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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

The relationship between parent health literacy and pediatric emergency department utilization: a systematic review

Andrea K Morrison¹, Matthew P Myrvik, David C Brousseau

¹Department of Pediatrics Section of Emergency Medicine, Medical College of Wisconsin, Milwaukee.

Academic Pediatrics

|May 18, 2013

Insights

Approximately 30% of parents in the emergency department (ED) have low health literacy. Interventions designed for parents with low health literacy can significantly reduce their child's ED utilization.

Area of Science:

Pediatric Emergency Medicine
Health Literacy Research
Public Health Interventions

Background:

Low parental health literacy can impede understanding of a child's medical condition and treatment.
No prior reviews have specifically examined parental health literacy within the emergency department (ED) setting.
The relationship between parental health literacy and pediatric ED utilization remains under-explored.

Purpose of the Study:

To systematically review the literature on parental health literacy and its association with pediatric emergency department (ED) use.
To determine the prevalence of low health literacy among parents in the ED.
To assess the impact of low literacy interventions on children's ED utilization.

Main Methods:

A systematic review of peer-reviewed literature from 1980 to May 2012, searching PubMed and CINAHL.
Included 17 studies after reviewing 483 titles and abstracts, focusing on those with validated parent health literacy measures.
Data extraction and quality appraisal were performed by two independent authors.

Main Results:

A median of 30% of parents in the ED demonstrated low health literacy.
The association between parental low health literacy and pediatric ED use showed mixed results across studies.
Seven out of eight interventions targeting low literacy parents were linked to decreased ED utilization, with pooled analysis showing significant effectiveness (OR 0.35).

Conclusions:

A substantial proportion of parents (approximately one-third) presenting to the ED have low health literacy.
Interventions aimed at parents with low health literacy appear effective in reducing their children's reliance on emergency department services.
Further research is needed to confirm if interventions directly target and improve health literacy.

Read full analysis

Abstract

Background:

Low health literacy in parents can potentially impact understanding of a child's diagnosis and treatment course. No reviews have addressed parent health literacy in the emergency department (ED), the relationship between parent health literacy and child ED utilization, or the impact of low literacy interventions on child ED utilization.

Objective:

To systematically evaluate the peer-reviewed literature pertaining to parental health literacy and ED utilization. The following key questions were addressed: question (Q) 1) What is the prevalence of low health literacy, as estimated by validated health literacy measures, of parents in the ED? Q2) Is parent low health literacy related to ED use for children? Q3) Do low literacy interventions targeting parents likely to have low health literacy affect ED use for children?

Data Sources:

The authors reviewed 483 unduplicated titles and abstracts published between 1980 and May 2012 using PubMed and CINAHL, with 117 retained for full review and 17 included in the final analytic review.

Study Eligibility Criteria, Participants, And Interventions:

All included articles had a valid measure of parent health literacy and a Q1) descriptive measurement of the population, Q2) ED utilization, or Q3) utilized a low literacy educational intervention.

Study Appraisal And Synthesis Methods:

One author extracted data verified by a second author. Studies were rated for quality by both authors.

Results:

Q1) A median of 30% (interquartile range 22-36%) of parents in the ED possesses low health literacy. Q2) Studies investigating the relationship between health literacy and ED yielded mixed results. Q3) Seven of 8 low literacy interventions were associated with a reduction in ED use. Random effects pooled odds ratios from 6 studies showed intervention effectiveness (odds ratio 0.35; 95% CI 0.15-0.81).

Limitations:

No intervention studies measured health literacy, limiting the ability to determine whether the low literacy intervention targeted health literacy.

Conclusions And Implications Of Key Findings:

Roughly 1 in 3 parents of children presenting to the ED have low health literacy. Importantly, interventions targeting parents likely to have low health literacy have an impact in reducing ED utilization.

Keywords:

adolescent child child, preschool emergency service health literacy hospital infant newborn patient education as topic utilization

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