Yin H Shonna, Johnson Matthew, Mendelsohn Alan L, Abrams Mary Ann, Sanders Lee M, Dreyer Benard P
New York University School of Medicine, Department of Pediatrics, 550 First Ave, NBV 8S4-11, New York, NY 10016, USA.
Pediatrics. 2009 Nov;124 Suppl 3:S289-98. doi: 10.1542/peds.2009-1162E.
To assess the health literacy of US parents and explore the role of health literacy in mediating child health disparities.
A cross-sectional study was performed for a nationally representative sample of US parents from the 2003 National Assessment of Adult Literacy. Parent performance on 13 child health-related tasks was assessed by simple weighted analyses. Logistic regression analyses were performed to describe factors associated with low parent health literacy and to explore the relationship between health literacy and self-reported child health insurance status, difficulty understanding over-the-counter medication labeling, and use of food labels.
More than 6100 parents made up the sample (representing 72600098 US parents); 28.7% of the parents had below-basic/basic health literacy, 68.4% were unable to enter names and birth dates correctly on a health insurance form, 65.9% were unable to calculate the annual cost of a health insurance policy on the basis of family size, and 46.4% were unable to perform at least 1 of 2 medication-related tasks. Parents with below-basic health literacy were more likely to have a child without health insurance in their household (adjusted odds ratio: 2.4 [95% confidence interval: 1.1-4.9]) compared with parents with proficient health literacy. Parents with below-basic health literacy had 3.4 times the odds (95% confidence interval: 1.6-7.4) of reporting difficulty understanding over-the-counter medication labels. Parent health literacy was associated with nutrition label use in unadjusted analyses but did not retain significance in multivariate analyses. Health literacy accounted for some of the effect of education, racial/ethnic, immigrant-status, linguistic, and income-related disparities.
A large proportion of US parents have limited health-literacy skills. Decreasing literacy demands on parents, including simplification of health insurance and other medical forms, as well as medication and food labels, is needed to decrease health care access barriers for children and allow for informed parent decision-making. Addressing low parent health literacy may ameliorate existing child health disparities.
评估美国父母的健康素养，并探讨健康素养在调节儿童健康差异方面的作用。
对2003年全国成人识字能力评估中具有全国代表性的美国父母样本进行了一项横断面研究。通过简单加权分析评估父母在13项与儿童健康相关任务上的表现。进行逻辑回归分析以描述与父母健康素养低相关的因素，并探讨健康素养与自我报告的儿童健康保险状况、理解非处方药标签的困难程度以及食品标签使用之间的关系。
样本包括6100多名父母（代表72600098名美国父母）；28.7%的父母健康素养低于基本水平/处于基本水平，68.4%的父母无法在健康保险表格上正确填写姓名和出生日期，65.9%的父母无法根据家庭规模计算健康保险政策的年度费用，46.4%的父母无法完成两项与药物相关任务中的至少一项。与健康素养熟练的父母相比，健康素养低于基本水平的父母家中更有可能有未参保的孩子（调整后的优势比：2.4 [95%置信区间：1.1 - 4.9]）。健康素养低于基本水平的父母报告难以理解非处方药标签的几率是前者的3.4倍（95%置信区间：1.6 - 7.4）。在未调整的分析中，父母健康素养与食品标签使用相关，但在多变量分析中不具有显著性。健康素养在一定程度上解释了教育、种族/族裔、移民身份、语言和收入相关差异的影响。
很大一部分美国父母的健康素养技能有限。需要降低对父母的识字要求，包括简化健康保险和其他医疗表格以及药物和食品标签，以减少儿童获得医疗保健的障碍，并使父母能够做出明智的决策。解决父母健康素养低的问题可能会改善现有的儿童健康差异。
