Harrington Kathleen F, Zhang Bin, Magruder Teresa, Bailey William C, Gerald Lynn B
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
Pediatr Allergy Immunol Pulmonol. 2015 Mar 1;28(1):20-26. doi: 10.1089/ped.2014.0379.
Health literacy has been associated with health disparities in many disease outcomes, including children's asthma. Parents are responsible for most of children's healthcare. Therefore, parents' health literacy may impact children's health outcomes, including asthma control. This study sought to determine the association between parent health literacy and children's asthma control among a cohort of predominately minority urban children aged between 6 and 12 years. This cross-sectional study assessed children with asthma and their parents at a single outpatient visit. English-speaking parents and their children, aged between 6 and 12 years with physician-diagnosed asthma, were eligible for this study. Healthcare providers assessed asthma control and severity, and parents completed demographic, health literacy, asthma control, and asthma knowledge measures. Children completed a pulmonary function test as part of the Asthma Control Questionnaire (ACQ) scoring. A total of 281 parent-child dyads provided data, with the majority of parents being mothers and African American, with a high school level education or less. Lower parent health literacy was associated with worse asthma control as rated both by the provider (=0.007) and the ACQ (=0.013), despite only moderate concordance between ratings (ρ=0.408, <0.0001). Lower parent health literacy also was associated with less asthma knowledge, which was associated with worse asthma control. Higher parent health literacy was associated with more parent asthma knowledge and better child asthma control. Pediatric providers should consider tailoring education or treatment plans or utilizing universal precautions for low health literacy.
健康素养与包括儿童哮喘在内的许多疾病结果中的健康差异有关。父母对儿童的大多数医疗保健负责。因此，父母的健康素养可能会影响儿童的健康结果，包括哮喘控制。本研究旨在确定在一群年龄在6至12岁的主要为少数族裔的城市儿童中，父母健康素养与儿童哮喘控制之间的关联。这项横断面研究在一次门诊就诊时对哮喘儿童及其父母进行了评估。讲英语的父母及其6至12岁、经医生诊断患有哮喘的孩子符合本研究的条件。医疗服务提供者评估哮喘控制情况和严重程度，父母完成人口统计学、健康素养、哮喘控制和哮喘知识测量。作为哮喘控制问卷（ACQ）评分的一部分，儿童完成了肺功能测试。共有281对亲子提供了数据，大多数父母为母亲，是非洲裔美国人，受教育程度为高中或以下。尽管提供者评分与ACQ评分之间的一致性仅为中等（ρ=0.408，<0.0001），但父母健康素养较低与提供者评估的较差哮喘控制（P=0.007）和ACQ评估的较差哮喘控制（P=0.013）相关。父母健康素养较低还与哮喘知识较少相关，而哮喘知识较少又与较差的哮喘控制相关。父母健康素养较高与更多的父母哮喘知识和更好的儿童哮喘控制相关。儿科医疗服务提供者应考虑针对健康素养较低的情况调整教育或治疗计划，或采用通用预防措施。
