Primary caregivers' health literacy and childhood obesity in Guatemala, a low/middle income country

Introduction: Low health literacy skills are associated with poor understanding of health information and clinical outcomes. They are also associated with difficulty understanding nutritional labels and portion sizes and therefore a higher body mass index (BMI). Childhood obesity, now an epidemic, is a risk factor for adult obesity. In children, parental influence is particularly relevant for weight management. Low adult health literacy skills may lead to a home environment that promotes child weight gain. Objective: To examine the association between primary caregivers' health literacy and childhood obesity in Guatemala. Methods: Three hundred 4 to 6 year old students will be selected from public and private schools of Guatemala City (urban) and Sacatepequez (rural). Primary caregivers will complete a questionnaire to assess basic demographic information, perception of their child's weight, and use of nutritional labels. Using the Newest Vital Sign instrument we will estimate caregiver's health literacy level to interpret nutritional labels. Child‘s weight and height will be measured using standard techniques and used to calculate BMI. Associations between variables will be assessed using chi-square tests, Spearman's rank correlation, and linear regression. Results: Data collection will be completed in May. We hypothesize that primary caregivers' low health literacy is associated with higher odds of childhood obesity. Furthermore, health literacy is expected to be low in all groups, but lower in public schools and rural caregivers compared to their private and urban counterparts. Discussion: We expect that data will support nutritional programs that prioritize parental education tailored to the Guatemalan literacy level.