Jordan Desha M, Bush Jeana S, Ownby Dennis R, Waller Jennifer L, Tingen Martha S
a Division of Allergy-Immunology & Rheumatology, Medical College of Georgia, Augusta University , Augusta , GA , USA.
b Department of Biostatistics & Epidemiology, Medical College of Georgia, Augusta University , Augusta , GA , USA.
J Asthma. 2019 Aug;56(8):882-890. doi: 10.1080/02770903.2018.1494191. Epub 2018 Sep 5.
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. 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. 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 ( = 0.26), SILS ( = 0.12), and NVS ( = 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. 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.
健康素养较低的人群对哮喘等慢性病的自我管理能力较差。关于父母健康素养和教育水平对儿童慢性病管理影响的研究结果尚无定论。我们推测患有哮喘的青少年中，父母与青少年的健康素养之间存在关联。我们收集了社会人口统计学数据；使用三种工具对青少年及其父母的健康素养进行评估：医学青少年/成人快速识字评估（REALM）、单项识字筛查工具（SILS）和最新生命体征（NVS）。通过计算加权kappa统计量并进行Bowker对称性检验来检验得分之间的一致性。共有243名青少年和203名父母完成了健康素养评估，得到198对观察结果。9至12年级学生，60.6%为女性，72.7%为非裔美国人（AA），平均年龄：15.3岁（±0.9）。父母的教育程度从高中以下（19.1%）到大学毕业（24.0%）不等。青少年与父母得分之间的一致性较差：REALM（κ = 0.26）、SILS（κ = 0.12）和NVS（κ = 0.29），且种族间的不一致性无显著差异。在阅读分数与REALM和NVS分数之间，以及REALM和NVS分数之间发现了中等强度的正相关（总体及种族群体之间）。由于SILS分数与健康素养水平呈反比关系，SILS分数（总体及种族群体之间）与阅读分数、REALM和NVS呈弱负相关。教育水平与传统识字能力之间的相关性表明，这些是哮喘青少年健康素养的影响因素。青少年与照顾者健康素养之间的相关性未得到证实。
