HEALTH LITERACY TRAINING AMONG GRADUATING CATEGORICAL PEDIATRIC RESIDENTS

Gretchen Caspary, Mary Ann Abrams, Benard Dreyer.. Department of Research, American Academy of Pediatrics, Elk Grove Village, IL; Iowa Health Systems, Johnston, IA; Department of Pediatrics, New York University Medical Center, New York, NY.

BACKGROUND: Health literacy (HL) is the ability to read, understand, and use health information to make appropriate health care decisions and follow treatment plans. The National Adult Literacy Survey estimated that nearly half of U.S. adults may struggle with low HL. Low HL has been linked in many studies to less health knowledge, less healthy behaviors, increased medical errors, increased hospitalizations, increased medical costs, and worse patient outcomes.

OBJECTIVE: To determine the level of awareness of and training in HL issues among residents in categorical pediatrics and availability of understandable health information for parents.

DESIGN/METHODS: As part of the 2005 AAP Graduating Residents Survey, 11 questions were asked about HL. After up to four mailings, 281 residents (56%) responded.

RESULTS: 90% had witnessed parents not sufficiently understanding the information delivered. Yet, 83% consider themselves to be "good" or "excellent" at converting medical terminology into everyday language for parents, and less than 1/3 would like more training in HL. On a five-item scale measuring confidence in HL skills (a=.816), residents with higher scores tend to begin HL discussions with patients at a younger age (p<.05), and those with lower scores desire more HL training (p<.001). Scores did not differ by gender (p=.286). Those with more formal training in parent/patient communication had higher scores on the scale (p<.001) than others. Only 32% "always" had interpretation services available, 21% "always" had health information materials easily understood by parents, and 15% "always" had health information materials in languages other than English. During training, 80% had exposure to a child literacy program such as "Reach Out and Read," and 82% were interested in future child literacy-promotion programs.

CONCLUSIONS: There appears to be a disjunction between pediatric residents' understanding of the HL issue, desire to help, and perception of their own competence in dealing with the problem. Formal training in communication appears to boost HL confidence. There is recognition of a lack of resources to help needy parents. There is a high degree of interest in participating in child literacy programs.