Parental health literacy and health knowledge, behaviours and outcomes in children: a cross-sectional survey

Abstract

Background: Health literacy (HL) is closely associated with leading health indicators such as engaging in healthy behaviours and experiencing a healthy social environment. Parents represent a critical subgroup among the adult population since they are not only responsible for their own health but also for the health of their children. Previous research suggests that parents with low HL are less likely to meet the preventive and health care needs of their children but there are gaps in the available information and there is not any data available yet for the German context. Methods: In preparation of an implementation study, a cross-sectional survey was conducted in 28 elementary and secondary schools in Germany. The parent questionnaire was completed by 4217 parents and included the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). The child questionnaire examined children's health knowledge, behaviours and outcomes. For children between 6 and 10 years, a parent reported on behalf of their children (N = 1518). Students 11 years and older completed a self-administered questionnaire (N = 2776). Bivariate and multivariate analyses were carried out. Spearman's Rho correlations assess the relationships between household characteristics, parental HL and the health behaviour and outcomes in children. Results: Among the participating parents, 45.8% showed problematic or inadequate HL. The major determinants of high parental HL were high socioeconomic status (SES) (r = .088***, 95% CI [.052, .124]), living in West Germany (r = .064***, 95% CI [.032, .096]) and older parental age (r = .057**, 95% CI [.024, .090]). In the multivariate model, only SES remained significant. High parental HL was associated with positive health behaviours in children including healthier nutrition, regular tooth brushing and more physical activity. The relationships between parental HL and smoking, alcohol, sexual activity among children and children's weight were not significant. Conclusions: The results confirm a relationship between low parental HL, SES and some child health behaviours likely to negatively impact their health and wellbeing including less healthy nutrition and less exercise. Strengthening the health knowledge and competencies of parents may contribute to improved child outcomes particularly in the areas of nutrition, exercise and dental health.

Heterogeneity of Access to Diabetes Technology Depending on Area Deprivation and Demographics Between 2016 and 2019 in Germany

“…4,10 Lower health literacy skills and more particularly lower parental perceived self-efficacy associated with lower socioeconomic status, may lead to a lower use of diabetes technology in more deprived regions. 12,25,26 Besides, the necessity to apply for reimbursement and the uncertainty of approval by health insurance may discourage some families in most deprived socioeconomic situations. 10,12 Overall, the persistent non-linear association between pump use and area deprivation indicates that several covariates with partly opposite effects are interacting.…”

Childhood Socioeconomic Position, Adult Educational Attainment and Health Behaviors: The Role of Psychological Capital and Health Literacy

“…The associations between SEP and health literacy have been established repeatedly. For example, in a recent study [23], high parental health literacy levels were predictive of healthier nutrition, increased physical activity, and regular tooth brushing in their children-and the only significant predictor of high health literacy was high SEP. Lower health literacy has, furthermore, consistently been associated with increased adult mortality, even after controlling for socioeconomic status [24]. Health literacy has also been shown to mediate between SEP-specifically, educational attainment -and self-reported health [25] and health behaviors [26].…”

Social Inequalities in Changes in Diet in Adolescents during Confinement Due to COVID-19 in Spain: The DESKcohort Project

“…Improving nutritional knowledge (school and family), establishing routines or rules related to meals, promoting home food availability of fruits and less healthful alternatives can be valuable ways of promoting healthy eating and reducing inequalities in dietary behaviors in adolescents [ 44 ]. Greater economic and educational resources can contribute to healthier dietary behavior through increased food budgets, nutritional knowledge, planning food purchases, and cooking skills [ 45 , 46 , 47 , 48 ]. Given that the availability and the purchase of food for the household are partly dependent on parents, these factors may play an important role in food choices by adolescents.…”