title: Health literacy and patient understanding of screening tests for aneuploidy and neural tube defects.
abstract: OBJECTIVE
  To determine if health literacy is associated with patient understanding of prenatal screening tests for fetal aneuploidy and neural tube defects.
  
  
  METHODS
  We performed a prospective observational study on a cohort of English-speaking patients receiving prenatal care in two resident-staffed ambulatory clinics. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine-7. Understanding of the prenatal screening tests was assessed using a modified Maternal Serum Screening Knowledge Questionnaire.
  
  
  RESULTS
  Over an 8-month period, 125 patients were approached, and 101 (81%) consented to the study. Thirty-eight (38%) women demonstrated low health literacy. Patients with low health literacy were more likely to demonstrate inadequate understanding when compared to those with adequate health literacy (97% versus 11%, respectively; P < 0.01). Similarly, patients with < 12th grade education were more likely to have inadequate understanding when compared to patients with > 12th grade education (53% versus 30%, respectively; P = 0.02). Health literacy is a more sensitive and specific predictor of inadequate understanding than education (sensitivity 84% versus 70%, respectively, P < 0.05; specificity 98% versus 47%, respectively, P < 0.05).
  
  
  CONCLUSIONS
  Patients with low health literacy are more likely to demonstrate inadequate understanding of these prenatal screening tests than women with adequate health literacy.
authors.affiliation: Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, IL, USA.
authors.forename: Regina N
authors.initials: RN
authors.lastname: Cho
authors.forename: Beth A
authors.initials: BA
authors.lastname: Plunkett
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.forename: Charla E
authors.initials: CE
authors.lastname: Simon
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000782:Aneuploidy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007087:Illinois; D008403:Mass Screening / Q000379:methods; D009436:Neural Tube Defects / Q000175:diagnosis* / Q000196:embryology; D010353:Patient Education as Topic; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D011795:Surveys and Questionnaires; D019037:Urban Health Services