title: The Health Literacy of Hong Kong Chinese Parents with Preschool Children in Seasonal Influenza Prevention: A Multiple Case Study at Household Level.
abstract: BACKGROUND
  Health literacy influences individual and family health behaviour, health services use, and ultimately health outcomes and health care costs. In Hong Kong, people are at risk of seasonal influenza infection twice a year for three-month periods. Seasonal influenza is significantly associated with an increased number of hospitalized children. There is no research that provides an understanding of parents' health knowledge and their access to health information concerning seasonal influenza, nor their capacity to effectively manage influenza episodes in household. Such knowledge provides valuable insight into enhancing parents' health literacy to effectively communicate health messages to their children and support healthy behaviour development through role modelling.
  
  
  METHODS
  A multiple case study was employed to gain a multifaceted understanding of parents' health literacy regarding seasonal influenza prevention. Purposive intensity sampling was adopted to recruit twenty Hong Kong Chinese parents with a healthy three-to-five year old preschool child from three kindergartens. A content analysis was employed to categorize, tabulate and combine data to address the propositions of the study. Comprehensive comparisons were made across cases to reveal the commonalities and differences.
  
  
  RESULTS
  Four major themes were identified: inadequate parents' knowledge and reported skills and practices related to seasonal influenza prevention; parental knowledge seeking and exchange practices through social connection; parents' approaches to health information and limited enabling environments including shortage of health resources and uneven resource allocation for health promotion.
  
  
  CONCLUSIONS
  The findings recommend that community health professionals can play a critical role in increasing parents' functional, interactive and critical health literacy; important elements when planning and implementing seasonal influenza health promotion.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
authors.forename: Winsome
authors.initials: W
authors.lastname: Lam
authors.affiliation: Faculty of Health, University of Technology, Sydney, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Dawson
authors.affiliation: Faculty of Health, University of Technology, Sydney, Australia.
authors.forename: Cathrine
authors.initials: C
authors.lastname: Fowler
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D057220:Health Literacy; D006723:Hong Kong; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010290:Parents; D012621:Seasons; D011795:Surveys and Questionnaires