title: Assessment of health literacy and numeracy among Spanish-Speaking parents of young children: validation of the Spanish Parental Health Literacy Activities Test (PHLAT Spanish).
abstract: OBJECTIVE
  To assess the health literacy and numeracy skills of Spanish-speaking parents of young children and to validate a new Spanish language health literacy assessment for parents, the Spanish Parental Health Literacy Activities Test (PHLAT Spanish).
  
  
  METHODS
  Cross-sectional study of Spanish-speaking caregivers of young children (<30 months) enrolled at primary care clinics in 4 academic medical centers. Caregivers were administered the 10-item PHLAT in addition to validated tests of health literacy (S-TOFHLA) and numeracy (WRAT-3 Arithmetic). Psychometric analysis was used to examine item characteristics of the PHLAT-10 Spanish, to assess its correlation with sociodemographics and performance on literacy/numeracy assessments, and to generate a shorter 8-item scale (PHLAT-8).
  
  
  RESULTS
  Of 176 caregivers, 77% had adequate health literacy (S-TOFHLA), whereas only 0.6% had 9th grade or greater numeracy skills. Mean PHLAT-10 score was 41.6% (SD 21.1). Fewer than one-half (45.5%) were able to read a liquid antibiotic prescription label and demonstrate how much medication to administer within an oral syringe. Less than one-third (31.8%) were able to interpret a food label to determine whether it met WIC (Special supplemental nutrition program for Women, Infants, and Children) guidelines. Greater PHLAT-10 score was associated with greater years of education (r = 0.49), S-TOFHLA (r = 0.53), and WRAT-3 (r = 0.55) scores (P < .001). Internal reliability was good (Kuder-Richardson coefficient of reliability; KR-20 = 0.61). An 8-item scale was highly correlated with the full 10-item scale (r = 0.97, P < .001), with comparable internal reliability (KR-20 = 0.64).
  
  
  CONCLUSIONS
  Many Spanish-speaking parents have difficulty performing health-related literacy and numeracy tasks. The Spanish PHLAT demonstrates good psychometric characteristics and may be useful for identifying parents who would benefit from receiving low-literacy child health information.
authors: Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY, USA. yinh02@med.nyu.edu
authors: H Shonna
authors: HS
authors: Yin
authors: Lee M
authors: LM
authors: Sanders
authors: Russell L
authors: RL
authors: Rothman
authors: Alan L
authors: AL
authors: Mendelsohn
authors: Benard P
authors: BP
authors: Dreyer
authors: Richard O
authors: RO
authors: White
authors: Joanne P
authors: JP
authors: Finkle
authors: Stefania
authors: S
authors: Prendes
authors: Eliana M
authors: EM
authors: Perrin
mesh_terms: D000328:Adult; D017028:Caregivers; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006630:Hispanic or Latino / Q000193:education*; D006801:Humans; D007802:Language; D008297:Male; D008433:Mathematics; D010290:Parents / Q000193:education*; D011594:Psychometrics / Q000379:methods*; D014481:United States