Screening for low literacy among adult caregivers of pediatric patients

Fam Med. 2003 Sep;35(8):585-90.


Background and objectives: The association between functional illiteracy and poor health has led to pediatric literacy promotion programs in the primary care setting. These interventions do not address linked parental literacy needs. An obstacle to referring adults to literacy services is the lack of an instrument that can efficiently identify individuals who could benefit from such programs. We sought to identify screening items sufficiently simple to use in clinical practice.

Methods: This cross-sectional study examined 98 adult primary caregivers of preschool children seen in an inner-city primary care setting. Literacy level and 17 variables predicted to be associated with low literacy were assessed.

Results: Three items were independently associated with a 6th grade reading level: (1) less than 12th grade completion, (2) not living with the child's other parent, and (3) not reading for pleasure. Receiver operating characteristic (ROC) curve analysis indicates that, used together, these variables have discriminant capacity, with an area under the ROC curve of.76.

Conclusions: Three items for use in a simple screening instrument for parental low literacy were identified. Used together, they had favorable characteristics but must be further tested for generalizability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Caregivers / statistics & numerical data*
  • Chi-Square Distribution
  • Child Care / standards
  • Child Care / statistics & numerical data*
  • Child, Preschool
  • Confidence Intervals
  • Cross-Sectional Studies
  • Educational Status*
  • Humans
  • Multivariate Analysis
  • Odds Ratio
  • Primary Health Care
  • Sensitivity and Specificity
  • Surveys and Questionnaires
  • United States