title: Low parental literacy is associated with worse asthma care measures in children.
abstract: OBJECTIVE
  To determine whether parental literacy is related to emergency department visits, hospitalizations, and days of school missed for children with asthma.
  
  
  METHODS
  We performed a retrospective cohort study at a university pediatric clinic. We enrolled children between 3 and 12 years old with a diagnosis of asthma and a regular source of care at the site of the study and their parent or guardian. Primary asthma care measures included self-reported rates of emergency department visits, hospitalizations, and days of school missed. Secondary asthma care measures included rescue and controller medication use, classification of asthma severity, and parental asthma-related knowledge.
  
  
  RESULTS
  We enrolled 150 children and their parents. Twenty-four percent of the parents had low literacy. Children of parents with low literacy had greater incidence of emergency department visits (adjusted incidence rate ratio [IRR] 1.4; 95% confidence interval 0.97, 2.0), hospitalizations (IRR 4.6; 1.8, 12), and days missed from school (IRR 2.8; 2.3, 3.4) even after adjusting for asthma-related knowledge, disease severity, medication use, and other sociodemographic factors. Parents with low literacy had less asthma-related knowledge, and their children were more likely to have moderate or severe persistent asthma and had greater use of rescue medications.
  
  
  CONCLUSIONS
  Low parental literacy is associated with worse care measures for children with asthma.
authors.affiliation: Division of General Internal Medicine and the Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599, USA. dewaltd@med.unc.edu
authors.forename: Darren A
authors.initials: DA
authors.lastname: DeWalt
authors.forename: Marylee H
authors.initials: MH
authors.lastname: Dilling
authors.forename: Marjorie S
authors.initials: MS
authors.lastname: Rosenthal
authors.forename: Michael P
authors.initials: MP
authors.lastname: Pignone
mesh_terms: D000041:Absenteeism; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017063:Outcome Assessment, Health Care; D010290:Parents; D012189:Retrospective Studies
chemical_list: D018927:Anti-Asthmatic Agents