Association Between Caregiver Health Literacy, Social Determinants of Health, and the Pediatric Oncology New Diagnosis Educational Experience

IF 2.3 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2025-08-29 DOI:10.1002/pbc.32014

K. Elizabeth Skipper, Aman Wadhwa, Peng Li, Marti Rice, Nataliya V. Ivankova, Paula D. Campos González, Adelynn J. Salem, Smita Bhatia, Wendy Landier

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Abstract

Background

Caregiver new diagnosis education is understudied in pediatric oncology. Caregiver health literacy (HL) and social determinants of health (SDoH) may affect the caregiver-reported educational experience (CREE) of receiving new diagnosis education. Our purpose was to determine relationships between HL, SDoH, and CREE by surveying caregivers who received new diagnosis education for their children undergoing cancer treatment.

Procedure

HL was assessed using the Newest Vital Sign (limited HL: 0–3; adequate HL: 4–6). Five SDoH domains (economic stability; education access/quality; healthcare access/quality; neighborhood/built environment; social/community context) were assessed (adverse SDoH: ≥1 adverse factor). CREE was assessed using items adapted from the Agency for Healthcare Research and Quality (AHRQ) Health Literacy Supplemental Items (possible range: 6–36; unfavorable: <33). Multivariable logistic regression was used to identify associations between unfavorable CREE score (outcome), SDoH, and HL, adjusting for caregiver sociodemographic and child clinical factors.

Results

Of 67 caregivers, 77.6% were mothers, 65.7% non-Hispanic White, median [range] age was 34 [20–69] years. Among the patients (N = 67): males were 56.7%, leukemia 55.2%, and median [range] age 4.4 [0.2–17.5] years. Over one-third (35.8%) of caregivers had limited HL, 71.6% had one or more adverse SDoH, and 40.3% reported unfavorable CREE. In multivariable logistic regression, adverse SDoH was associated with 6.3-fold higher odds of unfavorable CREE (adjusted odds ratio [aOR] = 6.3, 95% confidence interval [CI] = 1.4–28.7, p = 0.017); adequate HL was associated with 8.0-fold higher odds of unfavorable CREE (aOR = 8.0, 95% CI = 1.9–34.4, p = 0.005).

Conclusions

SDoH and HL are important factors to consider when providing new diagnosis education to pediatric oncology caregivers.

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护理人员健康素养、健康的社会决定因素和儿科肿瘤新诊断教育经验之间的关系。

背景：儿童肿瘤护理人员新诊断教育研究不足。照顾者健康素养（HL）和健康的社会决定因素（SDoH）可能影响照顾者报告的接受新诊断教育的教育经历（CREE）。我们的目的是通过调查接受新诊断教育的护理人员来确定HL、SDoH和CREE之间的关系。程序：使用最新生命体征评估HL（有限HL: 0-3；充足HL: 4-6）。评估了五个SDoH领域（经济稳定性、教育可及性/质量、医疗可及性/质量、邻里/建筑环境、社会/社区背景）（不利SDoH:≥1个不利因素）。CREE的评估项目改编自卫生保健研究和质量机构（AHRQ）健康素养补充项目(可能范围：6-36；不利：结果：67名护理人员中，77.6%为母亲，65.7%为非西班牙裔白人，年龄中位数[范围]为34岁[20-69]岁。67例患者中，男性56.7%，白血病55.2%，中位年龄4.4岁[0.2 ~ 17.5]岁。超过三分之一（35.8%）的护理人员有有限的HL， 71.6%有一个或多个不良的SDoH， 40.3%报告不良的CREE。在多变量logistic回归中，不良SDoH与不良CREE的几率高6.3倍相关（校正优势比[aOR] = 6.3, 95%可信区间[CI] = 1.4 ~ 28.7, p = 0.017）；足够的HL与8.0倍的不良CREE发生率相关（aOR = 8.0, 95% CI = 1.9-34.4, p = 0.005）。结论：SDoH和HL是儿科肿瘤护理人员进行新诊断教育时需要考虑的重要因素。

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来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.