title: Parental numeracy and asthma exacerbations in Puerto Rican children.
abstract: BACKGROUND
  Puerto Ricans share a disproportionate burden of childhood asthma in the United States. Little is known about the impact of low parental numeracy (a health literacy skill) on asthma morbidity in Puerto Rican children. Our objective was to examine whether low parental numeracy is associated with increased asthma morbidity in Puerto Rican children.
  
  
  METHODS
  This was a cross-sectional study of 351 children with asthma, aged 6 to 14 years, living in San Juan, Puerto Rico. Parents of study participants completed a modified version of the Asthma Numeracy Questionnaire. Multivariate linear or logistic regression was used to examine the relation between low parental numeracy (defined as no correct answers in the modified Asthma Numeracy Questionnaire) and indicators of asthma morbidity (severe asthma exacerbations, core measures of asthma exacerbations, and lung function measures). All multivariate models were adjusted for age, sex, household income, reported use of inhaled corticosteroids in the previous 6 months, and exposure to secondhand tobacco smoke.
  
  
  RESULTS
  Low parental numeracy was associated with increased odds of visits to the ED or urgent care for asthma (adjusted OR [aOR]=1.7, 95% CI=1.03-2.7, P=.04). The association between low parental numeracy and hospitalizations for asthma was significant only among children not using inhaled corticosteroids (aOR=2.8, 95% CI=1.4-5.6, P=.004). There was no association between low parental numeracy and use of systemic steroids or lung function measures.
  
  
  CONCLUSIONS
  Low parental numeracy is associated with increased asthma morbidity in Puerto Rican children.
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Christian
authors.initials: C
authors.lastname: Rosas-Salazar
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Sima K
authors.initials: SK
authors.lastname: Ramratnam
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA.
authors.forename: John M
authors.initials: JM
authors.lastname: Brehm
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Yueh-Ying
authors.initials: YY
authors.lastname: Han
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Edna
authors.initials: E
authors.lastname: Acosta-Pérez
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: María
authors.initials: M
authors.lastname: Alvarez
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Angel
authors.initials: A
authors.lastname: Colón-Semidey
authors.affiliation: Behavioral Sciences Research Institute and Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Apter
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA. Electronic address: juan.celedon@chp.edu.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Celedón
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000208:ethnology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D057220:Health Literacy; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010290:Parents; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D011795:Surveys and Questionnaires