Unlocking Health Literacy: investigating Parental Health Literacy and Child Weight Outcomes

Abstract Background While parental health literacy (HL) is widely recognized as crucial for child health, research on its impact on children’s weight-related outcomes remains limited. This study aims to fill this gap by investigating the associations between parental HL and children’s anthropometric measurements, with a focus on child BMI Z-score and waist-to-height ratio (WHtR). Methods As part of a cluster randomized trial in primary schools serving vulnerable populations, 735 children (51.7% boys, mean age 7.7 years) participated. Parental HL was assessed using the HLS-Q12 questionnaire, comprising 12 items. Health literacy levels, standardized from 0 to 100, were categorized into ‘inadequate,’ ‘problematic,’ ‘sufficient,’ and ‘excellent’ HL. General HL and three specific domains-health promotion, disease prevention, and healthcare-were computed. Children’s weight, height, and BMI were measured following standardized procedures. Regression analyses examined HL’s impact on BMI Z-scores and WHtR. Results Parents with higher HL in disease prevention and health promotion had children with significantly lower BMI Z-scores, even after adjusting for parental education and children’s sex sex [-0.010 (-0.18; -0.0001) and -0.10 (-0.019; 0.01). Similar associations were found for WHtR [-0.0004 (-0.001; -0.0001)]. Parents with excellent HL in general and health promotion had significantly lower WHtR [-0.027 (-0.046; -0.008)] and BMI Z-score [-0.74 (-1.2; -0.28)]. Conclusions This study highlights the significant role of parental health literacy in shaping children’s weight-related outcomes. Higher levels of parental HL in disease prevention and health promotion were linked to lower BMI Z-scores and WHtR in children, independent of parental education and children’s sex. Enhancing parental HL, alongside promoting healthy behaviors and environments for children, could lead to more effective approaches for addressing this public health issue. Key messages • Parental health literacy is associated with children’s weight outcomes, emphasizing the need for HL-focused interventions. • Higher parental HL is associated with lower child BMI Z-scores and waist-to-height ratios, highlighting potential HL’s role in combating childhood obesity.