Successful enrollment in Text4Baby more likely with higher health literacy.

Adequate health literacy is vital for understanding and using health information. The authors assessed the health literacy of pregnant women and mothers of children under the age of 1 year and their success in self-enrolling in the Text4Baby health message program: 468 pregnant women and mothers of children under the age of 1 year completed an in-person baseline survey, including the Newest Vital Sign health literacy assessment, at 2 Metro-Atlanta Women, Infants, and Children clinics. They were asked to self-enroll in the Text4Baby message program and were later contacted by phone to see whether they had attempted to enroll in the program and whether they were successful. Of the 333 women contacted by phone to assess enrollment efforts, 21% had a high likelihood of limited literacy (a score of 0-1 on the Newest Vital Sign assessment), 48% had a chance of limited literacy (a score of 2-3), and 31% had adequate literacy (a score of 4-6). Attempting to self-enroll was not associated with health literacy (p = .70), but successful enrollment was more likely with higher literacy (p = .01). Results suggested a positive association between health literacy skills and successful self-enrollment in the Text4Baby program, which suggests the need for additional outreach efforts to assure enrollment by women with low health literacy skills.