More than one in four parents in the United States of America (USA) have low health literacy, which is associated with reduced health equity and negatively impacts child health outcomes. Early intervention (EI) programs are optimally placed to build the health literacy capacity of caregivers, which could improve health equity. The health literacy of interdisciplinary EI providers has not previously been measured. This study used the Health Literacy Questionnaire (HLQ) with EI providers (n = 10) to investigate evidence based on response (cognitive) processes. Narratives from cognitive interviews gave reasons for HLQ score choices, and concordance and discordance between HLQ item intent descriptions and narrative data were assessed using thematic analysis. Results found scales with highest concordance for Scales 3, 6, and 9 (each 96%, n = 24). Concordance was lowest on Scale 5 (88%, n = 22), although still strong with only 12% discordance. Three themes reflecting discordance were identified: (1) Differences between Australian and USA culture/health systems; (2) Healthcare provider perspective; and (3) Participants with no health problems to manage. Results show strong concordance between EI providers’ narrative responses and item intents. Study results contribute validity evidence for the use of HLQ data to inform interventions that build health literacy capacity of EI providers to then empower and build the health literacy of EI parents.

No abstract

Background: Early intervention (EI) providers work with parents of children with or who have risk factors of developmental delay or disability through Part C of the Individuals with Disabilities Education Act. Many parents in the United States have low health literacy; therefore, EI providers should be aware of and address families' health literacy needs. EI providers need to be health literate themselves to implement evidence-based recommended practices. Objective: This study aimed to measure health literacy levels of interdisciplinary EI providers and investigate associations between health literacy levels and demographic variables. Methods: A survey containing the Health Literacy Questionnaire (HLQ) was completed by EI providers working at 10 EI centers in Massachusetts. Scale scores were calculated and compared across demographic variables, including EI job role, age, years of EI experience, and highest education level. Key Results: Of 715 EI providers invited to participate, 376 surveys were completed (52.6% response rate). Most participants were women (92.6%, n = 348), reported race as White (85.4%, n = 321), had a mean age of 43.1 years (standard deviation [ SD ] 12.9) ranging from 20 to 74 years, and English as their primary language (89.6%, n = 337). EI providers scored the lowest on HLQ Scale 5 “Appraisal of health information” (mean [ M ] = 2.99 ( SD 0.50) [confidence interval (CI) 2.93, 3.04]), and Scale 7 “Navigating the healthcare system” ( M = 3.83 ( SD 0.58) [CI 3.77, 3.89]). EI providers having stronger health literacy profiles were generally older, with a higher education level, were licensed providers, or had more years of EI work experience. Conclusions: EI providers require adequate health literacy to manage their health needs and to effectively provide services to EI families. Study results may inform future targeted professional development to support improvement of EI providers' health literacy skills, including appraisal of health information and navigation of the health care system. [ HLRP: Health Literacy Research and Practice . 2022;6(2):e128–e136. ] Plain Language Summary: EI providers' health literacy profiles have not been previously investigated. Study results reveal EI providers struggled with health literacy skills of appraising health information and navigating the health care system, which are vital for EI practice. Health Literacy Questionnaire results can inform targeted professional development to improve EI providers' health literacy levels and their clinical practice.

Date Presented 03/28/20 Nationally, only 10% of children eligible for EI receive services. Parents with low health literacy have difficulty accessing the EI system. Accessible written information is needed to reduce this difficulty. This study evaluated EI materials provided by one state’s Department of Public Health. Four assessment tools measured accessibility, including the CDC Clear Communication Index. None of 26 materials had adequate scores. Materials need to be revised to be effective. Primary Author and Speaker: Catherine Leslie Additional Authors and Speakers: Taylor Delosh Contributing Authors: Jillian Crehan

Date Presented 03/26/20 This scoping review found 27 articles relating health literacy to EI. Analysis resulted in multiple themes, including a need for training to improve communication skills of EI providers, revision of written EI materials needed to increase effectiveness, and recommendations for making the EI system more accessible. Use of health-literacy principles by OT practitioners working in EI programs could improve access, utilization, and child outcomes for families. Primary Author and Speaker: Catherine Leslie Additional Authors and Speakers: Jillian Crehan