Abstract
Objective
To examine the association between caregiver health literacy and the likelihood of
a nonurgent emergency department (ED) visit in children presenting for fever.
Methods
This cross-sectional study used the Newest Vital Sign to assess the health literacy
of caregivers accompanying children with fever to the ED. Visit urgency was determined
by resources utilized during the ED visit. Findings were stratified by race and child
age. Chi-square and logistic regression analysis controlling for race were conducted
to determine the association between low health literacy and ED visit urgency.
Results
A total of 299 caregivers completed study materials. Thirty-nine percent of ED visits
for fever were nonurgent, and 63% of caregivers had low health literacy. Low health
literacy was associated with a higher proportion of nonurgent ED visits for fever
(44% vs 31%, odds ratio 1.8, 95% confidence interval [CI] 1.1, 2.9). Low health literacy
was associated with higher odds of a nonurgent visit in white and Hispanic caregivers
but not in black caregivers. In regression analysis, children ≥2 years old had higher
odds of a nonurgent visit if caregivers had low health literacy (adjusted odds ratio
2.0; 95% CI 1.1, 4.1); this relationship did not hold for children <2 years old (adjusted
odds ratio 0.8; 95% CI 0.4, 1.8).
Conclusions
Nearly two-thirds of caregivers with their child in the ED for fever have low health
literacy. Caregiver low health literacy is associated with nonurgent ED utilization
for fever in children over 2 years of age. Future interventions could target health
literacy skills regarding fever in caregivers of children ≥2 years.
Keywords
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References
- Low caregiver health literacy is associated with higher pediatric emergency department use and non-urgent visits.Acad Pediatr. 2014; 14: 309-314
- The relationship between parent health literacy and pediatric emergency department utilization: a systematic review.Acad Pediatr. 2013; 13: 421-429
- Nielsen-Bohlman L.T. Panzer A.M. Kindig D.A. Health Literacy: A Prescription to End Confusion. National Academies Press, Washington, DC2004
- Health literacy and child health promotion: implications for research, clinical care, and public policy.Pediatrics. 2009; 124: S306-S314
- Fever phobia: misconceptions of parents about fevers.Am J Dis Child. 1980; 134: 176-181
- Effectiveness of fever education in a pediatric emergency department.Pediatr Emerg Care. 2009; 25: 565-568
- Fever phobia: a survey of caregivers of children seen in a pediatric emergency department.Clin Pediatr. 2010; 49: 530-534
- Parental misinterpretations of over-the-counter pediatric cough and cold medication labels.Pediatrics. 2009; 123: 1464-1471
- Association of low caregiver health literacy with reported use of nonstandardized dosing instruments and lack of knowledge of weight-based dosing.Ambul Pediatr. 2007; 7: 292-298
- Parents’ medication administration errors: role of dosing instruments and health literacy.Arch Pediatr Adolesc Med. 2010; 164: 181-186
- Outpatient management without antibiotics of fever in selected infants.N Engl J Med. 1993; 329: 1437-1441
- Quick assessment of literacy in primary care: the Newest Vital Sign.Ann Fam Med. 2005; 3: 514
- Identifying children with special health care needs: development and evaluation of a short screening instrument.Ambul Pediatr. 2002; 2: 38-48
- Use of the emergency department by children enrolled in a primary care clinic.Pediatr Emerg Care. 1985; 1: 61-65
- Urgency classification methods for emergency department visits: do they measure up?.Pediatr Emerg Care. 2008; 24: 870-874
- Categorizing urgency of infant emergency department visits: agreement between criteria.Acad Emerg Med. 2006; 13: 1304-1311
- Usual source of care and nonurgent emergency department use.Acad Emerg Med. 2002; 9: 916-923
- Quality of primary care and subsequent pediatric emergency department utilization.Pediatrics. 2007; 119: 1131-1138
- Health literacy and child health outcomes: a systematic review of the literature.Pediatrics. 2009; 124: S265-S274
- Use of active ingredient information for low socioeconomic status parents’ decision-making regarding cough and cold medications: role of health literacy.Acad Pediatr. 2013; 13: 229-235
- Development of injury prevention materials for people with low literacy skills.Patient Educ Couns. 2006; 64: 119-127
- Why do parents bring children to the emergency department for nonurgent conditions? A qualitative study.Ambul Pediatr. 2008; 8: 360-367
- A qualitative assessment of reasons for nonurgent visits to the emergency department.Pediatr Emerg Care. 2012; 28: 220-225
- A profile of nonurgent emergency department use in an urban pediatric hospital.Pediatr Emerg Care. 2012; 28: 977-984
- A comparison of perceptions of fever and fever phobia by ethnicity.Clin Pediatr. 2010; 49: 172-176
Article Info
Publication History
Published online: June 16, 2014
Accepted:
May 11,
2014
Received:
February 14,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
