Literature DB >> 22321814

Perceived barriers to care and attitudes towards shared decision-making among low socioeconomic status parents: role of health literacy.

H Shonna Yin1, Benard P Dreyer, Karina L Vivar, Suzanne MacFarland, Linda van Schaick, Alan L Mendelsohn.   

Abstract

OBJECTIVE: Although low parent health literacy (HL) has been linked to poor child health outcomes, it is not known whether differences in perceptions related to access to care and provider-parent partnership in care are potential contributing factors. We sought to assess whether parent HL is associated with differences in perceived barriers to care and attitudes regarding participatory decision-making with the provider.
METHODS: This was a cross-sectional analysis of data collected from parents presenting with their child to an urban public hospital pediatric clinic in New York City. Dependent variables were caregiver-reported barriers to care (ability to reach provider at night/on weekends, difficult travel to clinic) and attitudes towards participatory decision-making (feeling like a partner, relying on doctor's knowledge, leaving decisions up to the doctor, being given choices/asked opinion). The primary independent variable was caregiver HL (Short Test of Functional Health Literacy in Adults [S-TOHFLA]).
RESULTS: A total of 823 parents were assessed; 1 in 4 (27.0%) categorized as having low HL. Parents with low HL were more likely to report barriers to care than those with adequate HL: trouble reaching provider nights/weekends, 64.9% vs. 49.6%, (p < 0.001, adjusted odds ratio [AOR] 1.7, 95% confidence interval [95% CI] 1.2-2.4); difficult travel, 15.3% vs. 8.0%, (p = 0.004, AOR 1.8, 95% CI 1.1-3.0). Low HL was also associated with not feeling like a partner (28.8% vs. 17.1%; AOR 2.0; 95% CI 1.4-3.0), preference for relying on the doctor's knowledge (68.9% vs. 52.2%; AOR 1.7; 95% CI 1.2-2.4), and preference for leaving decisions up to the doctor (57.7% vs. 33.3%; AOR 2.2; 95% CI 1.6-3.1).
CONCLUSIONS: Addressing issues of parent HL may be helpful in ameliorating barriers to care and promoting provider-parent partnership in care. Copyright Â
© 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Entities:  

Mesh:

Year:  2012        PMID: 22321814      PMCID: PMC3747780          DOI: 10.1016/j.acap.2012.01.001

Source DB:  PubMed          Journal:  Acad Pediatr        ISSN: 1876-2859            Impact factor:   3.107


  36 in total

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Authors:  H Shonna Yin; Matthew Johnson; Alan L Mendelsohn; Mary Ann Abrams; Lee M Sanders; Benard P Dreyer
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9.  Barriers to care questionnaire: reliability, validity, and responsiveness to change among parents of children with asthma.

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7.  Family perceptions of shared decision-making with health care providers: results of the National Survey of Children With Special Health Care Needs, 2009-2010.

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