P2.J193: Identifying Factors That Influence Healthy Eating Amid Rise in Childhood Obesity

Background: Childhood obesity is a result of multifactorial influences, including socioeconomic, environmental, and genetic. The prevalence of childhood obesity is highest for non-Hispanic Black children, especially in low-income families with lower levels of parental education. These populations are then at greater risk for hypertension, T2DM, and cardiovascular disease later in life. Limited resources and food insecurity pose a challenge to healthy eating, though research on the relationship between food insecurity and childhood obesity is inconsistent. This study aimed to assess baseline food insecurity and obesity rates for a clinic population and to identify local factors that influence healthy eating to guide potential interventions.

Methods: The Healthy Eating Survey was developed to assess multiple factors that could affect healthy eating practices. The brief survey included patient and caregiver demographics, patient BMI, caregiver knowledge of healthy eating, and an open-ended question on the significance of healthy eating. Food insecurity was also assessed using the Hunger Vital Sign screen.

Caregivers were recruited at well child visits for patients ages 2 to 17 years at an urban pediatric outpatient practice. Primary caregivers who completed the survey received a $10 gift card to a local grocery store. Families that screened positive for food insecurity and wanted information on food resources were contacted by a social worker.

Results: 324 caregivers completed the survey, encompassing 383 children. Patient BMI and caregiver demographics are shown in the table. 39.1% of caregivers screened positive for food insecurity, and of those interested in discussing food resources with a social worker, 80.6% preferred contact via phone rather than in-person. There was no significant difference in food insecurity prevalence for families with at least one overweight/obese child compared to those with no overweight/obese child (p=0.62). Survey results revealed families with higher levels of education were less likely to experience food insecurity (p=0.022).

For 3 of 4 knowledge questions on healthy eating, families with higher education were more likely to answer correctly (Figure 1). Caregivers with all levels of education emphasized the importance of healthy eating on the open-ended question, with prominent themes including having a balanced diet with fruits and vegetables, limiting junk food, living a long life, feeling strong, and preventing disease.

Conclusion: The prevalence of childhood obesity and food insecurity at this clinic is higher than the national average, and knowledge of healthy eating is generally low among caregivers. Since completion of this research, the clinic has been awarded a grant to fund a food resource specialist to assist families on a weekly basis. Quality improvement projects have also begun to assess the efficacy of various interventions, including retraining staff on screening processes and food resources, and better educating the community on healthy eating and the resources available to them.