Learning Objective #1: Describe the health literacy environment

Learning Objective #2: Define key literacy and health literacy concepts and measurement instrumentation

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Introduction: Insuring the understanding of health information and obtaining informed consent is difficult when there is a gap in health literacy due to a diverse multinational child/parent population. In 2003, this children's hospital had 1618 admissions with over 50% listing their primary language as Spanish and 43% being residents of countries other than the United States (39% Mexico, 4% Central and South America). Method: The first step in understanding the problem was to review existing health literacy research in educational materials, informed consents, and issues with translation/interpretation for Spanish speaking parents/patients. Findings: There is little research conducted on health literacy and reading ability versus understanding/applying the information in Spanish speaking populations. Of the studies reviewed in health care education (N = 26), informed consents (N = 8), and cross-cultural populations (N = 11), none were specifically related to our population. The only research found for a similar population is not health related but regarding reading literacy of itinerant farm workers. Reliable instruments are available for assessing our populations reading level, health literacy level, and the readability of written health information and consents. Research measuring understanding and application of information in a Spanish-speaking population has been infrequently reported. Next Steps: Determine the range of health literacy levels of our population and which instrument works best; Investigate how determining literacy level relates to child/parent comprehension and adherence to recommended medical regimens; Determine the adequacy of our translation, and explanation efforts in communicating health information and obtaining informed consent. Implications: It is important to increase staff awareness of child/parent literacy issues. There may be a need for different methods (audio or video) to provide health information and to develop several versions of the same written materials. There is a need for guidelines for appropriate readability level and methods of achieving the appropriate level.