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Health Literacy Among Parents of Newborn Infants

Mackley, Amy MSN, RNC-NIC, CCRC; Winter, Michael BS; Guillen, Ursula MD; Paul, David A. MD; Locke, Robert DO, MPH

Section Editor(s): Samra, Haifa A.

doi: 10.1097/ANC.0000000000000295
Professional Growth and Development

Background: Health Literacy is the ability to obtain, process, and understand health information to make knowledgeable health decisions.

Purpose: To determine baseline health literacy of neonatal intensive care unit (NICU) parents at a tertiary care hospital during periods of crucial information exchange.

Methods: Health literacy of English-speaking NICU parents was assessed using the Newest Vital Sign (NVS) on admission (n = 121) and discharge (n = 59). A quasi-control group of well-baby nursery (WBN) parents (n = 24) and prenatal obstetric clinic (PRE) parents (n = 18) were included. A single, Likert-style question measured nurses' assessment of parental comprehension with discharge teaching. Suspected limited health literacy (SLHL) was defined as the NVS score of 3 or less.

Findings/Results: Forty-three percent of parents on NICU admission and 32% at NICU discharge had SLHL (P < .01). SLHL for WBN and PRE parents was 25% and 58%, respectively. Parental age, gender, location, and history of healthcare-related employment were not associated with health literacy status at any time point. Thirty-nine percent of NICU parents and 25% of WBN parents with SLHL at time of admission/infant birth had a college education. Nurse subjective measurement of parental comprehension of discharge instructions was not correlated to the objective measurement of health literacy (P = .26).

Implications for Practice: SLHL is common during peak time periods of complex health discussion in the NICU, WBN, and PRE settings. NICU providers may not accurately gauge parents' literacy status.

Implications for Research: Methods for improving health communication are needed. Studies should evaluate SLHL in a larger NICU population and across different languages and cultures.

Department of Pediatrics, Division of Neonatology, Christiana Care Health System, Newark, Delaware (Ms Mackley and Drs Guillen, Paul, and Locke); Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania (Mr Winter); and Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (Drs Guillen, Paul, and Locke).

Correspondence: Amy Mackley, MSN, RNC-NIC, CCRC, Department of Pediatrics, Division of Neonatology, Christiana Care Health System, 4745 Ogletown-Stanton Rd, MAP 1, Ste 217, Newark, DE 19713 (

Institution where work occurred: Christiana Care Health System.

Partially supported by grants from NCRR (5P20RR016472-12) and NIGMS (8 P20 GM103446-12) at the National Institutes of Health, and the state of Delaware.

The authors declare no conflicts of interest.

© 2016 by The National Association of Neonatal Nurses