Background:
Obesity continues to rise in children and teens and is associated with increased morbidities such as diabetes and adverse birth outcomes. Although studies have focused on adult and parental knowledge and attitudes of obesity, little is known regarding youth understanding of unhealthy lifestyle choices and resultant reproductive outcomes.

Objectives:
To determine factors affecting youth's preconception knowledge regarding unhealthy lifestyle choices and obesity on birth outcomes in 2 zip codes.

Methods:
Healthy from Birth for Life (HFBFL)-Teen Fellowship is aimed at improving birth outcomes in 2 high-risk communities. HFBFL goal is to have youth adopt healthy lifestyles now to improve birth outcomes in the future. The first activity in this innovative preconception model was to engage program youth in a preconception curriculum. The second activity was engaging program youth in the development and administration of surveys. Surveys were collected (6/06-10/06) from 437 community peers (mean + SD=15.5+2.2 yrs) at community events, centers, schools in Mt. Vernon and Peekskill, NY. Chi square analysis was used.

Results:
Youth identified themselves as 58.1% female (F), 41.4% male (M) and majority as Black 76.9%. Females more than males overestimated the prevalence of overweight among youth (63% vs. 37%, p=0.015). However, females better understood the role genetics play in overweight (67%F vs. 33%M, p=0.014) and diabetes (64%F vs. 36%M, p=0.005). Poorer nutritional behaviors were associated with incorrect knowledge about the prevalence of overweight (p=0.001) and the link between television (TV)-watching and overweight risk (p= 0.002). Surprisingly, correct knowledge about the link between TV-watching and overweight risk was higher among frequent TV-watchers (p=0.045), but lower among frequent video game players (p=0.009). Higher parental education was positively associated with correct knowledge about: TV-watching and overweight risk (p=0.013), the role genetics play in diabetes (p= 0.002) and the link between maternal diabetes and neonatal outcome (p=0.043).

Conclusion and implications for practice:
Youth knowledge regarding obesity and resultant outcomes are significantly affected by demographic and behavioral factors. Results will aid in developing targeted preconception public health social health marketing initiatives.