Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

The Impact of Caregiver's (Parents) Health Literacy on Pediatric Asthma Outcomes

Funded Projects Search

Advanced Search >>

Project Number: R40 MC 08728-03
Grantee: University of Alabama at Birmingham
Department/Center: Pulmonary, Allergy and Critical Care Medicine
Project Date: 9/1/2007

Final Report

The Impact of Caregiver's (Parents) Health Literacy on Pediatric Asthma Outcomes Final Report (PDF) Exit Disclaimer

Principal Investigator

Kathy F. Harrington, PhD, MPH
Assistant Professor
618 20th Street South - OHB143
Birmingham, AL  35233
Phone: (205) 996-5889


  • Middle Childhood (6-11 years)


  • African American


Asthma prevalence and its associated morbidity among children are increasing worldwide, with minority and low-income inner city US children at increased risk. Access to care for this vulnerable population has not explained this health disparity, suggesting other modifiable factors should be examined. Low health literacy has been associated with inadequate utilization of preventive services, increased emergency visits, increased risk of hospitalization, and poor health outcomes. Furthermore, low health literacy is prevalent among those with lower socioeconomic status as well as minorities, mirroring trends in asthma morbidity. It is estimated that approximately half of US adults have health literacy limitations. These literacy limitations may affect how patients, or their caregivers, understand their health care practitioner's treatment recommendations and may also affect the recommendations that the health care practitioner prescribes, potential sources of asthma health disparities. To address eliminating asthma disparities and improving children's health, the goal of this study is to examine modifiable mechanisms for this health disparity by refining the previously examined role of parent health literacy in asthma outcomes (MCHB Strategic Research Issue II). We will also extend this knowledge by exploring associations with asthma control, asthma symptoms, and understanding of treatment recommendations, as well as sociocultural variables that may affect these relationships. Furthermore, we propose to study how the health care provider's perception of parent health literacy impacts prescribed treatment and to test the validity of a simple parent health literacy self-assessment tool. This project will enroll 279 children with asthma and their primary caregiver in a study that uses a retrospective cohort design to achieve the following specific aims: (1) Assess the health literacy of parents of pediatric asthma patients and its association with the child's asthma control. (2) Evaluate the relationship between concordance of parent health literacy and the healthcare provider's perception of parent health literacy with asthma control. (3) Examine the relationship between parent health literacy and child asthma outcomes (school days missed, adherence and urgent health care utilization). (4) Examine the relationship between provider perception of health literacy and provider treatment recommendations. (5) Determine how accurately parents can self-evaluate their health literacy level by assessing the concordance between an objective measure of parent health literacy (TOFHLA) and the parent's self-assessment. (6) Explore the effect of health literacy on provider-parent communication through in-depth interviews with parents and healthcare providers. Data will be collected through questionnaires from all participants and health care providers. Additional data will be collected via in-depth interviews from a sub-sample of participants and health care providers to assist in understanding patient-practitioner communications. The information collected as part of this study will allow us to better understand the mechanisms through which health literacy affects asthma outcomes and will provide new knowledge for development of interventions to reduce children's asthma health disparities.




Health Disparities, Asthma, Health Education & Family Support, Chronic Illness, Special Health Care Needs

Title V in Your State