William J Heerman1, Eliana M Perrin2, H Shonna Yin3, Lee M Sanders4, Svetlana K Eden5, Ayumi Shintani5, Tamera Coyne-Beasley2, Andrea B Bronaugh6, Shari L Barkin7, Russell L Rothman6. 1. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: Bill.Heerman@vanderbilt.edu. 2. Department of Pediatrics and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina. 3. Department of Pediatrics, New York University School of Medicine, New York, New York. 4. Department of Pediatrics and Center for Health Policy, Stanford University, Stanford, California. 5. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee. 6. Department of Internal Medicine and Pediatrics and Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee. 7. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Abstract
BACKGROUND: Unintentional injury is a leading cause of infant mortality. PURPOSE: To examine the role of caregiver health literacy in infant injury prevention behaviors. METHODS: A cross-sectional analysis of data collected in 2010-2012 from a randomized trial at four pediatric clinics was performed in 2012-2013. Caregiver health literacy was assessed with the Short Test of Functional Health Literacy in Adults. Caregiver-reported adherence to American Academy of Pediatrics-recommended injury prevention behaviors was assessed across seven domains: (1) car seat position; (2) car seat use; (3) sleeping safety; (4) fire safety; (5) hot water safety; (6) fall prevention; and (7) firearm safety. RESULTS: Data were analyzed from 844 English- and Spanish-speaking caregivers of 2-month-old children. Many caregivers were non-adherent with injury prevention guidelines, regardless of health literacy. Notably, 42.6% inappropriately placed their children in the prone position to sleep, and 88.6% did not have their hot water heater set <120°F. Eleven percent of caregivers were categorized as having low health literacy. Low caregiver health literacy, compared to adequate health literacy, was significantly associated with increased odds of caregiver non-adherence with recommended behaviors for car seat position (AOR=3.4, 95% CI=1.6, 7.1) and fire safety (AOR=2.0, 95% CI=1.02, 4.1) recommendations. Caregivers with low health literacy were less likely to be non-adherent to fall prevention recommendations (AOR=0.5, 95% CI=0.2, 0.9). CONCLUSIONS: Non-adherence to injury prevention guidelines was common. Low caregiver health literacy was significantly associated with some injury prevention behaviors. Future interventions should consider the role of health literacy in promoting injury prevention.
RCT Entities:
BACKGROUND: Unintentional injury is a leading cause of infant mortality. PURPOSE: To examine the role of caregiver health literacy in infant injury prevention behaviors. METHODS: A cross-sectional analysis of data collected in 2010-2012 from a randomized trial at four pediatric clinics was performed in 2012-2013. Caregiver health literacy was assessed with the Short Test of Functional Health Literacy in Adults. Caregiver-reported adherence to American Academy of Pediatrics-recommended injury prevention behaviors was assessed across seven domains: (1) car seat position; (2) car seat use; (3) sleeping safety; (4) fire safety; (5) hot water safety; (6) fall prevention; and (7) firearm safety. RESULTS: Data were analyzed from 844 English- and Spanish-speaking caregivers of 2-month-old children. Many caregivers were non-adherent with injury prevention guidelines, regardless of health literacy. Notably, 42.6% inappropriately placed their children in the prone position to sleep, and 88.6% did not have their hot water heater set <120°F. Eleven percent of caregivers were categorized as having low health literacy. Low caregiver health literacy, compared to adequate health literacy, was significantly associated with increased odds of caregiver non-adherence with recommended behaviors for car seat position (AOR=3.4, 95% CI=1.6, 7.1) and fire safety (AOR=2.0, 95% CI=1.02, 4.1) recommendations. Caregivers with low health literacy were less likely to be non-adherent to fall prevention recommendations (AOR=0.5, 95% CI=0.2, 0.9). CONCLUSIONS: Non-adherence to injury prevention guidelines was common. Low caregiver health literacy was significantly associated with some injury prevention behaviors. Future interventions should consider the role of health literacy in promoting injury prevention.
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