Health Literacy and Associated Outcomes in the Postpartum Period at Grady Memorial Hospital
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Health Literacy and Associated Outcomes in the Postpartum Period at Grady Memorial Hospital Jade D. Stafford1 · Emily R. Goggins1 · Eva Lathrop1 · Lisa B. Haddad1 Accepted: 5 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives Many studies correlate lower health literacy with poorer health outcomes and inferior provider-patient communication. Little is known about how impaired health literacy among women receiving prenatal care at inner city public hospitals may impact reproductive health behaviors and outcomes. The objective of this study was to assess health literacy among postpartum women receiving care at a public tertiary care center and to explore the association of impaired health literacy with prenatal care attendance and postpartum outcomes. Methods Written consent was obtained before completing the 7-item REALM-SF study tool to assess health literacy. A score of zero to three indicated low health literacy, four to six moderately low health literacy, and seven adequate health literacy. Patients completed a 25-item demographic questionnaire, and medical outcomes were obtained via this questionnaire and chart review. Descriptive statistics were generated, and bivariate and multivariate analyses evaluated the association between REALM-SF score and study outcomes. Results We recruited 300 adult English-speaking postpartum women and 293 were included in the final analysis. The majority of participants (53.9%) experienced impaired health literacy (score zero to six). Most respondents completed high school or higher education (77.1%), 17.8% had no prenatal care, and 83.6% reported that this pregnancy was unplanned. After adjusting for age, race, and education, women in the lowest health literacy group were less likely to indicate a plan to exclusively breastfeed (aRR = 0.54, p = 0.03). Conclusions for Practice Impaired health literacy affects a majority of our patients and is associated with reproductive health outcomes, including exclusive breastfeeding. Health care providers should attempt to overcome differences in health literacy through strong breastfeeding promotion. Verbal and written patient education materials should be tailored to the needs of patients with impaired health literacy. Keywords Breastfeeding · Contraception · Health literacy · Postpartum
Significance
Introduction
Low health literacy is associated with poor health outcomes and communication challenges. However, little is known about the association of health literacy on postpartum outcomes. After adjusting for age, race, and education, low health literacy was associated with decreased likelihood of planning to exclusively breastfeed.
Health literacy is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (US Department of Health and Human Services 2000). Health literacy is an essential element of a person’s ability to understand, process, and act on heal
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