A ‘Greenlight’ in the Pediatric Primary Care Setting

Image of foodTaking advantage of the frequency of primary care pediatric visits in the early years of life, the Department of Pediatrics at NYU Langone Medical Center, in partnership with the Charles B. Wang Community Health Center, has adapted an evidence-based program that teaches families about healthy eating and activity in order to prevent early childhood obesity in the Chinese American community.

The Greenlight program, which was developed in settings that serve predominantly low-income black and Hispanic families, trains pediatricians how to communicate with families using toolkits that contain culturally-tailored educational materials for people with low literacy. Approximately 90 million Americans—or 45 percent of the population—have basic or below basic literacy skills, and 110 million have basic or below basic quantitative skills. Minority, immigrant families are at particular risk. Low health literacy and numeracy is associated with lower rates of breastfeeding, difficulty understanding food labels and portion sizes, and higher rates of obesity.

In adapting the Greenlight program for Chinese American immigrant families, the team has attempted to go beyond translating language and changing ethnicity in photographs. Greenlight’s materials reflect deeper cultural values, norms and lifestyle differences. (For examples, view the Greenlight team’s poster which they recently presented at National Association of Community Health Centers annual conference where it won second prize.) The process has been complex, involving outreach to parents, providers and health educators. The materials – some of which are shown here – reflect the judgment and care of many participants. As one community member observed, “Translation is necessary, complicated and insufficient.”