A. M. Waters1, C. Onwubiko1, M. C. Shroyer1, J. S. Graham1, L. Wilkinson1, D. P. Galloway1, C. A. Martin1 1University Of Alabama at Birmingham,Pediatric Surgery,Birmingham, Alabama, USA
Introduction: Health literacy is estimated to be low in over one third of the US population and lower health literacy has been associated with higher morbidity and mortality rates. In the pediatric patient population, there is a significant role that parents/caregivers play in the health of their children. Children with intestinal failure have complex care requirements and effective communication between caregivers and medical providers is essential to patient well-being. We aim to evaluate the ability of the medical providers to assess parental medical knowledge.
Methods: We utilized the validated Parental Health Literacy Activities Test (PHLAT-8) assessment tool to measure parental understanding. The assessments were given to the primary caregiver during their child’s clinic appointment or hospital admission. Raw scores were used to categorize health literacy (inadequate = 1, moderate = 2, or adequate = 3). The survey responders’ level of education was also recorded. Providers (MD and NP) were also then surveyed to anticipate the mental capacity of the caregivers for these patients. Additionally, providers were recorded during patient interactions and the Flesch-Kincaid reading level of the transcript was determined to assess their ability to effectively communicate with patient’s caregivers.
Results: A total of 54 patient caregivers completed the PHLAT-8 assessment. Of the responders, 4.7% had a GED certificate, 51.2% high school diploma, 18.6% associates degree, 16.3% bachelor’s degree, and 9.3% had an advanced degree. The average health literacy was 2.62 +/-0.6, or less than the adequate range. Provider surveys estimated the caregiver’s level health literacy to range from 2.24 to 2.61. While providers underestimated caregiver’s health literacy, the average reading level of the recorded conversations were determined to be 10.4 with a range of 8.2 to 12.5.
Conclusion: This study is useful to incorporate into our clinical practice to help identify those caregivers who need extra education or resources to be able to properly care for children with intestinal failure and their associated complex medical issues. It also highlights the need for medical providers to be mindful of their manner of speech to ensure that caregivers of all levels can understand information given to them regarding their child’s healthcare.