Empowering Low-Income Parents with Skills to Reduce Excess Pediatric Emergency Room and Clinic Visits through a Tailored Low Literacy Training Intervention

Abstract

In this article, we evaluate the impact of a health literacy intervention to decrease emergency room and doctor's office visits for common childhood illness symptoms. Our education model trained low-income parents of young children (9,240 families) at 55 Head Start sites on the use of a low-literacy health book to respond to common childhood illnesses. The overall strategic framework required each Head Start site to create a Health Improvement Project to plan, successfully train, monitor, and keep the momentum through a strong follow-up with families regarding their health care decisions. The study was conducted from 2003 to 2006. Each family was tracked for 3 months prior to the training using self-report, and for 6 months afterward. The average number of emergency room and doctor visits among parents decreased 58% and 41% respectively (p < .001). Further, work days missed by the primary caretaker per year decreased 42%, and school days missed per year decreased 29% (p < .001). During the health literacy intervention, emergency room and doctor visits reported among parents decreased, as well as the number of work days and school days missed per year. Significant cost savings for the health care system can be anticipated through thoughtful broad dissemination of this training model.

Notes

*SD of the difference before/after intervention was calculated as sqrt(SD_before+SD_after).

**95% confidence interval was calculated based on the value of z_0.25 = 1.96 obtained from a table of normal distribution values.

Sources: Machlin, 2008; USC Center for Health Financing, Policy, & Management, 2008; Williams, 1996, 2005.