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Low parental numeracy and severe asthma exacerbations in a prospective study of Puerto Rican youth
Amanda Gutwein1, Yueh-Ying Han1, Angel Colón-Semidey2
1Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania.
Insights
Persistently low parental numeracy in Puerto Rican youth is linked to increased asthma exacerbations, including emergency department visits and hospitalizations. This study highlights the importance of health literacy in managing childhood asthma effectively.
Area of Science:
- Pediatric Asthma Research
- Health Literacy and Numeracy Studies
- Public Health and Epidemiology
Background:
- Numeracy, the ability to understand health information, is crucial for patient adherence and outcomes.
- The association between persistent low parental numeracy and childhood asthma exacerbations remains under-investigated.
- Understanding this link is vital for developing targeted interventions for vulnerable populations.
Purpose of the Study:
- To determine if persistently low parental numeracy is associated with asthma exacerbations in Puerto Rican youth.
- To evaluate the relationship between low parental numeracy and lung function in this population.
- To inform public health strategies aimed at improving asthma management through enhanced health literacy.
Main Methods:
- A prospective study involving 225 Puerto Rican youth diagnosed with asthma.
- Parental numeracy assessed at two time points approximately 5.3 years apart using a modified Asthma Numeracy Questionnaire.
- Asthma exacerbations defined by emergency department visits, hospitalizations, and severe exacerbations; lung function measured via spirometry.
Main Results:
- Persistently low parental numeracy was significantly associated with an increased risk of emergency department visits (OR, 2.17), hospitalizations (OR, 3.92), and severe asthma exacerbations (OR, 1.99).
- No significant association was found between persistently low parental numeracy and changes in lung function.
- These findings remained significant after adjusting for covariates like parental education and medication use.
Conclusions:
- Persistently low parental numeracy is a significant risk factor for asthma exacerbations in Puerto Rican youth.
- Interventions aimed at improving parental numeracy may help reduce asthma-related healthcare utilization.
- Further research should explore culturally tailored strategies to enhance health literacy in families managing childhood asthma.
Background:
Numeracy is the mathematical knowledge required to understand and act on instructions from health care providers. Whether persistently low parental numeracy is linked to childhood asthma exacerbations is unknown.
Objective:
To evaluate whether low parental numeracy at 2 time points is associated with asthma exacerbations and worse lung function in Puerto Rican youth.
Methods:
Prospective study of 225 youth with asthma in San Juan (PR) who participated in 2 visits approximately 5.3 years apart, with the first at ages 6 to 14 years and the second at ages 9 to 20 years. Parental numeracy was assessed with a modified version of the Asthma Numeracy Questionnaire (score range = 0-3 points), and persistently low parental numeracy was defined as a score less than or equal to 1 point at both visits. Asthma exacerbation outcomes included more than or equal to 1 emergency department (ED) visit, more than or equal to 1 hospitalization, and more than or equal to 1 severe exacerbation (≥1 ED visit or ≥1 hospitalization) for asthma in the year before the second visit. Spirometry was conducted using an EasyOne spirometer (NDD Medical Technologies, Andover, Massachusetts).
Results:
In an analysis adjusting for age, sex, parental education, use of inhaled corticosteroids, and the time between study visits, persistently low parental numeracy was associated with more than or equal to 1 ED visit for asthma (odds ratio [ORs], 2.17; 95% confidence interval [CI], 1.10-4.26), more than or equal to 1 hospitalization for asthma (OR, 3.92; 95% CI, 1.42-10.84), and more than or equal to 1 severe asthma exacerbation (OR, 1.99; 95% CI, 1.01-3.87) in the year before the follow-up visit. Persistently low parental numeracy was not significantly associated with change in lung function measures.
Conclusion:
Persistently low parental numeracy is associated with asthma exacerbation outcomes in Puerto Rican youth.
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