Parent Health Literacy, Depression, and Risk for Pediatric Injury.
Population-wide research on the impact of parent health literacy to children's health outcomes is limited. We assessed the relationship of low parent health literacy to a range of pediatric health risks within a large cohort of primary care patients.



Data were from 17 845 English- and Spanish-speaking parents of children aged ≤7 years presenting for well-child care. We used a 3-item screener to measure health literacy. Outcomes included secondhand smoke exposure, asthma treatment nonadherence, parent depression, child-rearing practices, injury prevention, and parent first-aid knowledge. We summarized study variables with descriptive statistics and then performed multivariable logistic regression to identify associations between low parent literacy and our dependent measures.



Mean child age was 4.8 years (SD 3.7); 36.5% of parent respondents had low health literacy. In models adjusted for child gender, race/ethnicity, insurance, age, and parent language preference, low parent health literacy was related to a range of pediatric health risks, including parent depression (adjusted odds ratio [AOR] 1.32; 95% confidence interval 1.18-1.48), firearm access (AOR 1.68; 1.49-1.89), not having a working smoke detector (AOR 3.54; 2.74-4.58), and lack of first-aid knowledge about choking (AOR 1.67; 1.44-1.93) and burns (AOR 1.45; 1.29-1.63). Children of parents with low health literacy were also more likely to watch >2 hours of television per day (AOR 1.27; 1.17-1.36).



Low parent health literacy is independently and significantly related to parent depression, child television viewing, and at-risk family behaviors associated with child injury. Use of low-literacy approaches to health-behavior interventions may be essential to address common child morbidities.
Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; echeng@iu.edu.
Erika R
ER
Cheng
Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Regenstrief Institute, Inc., Indianapolis, Indiana; and.
Nerissa S
NS
Bauer
Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Regenstrief Institute, Inc., Indianapolis, Indiana; and.
Stephen M
SM
Downs
Division of General Pediatrics, Center for Policy, Outcomes, and Prevention, Stanford University, Stanford, California.
Lee M
LM
Sanders
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education; D012307:Risk Factors; D057566:Self Report; D014947:Wounds and Injuries / Q000453:epidemiology*