Maternal health literacy among low-income mothers with infants



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Limited health literacy in parents often negatively influences their children’s health. Maternal health literacy in low-income families has been hypothesized as an important predictor of the health of family members, especially infants. This study of low-income families in Travis County, Texas, was conducted with the following objectives: (1) to characterize the level of maternal health literacy and its correlates within the family, (2) to determine relationships between maternal health literacy and health outcomes of families’ infants, and (3) to identify the underlying pathways that might describe the effect of maternal health literacy on theoretically selected mediators and, ultimately, on health outcomes of infants. The study’s conceptual framework was adapted from the Paasche-Orlow Wolf conceptual model. This study used a descriptive, cross-sectional, correlational design. Trained bilingual RAs collected data from low-income mothers of infants at two federally qualified community clinics in Travis County, Texas. The data were collected with the use of two health literacy scales: the Newest Vital Sign (NVS) screening tool for functional health literacy and the Parental Health Literacy Activities Test (PHLAT) for maternal health literacy. Individual health literacy abilities among mothers varied on the NVS and PHLAT. In the study sample, 72% and 63.4% of mothers on the NVS and PHLAT, respectively, were rated as having low health literacy. In the bivariate analysis, functional and maternal health literacy were positively correlated with education, household income, social support, and parenting self-efficacy, and they were negatively correlated with number of children. In the hierarchical multiple linear regression, race/ethnicity, education, and social support were found to significantly predict functional health literacy, and education was a significant predictor of maternal health literacy. Mothers with adequate health literacy tended to use more formal information sources than did mothers with low health literacy. There were significant differences in maternal health literacy and infant growth status. The study’s findings demonstrate that parenting self-efficacy has a mediating effect on health literacy and early parenting practices among mothers with infants. Mothers with low education levels and an ethnic minority status demonstrated low health literacy. Future research is needed to advance knowledge about maternal health literacy in low-income mothers and to inform potential heath literacy interventions for this target population.