Department of Global Public Health, K9, Karolinska Institute, Stockholm, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
Scand J Caring Sci. 2024 Dec;38(4):876-887. doi: 10.1111/scs.13292. Epub 2024 Aug 5.
Parents' low health literacy (HL) has negative impacts on child health. Parental interventions may improve parents' HL and thus impact child health positively.
This study aimed to gain knowledge about associations between parents' comprehensive HL (CHL) and child health after an extended postnatal home visiting program in Swedish multicultural, disadvantaged settings compared to parents receiving regular child healthcare (CHC).
This quasi-experimental study used a case-control sampling method to recruit first-time parents through two CHC centres in Stockholm (2017-2020). Participants (N = 151) were interviewed twice through structured questionnaires when their child was <2 months and 15-18 months old. HLS-EU-Q16 assessed parents' CHL. Children's medical records (0-18 months) were reviewed regarding breastfeeding, children's exposure to smoking, language development and healthcare utilisation. Data were analysed with regression models and non-parametric tests.
No significant association was found between parents' CHL and child health. However, significantly fewer unplanned visits to the CHC centre were observed among children (0-18 months) in the intervention group irrespective of CHL, compared with children to parents with improved CHL in the comparison group (F = 3.856, p = 0.011).
Postnatal home visiting interventions practicing proportional universalism and family-centred care may reduce unplanned visits within CHC in disadvantaged settings despite parents' CHL. Further studies with long-term follow-up are suggested to explore associations between parents' CHL and child health.
As a clinical study (not a clinical trial) with appropriate ethical permission with participants' consents, this study was retrospectively registered (18 February 2020) in the ISRCTN registry (ISRCTN10336603).
父母健康素养水平低会对儿童健康产生负面影响。父母干预措施可能会提高父母的健康素养水平，从而对儿童健康产生积极影响。
本研究旨在了解在瑞典多元文化、弱势群体环境中，与接受常规儿童保健的父母相比，接受扩展产后家访项目的父母的综合健康素养与儿童健康之间的关联。
本准实验研究采用病例对照抽样方法，通过斯德哥尔摩的两个儿童保健中心（2017-2020 年）招募首次当父母的人。当他们的孩子 <2 个月和 15-18 个月大时，通过两次结构问卷调查对参与者（N=151）进行访谈。使用 HLS-EU-Q16 评估父母的综合健康素养。回顾儿童 0-18 个月的医疗记录，评估母乳喂养、儿童吸烟暴露、语言发展和医疗保健利用情况。使用回归模型和非参数检验分析数据。
父母的综合健康素养与儿童健康之间没有显著关联。然而，无论父母的综合健康素养如何，干预组儿童（0-18 个月）到儿童保健中心的非计划性就诊次数明显减少，而对照组中父母综合健康素养提高的儿童则明显减少（F=3.856，p=0.011）。
尽管父母的健康素养水平不同，在弱势环境中，产后家访干预措施实践比例普遍主义和以家庭为中心的护理可能会减少儿童保健中心的非计划性就诊。建议进一步开展长期随访研究，以探索父母的综合健康素养与儿童健康之间的关联。
作为一项具有适当伦理许可并获得参与者同意的临床研究（非临床试验），本研究于 2020 年 2 月 18 日在 ISRCTN 注册处（ISRCTN83310154）进行了回顾性注册。
