Academic Pediatrics
Volume 10, Issue 5 , Pages 309-316, September 2010

Parental Understanding of Infant Health Information: Health Literacy, Numeracy, and the Parental Health Literacy Activities Test (PHLAT)

Departments of Medicine and Pediatrics (Ms Kumar, Drs Patterson and Rothman), and the Department of Biostatistics (Dr Choi) Vanderbilt University Medical Center, Nashville, Tenn; Department of Pediatrics, University of Miami, Miami, Fla (Dr Sanders and Ms Franco); Department of Pediatrics, Division of General Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Perrin and Ms Finkle); Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison, Wis (Dr Lokker); and Department of Health, State of Tennessee, Nashville, Tenn (Dr Gunn)

Received 11 November 2009; accepted 14 June 2010. published online 02 August 2010.

Abstract 

Objective

To assess parental health literacy and numeracy skills in understanding instructions for caring for young children, and to develop and validate a new parental health literacy scale, the Parental Health Literacy Activities Test (PHLAT).

Methods

Caregivers of infants (age <13 months) were recruited in a cross-sectional study at pediatric clinics at 3 academic medical centers. Literacy and numeracy skills were assessed with previously validated instruments. Parental health literacy was assessed with the new 20-item PHLAT. Psychometric analyses were performed to assess item characteristics and to generate a shortened, 10-item version (PHLAT-10).

Results

A total of 182 caregivers were recruited. Although 99% had adequate literacy skills, only 17% had better than ninth-grade numeracy skills. Mean score on the PHLAT was 68% (standard deviation 18); for example, only 47% of caregivers could correctly describe how to mix infant formula from concentrate, and only 69% could interpret a digital thermometer to determine whether an infant had a fever. Higher performance on the PHLAT was significantly correlated (P < .001) with education, literacy skill, and numeracy level (r = 0.29, 0.38, and 0.55 respectively). Caregivers with higher PHLAT scores were also more likely to interpret age recommendations for cold medications correctly (odds ratio 1.6, 95% confidence interval 1.02, 2.6). Internal reliability on the PHLAT was good (Kuder-Richardson coefficient of reliability = 0.76). The PHLAT-10 also demonstrated good validity and reliability.

Conclusions

Many parents do not understand common health information required to care for their infants. The PHLAT and PHLAT-10 have good reliability and validity and may be useful tools for identifying parents who need better communication of health-related instructions.

Keywords: anticipatory guidance, infants, literacy, parenting skills, safety

 

PII: S1876-2859(10)00158-0

doi:10.1016/j.acap.2010.06.007

Academic Pediatrics
Volume 10, Issue 5 , Pages 309-316, September 2010

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