Pediatricians and health literacy: descriptive results from a national survey.
OBJECTIVE
To describe pediatricians' self-reported experiences with health literacy, use of basic and enhanced communication techniques, and perceived barriers to effective communication during office visits.


METHODS
A national, random sample of 1605 nonretired, posttraining American Academy of Pediatrics members were surveyed in 2007 about health literacy and patient communication as part of the Periodic Survey of Fellows. The response rate was 56% (N = 900).


RESULTS
Eight-one percent of the pediatricians were aware of a situation in the previous 12 months in which a parent had not sufficiently understood health information that had been delivered to him or her. In addition, 44% of all pediatricians were aware of a communication-related error in patient care within the previous 12 months. Using simple language (99%), repeating key information (92%), and presenting only 2 or 3 concepts at a time (76%) were the most commonly used communication strategies. Enhanced communication techniques recommended by health literacy experts such as teach-back and indicating key points on written educational materials were used less often (23% and 28%, respectively). The most common reported barriers to effective communication were limited time to discuss information (73%), volume of information (65%), and complexity of information (64%). The majority of physicians rated themselves highly in their ability to identify caregiver understanding (64%), but only 21% rated themselves as very good or excellent in identifying a parent with a literacy problem. Fifty-seven percent of the respondents were interested in training to improve communication skills, and 58% reported that they would be very likely to use easy-to-read written materials, if available from the American Academy of Pediatrics.


CONCLUSIONS
Pediatricians are aware of health literacy-related problems and the need for good communication with families but struggle with time demands to implement these skills. Despite awareness of communication-related errors in patient care, pediatricians report underutilizing enhanced techniques known to improve communication.
Turner
Teri
T
Baylor College of Medicine, Department of Pediatrics, Texas Children's Hospital, Clinical Care Center, Suite 1540, 6621 Fannin St, CC 1540, Houston, TX 77030-2399, USA. tturner@bcm.tmc.edu
Cull
William L
WL
Bayldon
Barbara
B
Klass
Perri
P
Sanders
Lee M
LM
Frintner
Mary Pat
MP
Abrams
Mary Ann
MA
Dreyer
Benard
B
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000517:prevention & control; D032882:Comprehension; D004348:Drug Labeling; D018479:Early Intervention, Educational; D004522:Educational Status; D005260:Female; D005515:Food Labeling; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D020380:Needs Assessment; D011247:Pregnancy; D011320:Primary Health Care; D011368:Professional-Family Relations; D011640:Public Policy; D014481:United States