title: Health literacy and injury prevention behaviors among caregivers of infants.
abstract: BACKGROUND
  Unintentional injury is a leading cause of infant mortality.
  
  
  OBJECTIVE
  To examine the role of caregiver health literacy in infant injury prevention behaviors.
  
  
  METHODS
  A cross-sectional analysis of data collected in 2010-2012 from a randomized trial at four pediatric clinics was performed in 2012-2013. Caregiver health literacy was assessed with the Short Test of Functional Health Literacy in Adults. Caregiver-reported adherence to American Academy of Pediatrics-recommended injury prevention behaviors was assessed across seven domains: (1) car seat position; (2) car seat use; (3) sleeping safety; (4) fire safety; (5) hot water safety; (6) fall prevention; and (7) firearm safety.
  
  
  RESULTS
  Data were analyzed from 844 English- and Spanish-speaking caregivers of 2-month-old children. Many caregivers were non-adherent with injury prevention guidelines, regardless of health literacy. Notably, 42.6% inappropriately placed their children in the prone position to sleep, and 88.6% did not have their hot water heater set <120°F. Eleven percent of caregivers were categorized as having low health literacy. Low caregiver health literacy, compared to adequate health literacy, was significantly associated with increased odds of caregiver non-adherence with recommended behaviors for car seat position (AOR=3.4, 95% CI=1.6, 7.1) and fire safety (AOR=2.0, 95% CI=1.02, 4.1) recommendations. Caregivers with low health literacy were less likely to be non-adherent to fall prevention recommendations (AOR=0.5, 95% CI=0.2, 0.9).
  
  
  CONCLUSIONS
  Non-adherence to injury prevention guidelines was common. Low caregiver health literacy was significantly associated with some injury prevention behaviors. Future interventions should consider the role of health literacy in promoting injury prevention.
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: Bill.Heerman@vanderbilt.edu.
authors.forename: William J
authors.initials: WJ
authors.lastname: Heerman
authors.affiliation: Department of Pediatrics and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Perrin
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, New York.
authors.forename: H Shonna
authors.initials: HS
authors.lastname: Yin
authors.affiliation: Department of Pediatrics and Center for Health Policy, Stanford University, Stanford, California.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Sanders
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Svetlana K
authors.initials: SK
authors.lastname: Eden
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shintani
authors.affiliation: Department of Pediatrics and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
authors.forename: Tamera
authors.initials: T
authors.lastname: Coyne-Beasley
authors.affiliation: Department of Internal Medicine and Pediatrics and Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Bronaugh
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Shari L
authors.initials: SL
authors.lastname: Barkin
authors.affiliation: Department of Internal Medicine and Pediatrics and Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
mesh_terms: D000328:Adult; D017028:Caregivers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D017751:Safety Management / Q000379:methods / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000517:prevention & control*
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