Health Literacy and Child Health Outcomes: Parental Health Literacy and Medication Errors

The Impact of Education and Health Literacy on Neonatal and Family Well-Being

Education access and quality are the second of five domains of determinants of health influencing the well-being of families and communities. In this column, the impacts of educational attainment and health literacy on health and well-being will be described. There is an increased need for adequate health literacy during pregnancy and parenting, including when infants require NICU care and following their discharge into the early years and beyond. Creating environments where universal precautions for health literacy and plain language communication are used will improve health outcomes for infants and parenting confidence. NICU nurses hold an essential role in creating these environments and tailoring education to parent needs.

Effectiveness of pictograms in patients or caregivers in healthcare settings: a systematic review

Objectives

Pictorial representation has shown to be potential in enhancing patient knowledge. This study aimed to identify the usefulness of pictograms improving the knowledge of the patients or their caregivers.

Key findings

The electronic databases such as PubMed, CINAHL, Embase and Scopus were searchedfor relevant studies. The Cochrane risk of bias tool was used to assess the quality of the included studies. The study was conducted following PRISMA guidelines. Pictograms were used alone or in combination with the text-based/written or verbal/ oral instructions of medication used in study intervention. All the included studies showed similar outcomes that had a positive impact on improving patient adherence and helped in decreasing the dosing error. Factors such as age, gender, literacy level had a negative impact on adherence. Pictograms had a positive impact on the adherence in patients with low health literacy levels than the written/oral interventions.

Summary

The current review provided insights on the effectiveness of pictograms in patients or their caregivers of various age groups in healthcare settings. Future studies should be aimed to identify the knowledge gaps and barriers impacting the effectiveness of pictograms in various settings.

Advancing perspectives on health literacy in childhood and youth

Children and young people's importance as core target population for health literacy has been highlighted throughout the literature due to the relevance of the early life phases for maintaining, restoring and promoting health during the life course. Transferring health literacy concepts to the target population, however, requires proper testing of their applicability and their fit to the developmental phases as well as the target populations' realities and needs. This article aims to discuss children's and young people's health literacy by elaborating and exploring childhood and youth as life phases with unique characteristics from multidisciplinary perspectives. Drawing on theories and findings from developmental studies, sociology and socialization research, health literacy in childhood and youth is discussed along five 'D' dimensions: (i) disease patterns and health perspectives, (ii) demographic patterns, (iii) developmental change, (iv) dependency and (v) democracy. The unique particularities of children and young people relevant for health literacy include their disease and health-risk profiles, their vulnerability to demographic factors, their social role and status, and their right to participation. Inter- and intra-generational relationships and an unequal distribution of power can either promote or hinder children and young people's health literacy development and their opportunities for participating in health-related decision making. Specifying what is called the 'contextual' and 'relational' dimension of health literacy for the target group requires considering their personal attributes and agency as contextually embedded and interrelated. Taking these considerations into account can help to move towards a more tailored and holistic approach to health literacy of children and young people.

The impact of traditional literacy and education on health literacy in adolescents with asthma

Introduction: People with low health literacy have poorer self-management of chronic diseases like asthma. Studies of parent health literacy and education level on the management of children's chronic illnesses reveal inconclusive results. We hypothesized a correlation between parent and adolescent health literacy in teens with asthma. Methods: Sociodemographic data were obtained; health literacy was assessed on adolescents and parents with three instruments: Rapid Estimate of Adolescent/Adult Literacy in Medicine (REALM), Single Item Literacy Screener (SILS) and Newest Vital Sign (NVS). Agreement between scores was examined by calculating weighted kappa statistics and performing Bowkers test of symmetry. Results: In all, 243 adolescents and 203 parents completed health literacy assessments yielding 198 paired observations. 9th-12th graders, 60.6% female, 72.7% African-American (AA), mean age: 15.3 years (±0.9). Parent education ranged from < high school (19.1%) to college graduate (24.0%). Agreement between adolescent and parent scores was poor: REALM (κw = 0.26), SILS (κw = 0.12), and NVS (κw = 0.29) and disagreement did not significantly differ by race. Positive correlations of moderate strength (overall and between racial groups) were found between reading scores and both REALM and NVS scores, and between REALM and NVS scores. Due to the inverse relationship of SILS scores with health literacy level, SILS scores (overall and between racial groups) were weakly and negatively correlated with reading scores, REALM and NVS. Conclusion: Correlation between education level and traditional literacy suggests that these are contributing factors to the health literacy of adolescents with asthma. Correlation between adolescent and caregiver health literacy was not supported.