Associations Between Caregiver Health Literacy and Preschool Children's Secondhand Smoke Exposure.
OBJECTIVE
Examine the associations between caregiver health literacy (HL) and smoking-related outcome expectancies, implementation of home/car smoking bans (H/CSBs), and child secondhand smoke exposure (SHSe).


METHODS
Caregivers of Head Start children residing with a smoker(s) completed measures assessing HL, outcome expectancies, and H/CSB implementation. Biomarkers of child SHSe included home air nicotine monitors and child salivary cotinine.


RESULTS
Caregivers with lower HL had higher levels of home air nicotine and child salivary cotinine in the full sample and among smokers. After controlling for child age and number of smokers in the home, lower HL was associated with higher endorsement of negative smoking expectancies in the full sample and in smokers. HL was not associated with H/CSB implementation across groups.


CONCLUSIONS
Caregiver HL is associated with child SHSe and is important in shaping smoking-related beliefs. HL is not directly related to adoption of SHSe-reduction behaviors such as H/CSBs.
Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine.
Josie S
JS
Welkom
Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine.
Kristin A
KA
Riekert
Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine.
Cynthia S
CS
Rand
Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine meakin1@jhmi.edu.
Michelle N
MN
Eakin
D000328:Adult; D017028:Caregivers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003367:Cotinine / Q000378:metabolism; D005260:Female; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009538:Nicotine / Q000032:analysis; D011203:Poverty; D012463:Saliva / Q000378:metabolism; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data
D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003367:Cotinine
children; disparities; parents; tobacco use