Parent Health Literacy, Depression, and Risk for Pediatric Injury

Abstract

BACKGROUND: Population-wide research on the impact of parent health literacy to children’s health outcomes is limited. We assessed the relationship of low parent health literacy to a range of pediatric health risks within a large cohort of primary care patients. METHODS: Data were from 17 845 English- and Spanish-speaking parents of children aged ≤7 years presenting for well-child care. We used a 3-item screener to measure health literacy. Outcomes included secondhand smoke exposure, asthma treatment nonadherence, parent depression, child-rearing practices, injury prevention, and parent first-aid knowledge. We summarized study variables with descriptive statistics and then performed multivariable logistic regression to identify associations between low parent literacy and our dependent measures. RESULTS: Mean child age was 4.8 years (SD 3.7); 36.5% of parent respondents had low health literacy. In models adjusted for child gender, race/ethnicity, insurance, age, and parent language preference, low parent health literacy was related to a range of pediatric health risks, including parent depression (adjusted odds ratio [AOR] 1.32; 95% confidence interval 1.18–1.48), firearm access (AOR 1.68; 1.49–1.89), not having a working smoke detector (AOR 3.54; 2.74–4.58), and lack of first-aid knowledge about choking (AOR 1.67; 1.44–1.93) and burns (AOR 1.45; 1.29–1.63). Children of parents with low health literacy were also more likely to watch >2 hours of television per day (AOR 1.27; 1.17–1.36). CONCLUSIONS: Low parent health literacy is independently and significantly related to parent depression, child television viewing, and at-risk family behaviors associated with child injury. Use of low-literacy approaches to health-behavior interventions may be essential to address common child morbidities.