Health literacy and patient understanding of screening tests for aneuploidy and neural tube defects.
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.
Cho
Regina N
RN
Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, IL, USA.
Plunkett
Beth A
BA
Wolf
Michael S
MS
Simon
Charla E
CE
Grobman
William A
WA
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