Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity.  At 4 primary-care pediatric residency training sites across the US, 865 English and Spanish speaking infant-parent dyads were enrolled at the 2-month well-child checkup to be followed through the 24-month well-child checkup.

       Two sites were randomly assigned to the Greenlight intervention, and two sites were assigned to an active attention-control arm, implementing the American Academy of Pediatrics’ The Injury Prevention Program (TIPP).  The intervention consists of an interactive educational toolkit, including low-literacy materials designed for use during well-child visits, and a clinician-centered curriculum for providing low-literacy guidance on obesity prevention. The control consists of TIPP educational handouts and tools given at the same well-child visit intervals as intervention, and a structured curriculum to educate residents in the provision of injury prevention counseling. The study is designed to inform evidence- based standards for early childhood obesity prevention, and more generally to inform optimal approaches for low-literacy messages and health literacy training in primary preventive care. 

Funding:  All phases of this study were supported by the Eunice Kennedy Shriver Institute for Child Health
and Development, NICHD (R01 HD049794), with supplemental funding from CDC and OBSSR
(Grant #R01HD059794-04S1, R01HD059794-04S2).  Parts of the study were supported the National
Institutes of Health’s National Center for Advancing Translational Sciences through its Clinical and
Translational Science Awards Program (CTSA), grants # 1UL1RR029893, UL1TR000445 and UL1RR025747