Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health

Background: Although health literacy (HL) skills may change over time, most research treats HL as a constant, using baseline HL to predict other health-related constructs. Few studies have explored change in HL over time. Objective: We examined person-level differences in HL trajectories. We identif...

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Main Authors: Sarah J. Schmiege, Luohua Jiang, Judith Albino, Rachel L. Johnson, Anne R. Wilson, Angela G. Brega
Format: Article
Language:English
Published: SLACK Incorporated 2023-04-01
Series:Health Literacy Research and Practice
Online Access:https://journals.healio.com/doi/10.3928/24748307-20230419-01
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author Sarah J. Schmiege
Luohua Jiang
Judith Albino
Rachel L. Johnson
Anne R. Wilson
Angela G. Brega
author_facet Sarah J. Schmiege
Luohua Jiang
Judith Albino
Rachel L. Johnson
Anne R. Wilson
Angela G. Brega
author_sort Sarah J. Schmiege
collection DOAJ
description Background: Although health literacy (HL) skills may change over time, most research treats HL as a constant, using baseline HL to predict other health-related constructs. Few studies have explored change in HL over time. Objective: We examined person-level differences in HL trajectories. We identified subgroups (latent classes) based on longitudinal assessments of HL and examined the association of class membership with demographic and oral health variables. Methods: We used four measurement waves of parental HL data, reflecting the risk of limited HL, collected as part of an intervention to reduce dental decay in American Indian children (N = 579 parent-child dyads at baseline). Repeated measures latent class analysis (RMLCA) models were estimated to identify subgroups of HL trajectories over time. We examined class membership in association with baseline demographics and with 36-month assessments of parental oral health knowledge, beliefs, and behaviors as well as pediatric oral health. Key Results: A four-class model best fit the data. The largest class (high HL; 49.7% of the sample) was characterized by high levels of HL at all waves. A second class (improving HL; 17.7%) improved over all waves. The remaining two classes were characterized as moderate HL (20%) and low HL (12.6%) and maintained relatively stable HL levels over time. Higher educational attainment was associated with membership in the high HL and improving HL classes. Older age among this young-adult sample and higher income also were associated with high HL class membership. Parents in the high HL and improving HL classes exhibited more favorable performance on measures of oral health knowledge, beliefs, and behavioral adherence than did those in the other classes. Class membership was not associated with pediatric oral health. Conclusions: RMLCA demonstrated person-level variability in HL trajectories. Longitudinal patterns were associated with baseline demographics and prospectively with parental oral health knowledge, beliefs, and behaviors, but not with pediatric oral health. [HLRP: Health Literacy Research and Practice. 2023;7(2):e89–e98.]
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spelling doaj.art-fe8b3575127048f9a9acb74ee5ba3b5e2023-08-09T13:37:35ZengSLACK IncorporatedHealth Literacy Research and Practice2474-83072023-04-0172e89e9810.3928/24748307-20230419-01Patterns of Change in Parental Health Literacy in Relation to Children's Oral HealthSarah J. SchmiegeLuohua JiangJudith AlbinoRachel L. JohnsonAnne R. WilsonAngela G. BregaBackground: Although health literacy (HL) skills may change over time, most research treats HL as a constant, using baseline HL to predict other health-related constructs. Few studies have explored change in HL over time. Objective: We examined person-level differences in HL trajectories. We identified subgroups (latent classes) based on longitudinal assessments of HL and examined the association of class membership with demographic and oral health variables. Methods: We used four measurement waves of parental HL data, reflecting the risk of limited HL, collected as part of an intervention to reduce dental decay in American Indian children (N = 579 parent-child dyads at baseline). Repeated measures latent class analysis (RMLCA) models were estimated to identify subgroups of HL trajectories over time. We examined class membership in association with baseline demographics and with 36-month assessments of parental oral health knowledge, beliefs, and behaviors as well as pediatric oral health. Key Results: A four-class model best fit the data. The largest class (high HL; 49.7% of the sample) was characterized by high levels of HL at all waves. A second class (improving HL; 17.7%) improved over all waves. The remaining two classes were characterized as moderate HL (20%) and low HL (12.6%) and maintained relatively stable HL levels over time. Higher educational attainment was associated with membership in the high HL and improving HL classes. Older age among this young-adult sample and higher income also were associated with high HL class membership. Parents in the high HL and improving HL classes exhibited more favorable performance on measures of oral health knowledge, beliefs, and behavioral adherence than did those in the other classes. Class membership was not associated with pediatric oral health. Conclusions: RMLCA demonstrated person-level variability in HL trajectories. Longitudinal patterns were associated with baseline demographics and prospectively with parental oral health knowledge, beliefs, and behaviors, but not with pediatric oral health. [HLRP: Health Literacy Research and Practice. 2023;7(2):e89–e98.]https://journals.healio.com/doi/10.3928/24748307-20230419-01
spellingShingle Sarah J. Schmiege
Luohua Jiang
Judith Albino
Rachel L. Johnson
Anne R. Wilson
Angela G. Brega
Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health
Health Literacy Research and Practice
title Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health
title_full Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health
title_fullStr Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health
title_full_unstemmed Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health
title_short Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health
title_sort patterns of change in parental health literacy in relation to children s oral health
url https://journals.healio.com/doi/10.3928/24748307-20230419-01
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