Health literacy and parental behaviors related to poor health in preschool children

Background

Working parents may find it difficult to prioritize their child’s health when the child is in poor health because of work-related constraints. Health literacy may help reduce inappropriate parental behaviors involving childcare facilities, but evidence is limited. This study examined the association between health literacy and inappropriate parental behaviors related to childcare facility use when preschool children are in poor health.

Methods

Data were from a September 2023 online survey of 981 working parents with children aged 3–6 years attending childcare facilities in Japan. Inappropriate parental behaviors were assessed using six items, including sending the child to childcare despite poor health. Health literacy was measured using the Communicative and Critical Health Literacy scale (CCHL; Ishikawa et al., 2008) and categorized into high and low groups. Associations were examined using Poisson regression adjusted for parental sex, age, educational attainment, employment status, and perceived economic situation.

Results

Among participants, 481 (49.0%) had high CCHL. Compared with the high CCHL group, the low CCHL group was more likely to report inappropriate parental behaviors. Low CCHL was associated with sending the child to childcare without informing the facility of diarrhea or vomiting (adjusted prevalence ratio [APR]=2.09, 95% confidence interval [CI]:1.56–2.74) and being unable to pick up the child immediately for personal reasons (APR=1.50, 95% CI:1.24–1.81). Significant associations were observed for five of six items, whereas no association was found for being unable to pick up the child due to work-related reasons.

Conclusions

Lower CCHL was associated with inappropriate parental behaviors related to children’s poor health and childcare facility use, except for behaviors driven by work-related constraints. Improving parents’ health literacy may help reduce such behaviors.

Key messages

• Lower health literacy was associated with inappropriate parental behaviors involving childcare facilities when preschool children were in poor health.

• Improving health literacy may promote appropriate parental behaviors regarding childcare use when children are in poor health.