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Assessment of Health Literacy and Numeracy Among Spanish-Speaking Parents of Young Children: Validation of the Spanish Parental Health Literacy Activities Test (PHLAT Spanish)

  • H. Shonna Yin
    Correspondence
    Address correspondence to H. Shonna Yin, MD, MS, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, NBV 8S4-11, New York, NY 10016.
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Lee M. Sanders
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Russell L. Rothman
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Alan L. Mendelsohn
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Benard P. Dreyer
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Richard O. White
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Joanne P. Finkle
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Stefania Prendes
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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  • Eliana M. Perrin
    Affiliations
    Department of Pediatrics, NYU School of Medicine and Bellevue Hospital Center, New York, NY (Drs Yin, Mendelsohn, Dreyer); University of Miami Miller School of Medicine, Miami, Fla. (Dr Sanders and Ms Prendes); Departments of Pediatrics and Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Dr Rothman); Department of Pediatrics, Meharry Medical College, Nashville, Tenn. (Dr White); and Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (Ms. Finkle and Dr Perrin)
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Published:November 07, 2011DOI:https://doi.org/10.1016/j.acap.2011.08.008

      Abstract

      Objective

      To assess the health literacy and numeracy skills of Spanish-speaking parents of young children and to validate a new Spanish language health literacy assessment for parents, the Spanish Parental Health Literacy Activities Test (PHLAT Spanish).

      Methods

      Cross-sectional study of Spanish-speaking caregivers of young children (<30 months) enrolled at primary care clinics in 4 academic medical centers. Caregivers were administered the 10-item PHLAT in addition to validated tests of health literacy (S-TOFHLA) and numeracy (WRAT-3 Arithmetic). Psychometric analysis was used to examine item characteristics of the PHLAT-10 Spanish, to assess its correlation with sociodemographics and performance on literacy/numeracy assessments, and to generate a shorter 8-item scale (PHLAT-8).

      Results

      Of 176 caregivers, 77% had adequate health literacy (S-TOFHLA), whereas only 0.6% had 9th grade or greater numeracy skills. Mean PHLAT-10 score was 41.6% (SD 21.1). Fewer than one-half (45.5%) were able to read a liquid antibiotic prescription label and demonstrate how much medication to administer within an oral syringe. Less than one-third (31.8%) were able to interpret a food label to determine whether it met WIC (Special supplemental nutrition program for Women, Infants, and Children) guidelines. Greater PHLAT-10 score was associated with greater years of education (r = 0.49), S-TOFHLA (r = 0.53), and WRAT-3 (r = 0.55) scores (P < .001). Internal reliability was good (Kuder-Richardson coefficient of reliability; KR-20 = 0.61). An 8-item scale was highly correlated with the full 10-item scale (r = 0.97, P < .001), with comparable internal reliability (KR-20 = 0.64).

      Conclusions

      Many Spanish-speaking parents have difficulty performing health-related literacy and numeracy tasks. The Spanish PHLAT demonstrates good psychometric characteristics and may be useful for identifying parents who would benefit from receiving low-literacy child health information.

      Keywords

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