Research articleLow Parental Literacy Is Associated With Worse Asthma Care Measures in Children
Section snippets
Study Design
We conducted a retrospective cohort study in 3 outpatient pediatrics clinics (general, asthma and allergy, and pulmonary) at the North Carolina Children’s Hospital, the public children’s hospital of the state. Patients in these clinics receive care from attending faculty and residents from the University of North Carolina at Chapel Hill School of Medicine.
Study Participants
Potential subjects were identified at the beginning of each clinic session. A research assistant screened daily appointment lists for
Results
Between January 2004 and March 2005, 150 children with asthma and their parents were enrolled into the study (Figure). The characteristics of study participants are shown in Table 2, stratified by parental literacy status. Among the 150 participating parents, 36 (24%) were considered to have low literacy, defined as less than a 9th-grade reading level on REALM. Those in the low parental literacy group were more likely to be African American and to have an annual household income below $15 000.
Discussion
We found that children of parents with low literacy reported more severe asthma symptoms and were more likely to report missing school and requiring ED visits or hospitalization than children of parents with higher literacy. Parents with low literacy had lower mean scores on asthma knowledge questions and reported more frequent use of albuterol, but the differences were small. We find it particularly disconcerting that children whose parents have lower literacy are more prone to miss days of
Acknowledgments
This study was funded by the Pfizer Health Literacy Scholar Award and the Robert Wood Johnson Foundation Clinical Scholars Program. Dr DeWalt was also supported by the National Center for Research Resources under grants 5K12RR017667-04 and 5M01RR-000046 and the Translational Scholars Program at the University of North Carolina. Drs DeWalt and Pignone have received grants and honoraria from Pfizer Inc for work related to health literacy. No product of Pfizer is mentioned in this article. Charity
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