Division of General Pediatrics, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
Department of Pediatrics, Boston University School of Medicine, Boston, MA.
J Pediatr. 2018 Nov;202:265-271.e3. doi: 10.1016/j.jpeds.2018.06.021. Epub 2018 Jul 18.
To determine whether health literacy was associated with parental self-efficacy in a diverse sample of parents of newborns. We hypothesized that parents with lower health literacy would have lower parental self-efficacy.
We conducted a cross-sectional analysis of baseline surveys from 253 English and Spanish speaking parents >18 years old with newborns <28 days old enrolled in a trial testing a multisite primary care-based parenting intervention. Surveys assessed parental, child, and environmental characteristics, and used validated instruments to measure health literacy and parental self-efficacy (total and 4 subtypes). Bivariate analyses identified parental, child, and environmental characteristics associated with parental self-efficacy. Multivariable linear regression models examined the associations between health literacy and parental self-efficacy, adjusting for covariates.
Parents (median age, 29 years) were 92.1% female, 54.5% black/African American, and 29.6% Hispanic/Latino. More than one-half (58.9%) had completed some college education or more, 49.0% spoke mostly English, and 16.2% had low health literacy. In bivariate analyses, parental self-efficacy was significantly lower in parents with fewer household residents. In multivariable analyses, parents with low compared with high health literacy had significantly lower parental self-efficacy scores (total and 4 subtypes including caretaking procedures, evoking behaviors, reading behaviors and signaling, and situational beliefs).
Lower health literacy was associated with lower parental self-efficacy in parents of newborns. To maximize impact on positive parenting behaviors and child outcomes, interventions assisting parents with low parental self-efficacy should consider strategies to address low health literacy.
在一个新生儿父母的多样化样本中，确定健康素养是否与父母的自我效能感有关。我们假设，健康素养较低的父母自我效能感较低。
我们对参加一项测试多地点基于初级保健的育儿干预试验的 253 名 18 岁以上、新生儿<28 天的英语和西班牙语父母的基线调查进行了横断面分析。调查评估了父母、孩子和环境特征，并使用经过验证的工具测量健康素养和父母自我效能感（总分和 4 个亚型）。双变量分析确定了与父母自我效能感相关的父母、孩子和环境特征。多变量线性回归模型检查了健康素养与父母自我效能感之间的关联，调整了协变量。
父母（中位数年龄 29 岁）中 92.1%为女性，54.5%为黑人/非裔美国人，29.6%为西班牙裔/拉丁裔。超过一半（58.9%）完成了一些大学教育或以上，49.0%主要说英语，16.2%的人健康素养较低。在双变量分析中，家庭居民较少的父母自我效能感显著较低。在多变量分析中，与健康素养较高的父母相比，健康素养较低的父母自我效能感评分（总分和 4 个亚型，包括照顾程序、唤起行为、阅读行为和信号以及情境信念）显著较低。
新生儿父母的健康素养较低与自我效能感较低有关。为了最大限度地提高对积极育儿行为和儿童结果的影响，帮助自我效能感较低的父母的干预措施应考虑解决低健康素养的策略。
