with BMI above the 50th percentile, before and after well-child visits, at 4 clinics with large Medicaid populations. Parents completed validated measures of acculturation, health literacy, control over health care decision-making, and perceived empathy from medical providers. Parent/child BMI and demographics were collected. Multivariate linear regression identified factors associated with change in readiness after a visit in a model for children with high-normal BMI and a model for children with obesity.

Results

Of 154 respondents: mean parent age 29y [range 22-46y], 95% mother, 40% Spanish only, 35% < high school education, 63% income < federal poverty, 47% obese, and 86% reported child weight 'not at all a problem' pre-visit. Children age 2-6y, 23% obese. Mean baseline readiness=17.7 [range 7-34] increased mean +0.7 [range -13 to +15] after visit (p=0.01). Model (R^2=0.95) for parents of child with obesity: low health literacy beta=4.8 and low control in health decisions 6.2 were associated with increased readiness after a visit. In a model(R^2=0.20) for parents of child with high-normal BMI: higher health literacy 1.5, and low control in health decisions 1.9, predicted increased readiness.

Conclusions

The effects on readiness to change of tailoring communication about obesity prevention and treatment to health literacy and decision-making preferences should be studied in parents of Latino preschoolers. Funded NIH-K23DK104090