Parental Health Literacy: The cognitive and social skills that determine the motivation and ability of parents to gain
access to, understand, and use
information and services in ways that promote and maintain
their health and that of their children*. At Beginnings Guides and the Center for Health Literacy Promotion, we
focus on Maternal Health Literacy,
that is, what mothers actually do for personal and child health with the information
and services available to them, or said another way, how mothers integrate health
info and services into their daily lives. Reason #1 Skills for effective
parenting also are skills for health literacy. Literacy and health
literacy are foundational to the goals of home visitation and to parents’
goals for their
families. Conversely, low literacy and low health literacy are barriers to
home visiting and
family goals. Cognitive skills for
health literacy are the 3Rs (reading, ‘riting and ’rithmatic),basic
literacy skills needed to participate in society (e.g. employment,
healthcare), utilize community
resources, and promote school readiness. Social skills for health literacy are interaction
and reflection. Home visitors will recognize these skills as the foundation
for attachment
and bonding and responsive parenting. Way #1: Add local literacy enhancing services to your list of community
partners. Consider
adult basic education, English Language Learning, public library programs,
GED programs,
and tutoring services. Plan with them a collaborative process to refer parents speaker
or teacher to help integrate health education into local literacy programs.
Use the Beginnings Pregnancy Guide or Parent’s Guide as curriculum to simultaneously address literacy/health
literacy and health education. Or focus a session or series of sessions on the Key Messages. Way #2 Identify parents with low
literacy skills.
You can use the ELF, a 3-question screen that
produces a proxy REALM (Rapid Estimate of Adult Literacy in Medicine) score
without a potentially
embarrassing and alienating literacy test. Or use this 1- question screen:
“How many
books to you have?” Observation or self-report of owning 10 or more adult or
child books indicates
adequate literacy. Way #3 Learn to ask reflective
questions. Reflective questions (RQs) or “Teaching by
Asking” develops
interactive and reflective skills – the social skills at the foundation
of both health literacy and
parenting. RQ’s require the parent to think
about facts, events, behaviors; link to
feelings,consequences,
knowledge, experience; and formulate a positive, purposeful response.; in short, to Think, Link and Respond. Reason #2 Home visitors’ usual
efforts can promote health literacy. Health literacy is promoted
through health education, skills development and direct assistance to use
info and services
for health. So, when visitors are
equipped with knowledge of health literacy and some simple
strategies, usual health education and skills development efforts to promote
attachment and
bonding, responsive parenting, and school readiness can also promote
functional health literacy.
Way #4 Offer direct
assistance to use info and services for health. This part may be new to home
visitors. Training is available to help programs
integrate assistance to make meaning from
information and apply it in context into health education activities. This
may be as simple as
inviting the parent to read aloud and highlight a pertinent paragraph from Beginnings Guides and then
talking about it together. Reading aloud takes learning deeper faster because
it uses multiple
senses. Or direct assistance might be reviewing with the parent materials
obtained at a
doctors’ visit, such as an appointment slip for the next visit. Ensure the
parent can find the time and
date; enter the appointment on a calendar. Then discuss what needs to happen
to keep the
appointment (transportation, childcare, time off work), and what questions
s/he wants to ask the
doctor. Notes
& References *Adapted from the definition of maternal health literacy in
Renkert, S. & Nutbeam,
D. (2001). Opportunities to improve maternal health literacy through
ante-natal education:
An exploratory study. Health Promotion
International, 16, 381–388. Stay tuned for more reasons and ways to
promote health literacy in home visitation. Davis,
T.C., Crouch, M.A., Long, S.W., Jackson, R. H., Bates, P. George, R.B. &
Bairnsfather, L.E.
(1991). Rapid assessment of literacy levels of adult primary care patients. Family Medicine, 23, 433-435. Bennett,
I.M., Robbins, S. & Haecker, T. (2003). Screening for low literacy among
adult caregivers
of pediatric patients. Family Medicine,
35, 585-590 attachment,
and the transmission gap: a preliminary study.Attachment and Human Development 7(3):283-98. Wallace, L. S., Rogers,
E. S., Roskos, S. E., Holiday, D. B. & Weiss, B. D. (2005). Brief
report: Screening items to identify patients with limited health literacy
skills. Journal of General Internal Medicine, 21, 874–877. |
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CategoriesHealth LiteracyMaternal Child Health |
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