Embedding a Health Literacy Intervention Within Established Parenting Groups: An Australian Feasibility Study

Abstract

Background: A significant proportion of new parents in high-income countries have lower health literacy, but few health literacy interventions exist for this group. Objective: This study investigated the feasibility of delivering health literacy content within existing postnatal parenting groups. Methods: Multicenter feasibility study using a seven-group pre-test post-test design. Parents older than age 16 years with children between age 4 and 26 weeks with sufficient English fluency were invited to participate in a 4-week health literacy program (four 2-hour sessions) delivered by trained facilitators (e.g., child and family health nurses). Mixed-methods evaluation was used, with quantitative data analyzed descriptively and qualitative data (e.g., focus groups, observations, interviews) analyzed using the Framework approach. Key Results: Our health literacy program was successfully delivered at six sites in New South Wales, Australia, in 2018. Our recruitment strategy was successful in reaching diverse learners (N = 73), many who were born in a country other than Australia. However, few had limited health literacy as assessed by a subjective, single-item measure, and only half completed the follow-up questionnaires. High baseline knowledge, skills, and confidence among participants limited the potential for change in these quantitative outcomes but shed light on the utility of different measurement instruments in this context. Qualitative analyses suggested that the health literacy program aligned well with the institutional objectives of child and family health services and was acceptable to learners from diverse cultural backgrounds. However, in its current form, it may be perceived as too simple for learners with higher levels of education and literacy. Conclusions: Our study has offered practical insights into the feasibility of embedding a health literacy intervention into established postnatal parenting groups and shown how program resources and facilitator training could be adapted to make the program more suitable for a range of learners and better support facilitators. [HLRP: Health Literacy Research and Practice. 2020;4(1):e67-e78.] Plain Language Summary: This study looked at the feasibility of delivering a 4-week health literacy program to new parents using existing postnatal parenting groups in New South Wales, Australia. Although the program was generally acceptable to learners and facilitators, this study offers several strategies to further improve the program so that it better supports facilitators and suits a wider range of learners.

Using Feasibility Data and Codesign to Refine a Group-Based Health Literacy Intervention for New Parents

“…Findings from feasibility testing ( Muscat et al, 2020 ) were incorporated into version 2 of the Parenting Plus program in collaboration with health care staff and patient partners. The codesign process identified patient and staff priorities for revision and ensured modifications adequately addressed underlying issues.…”

“…In July 2020, we reported on a study that assessed the feasibility of embedding a group-based health literacy skills training program (Parenting Plus, version 1) within established parenting groups in New South Wales (NSW), Australia ( Muscat et al, 2020 ). Findings indicated that staff and parents wanted more information about parenting topics (e.g., starting solid foods) in addition to skills training, more time for group discussion, and content adaptable to parents from diverse backgrounds.…”

“…This article should be read in conjunction with our feasibility article ( Muscat et al, 2020 ) as we now detail how the revised version of the program was developed. First, we used the feasibility findings and a codesign process involving patient partners (new parents) and health staff (including staff who work directly with new parents and managerial staff who manage child and family health services) to develop version 2.…”

Relationship between parents' health literacy and child health: systematic review

“…Merlino et al (2020) have shown that external support structures consisting of family and friends play an integral role in imparting health literacy to young people, particularly indigenous males. Health literacy courses have been effective in leading towards better health outcomes in the Australian context (Muscat et al, 2020). Therefore, the use of productive measures can lead towards improvement in child health outcomes.…”

Incorporating digital platforms into nutritional care in chronic kidney disease

“…Therefore, research is needed in culturally, linguistically, and socio‐economically diverse populations. Findings from studies, such as the ongoing SUCCESS trial, 28 which are trialing digital interventions in ethnically‐diverse populations, suggest that more targeted recruitment strategies to identify people with CKD with low health literacy are needed.…”