Health literacy at work to address overweight and obesity in adults: The development of the obesity action kit

Abstract

Overweight and obesity are chronic conditions affecting approximately 68% of adults and 31.7% of children ages 2–19 in the United States. Our aim was to apply an ecological model of health literacy to better understand consumer needs relating to overweight and obesity, and use this information to develop an Obesity Action Kit for the New York City (NYC) Department of Health and Mental Hygiene's (DOHMH) Public Health Detailing Program.

Methods included: (1) conducting a health literacy load analysis on a wide range of existing consumer messaging about overweight and obesity, (2) in-depth interviews with providers, and (3) focus groups with consumers. Provider themes included a universal concern about patient obesity and frustration with lack of success as well as an appreciation of the complexity of the issue, including its strong cultural drivers. Consumer themes included skepticism about providers' role in helping them manage weight; strong cultural contextualizing; emotional distress and self-blame; poor food availability; and the desire for positive, empowering messages about weight management. Findings were translated into the content of the Obesity Action Kit. Our target population included primary care providers visited by the Public Health Detailing Program and overweight residents residing in low-income communities of NYC.

Keywords:

• Obesity
• Health promotion
• Provider education
• Academic detailing
• Nutrition training
• Health literacy

Acknowledgements

The authors would like to thank the many Health Department representatives for their detailing as well as health care providers and parents who participated in interviews and focus groups that assisted in the development of the Obesity Action Kit.