Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Background: Health literacy is an important predictor of healthcare outcomes, but research on this topic has largely been absent from the emergency medicine literature.

Objectives: We measured the prevalence of health literacy in parents or guardians of pediatric patients seen in the emergency department (ED).

Methods: This was an observational study conducted in a Midwestern urban, university-based, tertiary, Level 1 trauma center ED with 33,000 visits/year. Using convenience sampling during a three-month period, English-speaking parents or guardians of pediatric patients (< 19 yrs.) were asked to complete the short version of the Test of Functional Health Literacy for Adults (s-TOFHLA). Parents/guardians were excluded if they had uncorrected visual impairment, required an interpreter, had altered mental status, or if the patients they accompanied were the subjects of a medical or trauma activation.

Results: Of the 188 parents or guardians approached, six did not consent or withdrew, one was excluded, leaving 181 (96.3%) in the study. Of these, 19 (10.5%) had either "marginal" or "inadequate" health literacy, while 162 (89.5%, 95% CI: 84.1%, 93.6%) had "adequate" health literacy.

Conclusions: A large majority (89.5%) of English-speaking parents or guardians of pediatric patients evaluated in the ED have adequate health literacy. This data may prompt ED professionals to adjust their communication styles in the evaluation of children. Future multi-center studies are needed to confirm the findings in this pilot study. [WestJEM.2008:9:130-134]