Evaluating Health Literacy in Families of Injured Children: A Prospective Observational Cohort Study at a Level One Pediatric Trauma Center

Background Low health literacy(HL) has been associated with poor health outcomes in children. Optimal recovery after pediatric injury requires caregiver participation in complicated rehabilitative and medical aftercare. We aimed to quantify HL among guardians of injured children and identify factors associated with low HL of guardians. Methods A prospective observational cohort study was conducted to evaluate the HL using the Newest Vital Sign™ of guardians of injured children (<18 years) admitted to a level 1 pediatric trauma center. Patient and guardian characteristics were compared across levels of HL using univariate statistics. We conducted multivariable logistic regression to identify factors independently-associated with low HL. Results A sample of 95 guardian-child dyads were enrolled. The majority of guardians had low HL (n=52, 55%), followed by moderate HL (n= 36, 38%) and high HL (n= 7, 7%). Many families received public benefits (n= 47, 49%) and 12 guardians (13%) had both housing and employment insecurity. Guardians with low HL were significantly more likely to have insecure housing and not have completed any college. Conclusion The majority of injured children had a primary guardian with low HL. Pediatric trauma centers should consider screening for low HL to ensure that families have adequate post-discharge support. Level of Evidence Level 3.