Health Literacy Implications for Health Care Reform Workshop Summary (2011) / Chapter Skim
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Appendix D: Health Literacy and the Health Reform: Where Do Children Fit In?
Appendix D: Health Literacy and the Health Reform: Where Do Children Fit In?
Pages 101-114
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From page 101... ...
Two recent reviews suggest that the strongest and most consistent associations are those between a mother's health literacy and her own mental health (itself a modifiable determinant of child health) , between a mother's health lit eracy and her child's access to needed care, and between an adolescent's health literacy and her/his likelihood to engage in risky health behaviors.
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From page 102... ...
As a health-literate adult, Zoe effectively accesses and uses written and electronic health information, and she serves as an effective advocate for her own health, for her children's health, and for her grandchildren's health. At the population-health and public-policy level, this life-course perspective suggests that improving the nation's health will require coordinated investments from educational and health systems to support the health literacy skills of individuals as they mature from newborn citizens to senior citizens.
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From page 103... ...
and CHIPlegislated standards.19 While the complexity of enrollment forms is clearly a significant enrollment barrier for low-literacy families with CHIP or Medicaid-eligible children,97 a recent Urban Institute study suggested that the barriers to CHIP enrollment were myriad, including cumbersome enrollment eligibility screening processes, narrow enrollment periods, and under-resourced state outreach efforts. In response to Children's Health Insurance Reauthorization Act (CHIPRA)
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From page 104... ...
C Bundle the eligibility assessment for all maternal and child health pro grams (e.g., WIC, SNAP, school-lunch program, CHIP, Medicaid for children, and Medicaid for adult caregivers of eligible children)
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From page 105... ...
Improving health care quality for all children will likely require health system changes that provide each child with a Family-Centered Medical Home, an evidence-based system of care that was originally developed to attend to the needs of children with complex chronic conditions.2,4,73 The key components of a family-centered medical home are continuous access to comprehensive, culturally effective, and coordinated care that meets the health and developmental needs of the child and her/ his family. In practice, this often means minor restructuring to a hospital or primary care system that facilitates 24/7 telephone access and a care coordinator (nurse, parent, or community health worker)
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From page 106... ...
In studies among children with asthma and type-1 diabetes, those who have caregivers with low health literacy are at increased risk for unmet health care needs, worse control of illness, and more preventable use of the emergency room.92-95 Adjusted for socioeconomic status and ethnicity, mothers with low health literacy skills are more likely to smoke96 and to have depressive symptoms.45-48 Several studies have demonstrated that mothers with low literacy were significantly less likely to understand information regarding home safety for young children.15,29 Low maternal health literacy is associated with increased risk for child obesity -- including a decreased likelihood of exclusive breastfeeding at two months postpartum,40 decreased ability to understand and use and WIC information,51 nonuse of nutrition-fact labels when choosing food for their children,42 and inaccurate perception of child weight.43 Parent health literacy may be a critical family-centered characteristic that moderates the effectiveness of the Family-Centered Medical Home -- for children with chronic health conditions, for children at risk for chronic-health conditions, and for all children. At the level of state programs, health systems, and individual practices -- a Family-Centered Medical Home reform offers ready opportunities to implement both "universal health literacy precautions" and targeted approaches that provide families with limited health literacy a more culturally effective and intensive care coordination to meet their children's health needs.
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From page 107... ...
By funding the CDC and the NIH to develop low-literacy decision aids to enhance shared decision making, Section 3506 pro vides a platform for developing systems that increase parent and child involvement in the care of a child chronic illness. To be effec tive for child health, these decision aids must be family-centered, with an attention not only to the literacy-needs of parents, but also to the developmentally-appropriate literacy skills of children.
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From page 108... ...
that target high-impact child health out comes: healthy nutritional and physical activity behaviors, child safety behaviors, oral health practices, childhood immunizations, interpretation of common child health screening tests, parent men tal health, and parent smoking cessation.
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From page 109... ...
Make health literacy training a required component of post graduate training in child health (e.g., Pediatrics, Family Medicine, Pediatric Nurse Practitioners)
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From page 110... ...
2. AAP National Center of Medical Home Initiatives for Children with Special Needs, www.medicalhomeinfo.org, accessed March 8, 2009.
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From page 111... ...
Low caregiver health literacy: risk factor for child access to a medical home. Presented at the Pediatric Academic Societies Annual Meeting; May 15, 2005; Washington, DC.
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From page 112... ...
Parent depression and low health literacy: risk factors for child health disparities? Pediatric Academic Societies Annual Meeting, Toronto, Canada, 5-8 May 2007.
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From page 113... ...
Doak CC, Doak LG, Root JH. Teaching Patients with Low Literacy Skills, 2nd ed., Philadelphia: Lippincott; 1996.
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From page 114... ...
Low Parent Health Literacy is Associated with Poor Glycemic Control in Children with Type 1 Diabetes Mellitus. Pediatric Academic Societies Meeting, Honolulu, May 2008 95.
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