Author(s): Cho RN, Plunkett BA, Wolf MS, Simon CE, Grobman WA
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Abstract OBJECTIVE: To determine if health literacy is associated with patient understanding of prenatal screening tests for fetal aneuploidy and neural tube defects. METHODS: We performed a prospective observational study on a cohort of English-speaking patients receiving prenatal care in two resident-staffed ambulatory clinics. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine-7. Understanding of the prenatal screening tests was assessed using a modified Maternal Serum Screening Knowledge Questionnaire. RESULTS: Over an 8-month period, 125 patients were approached, and 101 (81\%) consented to the study. Thirty-eight (38\%) women demonstrated low health literacy. Patients with low health literacy were more likely to demonstrate inadequate understanding when compared to those with adequate health literacy (97\% versus 11\%, respectively; P < 0.01). Similarly, patients with < 12th grade education were more likely to have inadequate understanding when compared to patients with > 12th grade education (53\% versus 30\%, respectively; P = 0.02). Health literacy is a more sensitive and specific predictor of inadequate understanding than education (sensitivity 84\% versus 70\%, respectively, P < 0.05; specificity 98\% versus 47\%, respectively, P < 0.05). CONCLUSION: Patients with low health literacy are more likely to demonstrate inadequate understanding of these prenatal screening tests than women with adequate health literacy.
This article was published in Prenat Diagn
and referenced in Journal of Pregnancy and Child Health