Effect of Literacy on Breast-feeding Outcomes

University of New Mexico, Albuquerque, New Mexico, United States
Southern Medical Journal (Impact Factor: 0.93). 04/2001; 94(3):293-6. DOI: 10.1097/00007611-200103000-00005
Source: PubMed


We studied the effect of functional health literacy on the initiation and continuance of breast-feeding in women at a public health clinic.
Subjects were 61 first-time mothers aged 18 years or older who spoke English as their first language. They were divided into two groups, one who exclusively breast-fed for at least the first 2 months and one who never initiated breast-feeding or did not exclusively breast-feed for at least 2 months. The Rapid Estimate of Adult Literacy in Medicine (REALM) was administered, providing reading grade-level estimates for each subject.
An association between functional health literacy and breast-feeding was seen, with only 23% of the women in the lower literacy group exclusively breast-feeding during the first 2 months compared with 54% of women in the higher literacy group.
Many patients need simpler health education materials encouraging breastfeeding. These materials are needed both before and during pregnancy.

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    • "Low health literacy levels has been associated with reduced use of health services (Berkman et al., 2011), and inappropriate use of services such as attending emergency departments for non-urgent issues (Kubicek et al., 2012), difficulties contacting after-hours medical providers (Yin et al., 2012) and in actioning health referrals (Jimenez et al., 2013). In addition, Kaufman et al. (2001) found that low health literacy was associated with low levels of breastfeeding. Research into the impact of parental health literacy on childhood asthma has identified that parents with low health literacy are less likely to report their child as being in good health (Dunn-Navarra et al., 2012) and in many instances they will say that their asthmatic child is in poor or fair health. "
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    ABSTRACT: Most families can access a range of health information and advice. Information and advice sources often include nurses, the Internet, social media, books, as well as family and friends. While the immediate aim may be to find information, it can also be to assist with parenting skills, solve parenting problems or as part of decision-making processes about their child’s health. These processes are strongly influenced by the parent’s level of health literacy. Health literacy describes a person’s capacity to obtain and utilize health related information. Although there are numerous health literacy definitions all have clearly defined steps. These steps are: obtaining relevant information; then understanding this information; and finally being able to use the information to achieve the expected outcome. Previous research has linked low levels of parental health literacy with poorer child health outcomes. Given this link, increasing health literacy levels would be advantageous for both families and health services. Nurses working with families are in a position to support the family to increase their health literacy through the use of a variety of strategies. This article outlines how health literacy can influence the way parents seek help when they are concerned about child health issues, the relevance of parental health literacy for nurses and suggests some tools that could be used to support the increase of health literacy.
    No preview · Article · Aug 2015 · Issues in Comprehensive Pediatric Nursing
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    • "A 2011 meta-analysis conducted for the Agency for Healthcare Research and Quality found that low health literacy is associated with lower acceptance of influenza vaccine and decreased ability to interpret health messages [11]. Other studies have found that women with low health literacy are less likely to breastfeed [12], plan their pregnancy [13], and to be insured [14]. These associations are not consistent across all studies, suggesting that other factors, such as attitudes and cultural beliefs about medicine, may mediate the effect of health literacy on health behaviors [15]. "
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    ABSTRACT: Background Text4baby provides educational text messages to pregnant and postpartum women and targets underserved women. The primary purpose of this study is to examine the health behaviors and cell phone usage patterns of a text4baby target population and the associations with health literacy. Methods Pregnant and postpartum women were recruited from two Women, Infant and Children clinics in Atlanta. Women were asked about their demographics, selected pregnancy or postpartum health behaviors, and cell phone usage patterns. Health literacy skills were measured with the English version of the Newest Vital Sign. Multivariable logistic regression was used to examine health behaviors and cell usage patterns by health literacy classification, controlling for commonly accepted confounders. Results Four hundred sixty-eight women were recruited, and 445 completed the Newest Vital Sign. Of these, 22% had inadequate health literacy, 50% had intermediate health literacy, and 28% had adequate health literacy skills. Compared to adequate health literacy, limited literacy was independently associated with not taking a daily vitamin during pregnancy (OR 3.6, 95% CI: 1.6, 8.5) and never breastfeeding their infant (OR 1.4, 95% CI: 1.1, 1.8). The majority (69.4%) of respondents received nine or more text messages a day prior to enrollment, one in four participants (24.6%) had changed their number within the last six months, and 7.0% of study participants shared a cell phone. Controlling for potentially confounding factors, those with limited health literacy were more likely to share a cell phone than those with adequate health literacy (OR 2.57, 95% CI: 1.79, 3.69). Conclusions Text4baby messages should be appropriate for low health literacy levels, especially as this population may have higher prevalence of targeted unhealthy behaviors. Text4baby and other mhealth programs targetting low health literacy populations should also be aware of the different ways that these populations use their cell phones, including: sharing cell phones, which may mean participants will not receive messages or have special privacy concerns; frequently changing cell phone numbers which could lead to higher drop-off rates; and the penetrance of text messages in a population that receives many messages daily.
    Full-text · Article · May 2014
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    • "Five studies were found to have investigated the relationships between health literacy levels and preventive health or health risk behaviours [22,29-32]. All used the REALM to measure health literacy but no two used the same levels for comparison. "
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    ABSTRACT: Much of the evidence of an association between low functional or health literacy and poor health comes from studies that include people who have various cognitive difficulties or who do not speak the dominant language of their society. Low functional or health literacy among these people is likely to be evident in spoken conversation. However, many other people can talk readily about health and other issues but have problems using written information. Consequently, their difficulties may be far less evident to healthcare professionals, creating a 'hidden population' whose functional or health literacy problems have different implications because they are less likely to be recognised and addressed.We aimed to review published research to investigate relationships between low functional or health literacy and health in working age adults who can converse in the dominant language but have difficulty with written language. We searched reviews and electronic databases for studies that examined health-related outcomes among the population of interest. We systematically extracted data relating to relationships between low functional or health literacy and both health status and various possible mediators or moderators of the implications of literacy for health. We developed a narrative review. Twenty-four studies met our inclusion criteria. Lower functional or health literacy in this population was found to be associated with worse health status. This may be mediated by difficulties accessing healthcare, and poorer self-management of health problems. It is currently unclear whether, how or to what extent these difficulties are mediated by poorer knowledge stemming from low functional or health literacy. The variation in functional or health literacy measures and comparisons make it difficult to compare study findings and to establish the implications of different literacy issues for health outcomes. There is evidence in the literature that low functional or health literacy is associated with poor health in the 'hidden population' of adults whose literacy difficulties may not be evident to health care providers. Further research is needed to help understand the particular disadvantages faced by this population and to establish appropriate responses.
    Full-text · Article · Aug 2010 · BMC Public Health
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