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Physician Resource

Childhood Obesity Study Reinforces Importance of Universal Health Literacy Precautions

At a Glance

  • UVA-led study aimed to improve BMI scores among children
  • Researchers used materials designed for those with limited health literacy
  • Outcomes were positive for families with low and high health literacy levels
  • The study is a reminder for all providers to consider health literacy when caring for patients

It may be common knowledge among care providers, yet the findings from a recent study led by University of Virginia School of Medicine researchers are an important reminder that health literacy has a significant impact on patient outcomes. The 15-week pilot study focused on addressing obesity-related behaviors among children in the medically underserved Dan River region of Virginia and North Carolina by utilizing strategies that follow universal health literacy precautions. That is, treating all patients as if they are at risk of not understanding health information.

“This study reinforced the idea that, regardless of health literacy status, everyone can benefit from simplified health information,” says Jamie Zoellner, PhD, the study’s co-principal investigator and a researcher in the UVA Department of Public Health Sciences.

The researchers designed program materials (newsletters for children, along with parent and child workbooks) and teaching sessions (six small-group family classes, six telephone support calls and 24 exercise sessions) with the assumption that all participants may have difficulty reading, comprehending and acting on health information. “We made a conscious effort to reduce literacy demands of program components, to reinforce key messages and to implement practice activities that promote skill development and self-management,” says Zoellner.

This approach led to similar positive outcomes for families with low and high health literacy levels. Along with improvements in body mass index, children and adults reduced their consumption of sugar-sweetened drinks. Children with parents of all health literacy levels also saw improvements in quality of life, while adults saw improvements in physical activity levels as well as fruit and vegetable consumption.

A six-month version of this childhood obesity treatment program, called iChoose, is now being tested in the Dan River region. “The goal is to establish a sustainable program to improve BMI scores among children,” says Zoellner. “We are still enrolling families in this research program. We’re not quite ready to roll out a childhood obesity program to the public, but we are moving in that direction, possibly in the next year or two. I would welcome the opportunity to speak with any interested community providers about how they might implement these strategies in their own practices.”

The takeaway from this study for all healthcare providers: consider approaching every patient encounter with health literacy in mind. Ensure all written materials shared with patients are written for a fifth-grade reading level and integrate verbal teach-back methods into your consultations — ask patients to restate in their own words or demonstrate what they were taught — to ensure they understood the information they were receiving. For more tips, download the most recent Health Literacy Universal Precautions Toolkit by the Agency for Healthcare Research and Quality.

To learn more about the childhood obesity study, contact Dr. Zoellner at 434.962.4488 or













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