Relationship Between Health Literacy in Parents and Asthma Control in Their Children: A Prospective Study in a Diverse Suburban Population

Background: Patients with low health literacy may not have an adequate understanding of basic health information, and were more likely to skip necessary tests and treatments, or wrongly administer medications. There are limited studies on rapid assessment of health literacy in parents and its impact on asthma control in their children. Materials and Methods: This study involves prospective assessment of health literacy in parents and asthma control in their children, age ≥2 years. Primary caregivers completed the Short Assessment of Health Literacy (SAHL) and the Newest Vital Signs (NVSs) questionnaires. Scores of ≤14 on the SAHL or ≤3 on the NVS were considered indicative of low health literacy and/or numeracy. Asthma control was assessed with the Asthma Control Test (ACT), Child ACT (cACT), or the Test for Respiratory and Asthma Control in Kids (TRACK). Scores of ≤19 on the ACT or cACT, and <80 on the TRACK were considered indicative of not well-controlled asthma. Results: Two hundred sixty-four children were enrolled, with mean age of 8.9 + 4.4 years. Sixty-three percent were male. Seventy-seven percent of parents identified themselves as White, 18% Black/African American, and 7% Asian. Twenty-five percent had state-supported health insurance. Seventy-eight parents (30%) were assigned to the low health literacy group. There were no differences between the 2 groups in age, race, or sex. Those with low health literacy were more likely to have state-supported health insurance, P < 0.0001. Fifty-four percent of the children whose parents had low health literacy had asthma not well controlled as compared with 30% of those with health literacy scores in the normal range, odds ratio: 2.66 (95% confidence interval: 1.55–4.56). This relationship persisted on multivariate analysis after accounting for health insurance and age. Conclusion: Low health literacy in primary caregivers is associated with not well-controlled asthma in children in a diverse, suburban population.