The role of parent health literacy among urban children with persistent asthma

Health literacy (HL) affects adult asthma management, yet less is known about how parent HL affects child asthma care. Objective: To examine associations between parent HL and measures related to child asthma. Methods: Parents of 499 school-age urban children with persistent asthma in Rochester, New York completed home interviews. Measures: the Rapid Estimate of Adult Literacy in Medicine (REALM) for parent HL: National Heart Lung and Blood Institute (NHLBI) criteria for asthma severity, and validated measures of asthma knowledge, beliefs, and experiences. Analyses: bivariate and multivariate analyses of associations between parent HL measures related to child asthma. Results: Response rate: 72%, mean child age: 7.0 years. Thirty-two percent had a Hispanic parent; 88% had public insurance. Thirty-three percent had a parent with limited HL. Low parent HL was independently associated with greater parent worry, parent perception of greater asthma burden, and lower parent-reported quality of life. Measures of health care use (e.g., emergency care and preventive medicines) were not associated with parent HL. Conclusions: Parents with limited HL worried more and perceived greater overall burden from the child's asthma, even though reported health care use did not vary. Practice implications: Improved parent understanding and provider-parent communication about child asthma could reduce parent-perceived asthma burden, alleviate parent worry, and improve parent quality of life. (C) 2009 Elsevier Ireland Ltd. All rights reserved.