Parental Health Literacy and Patient Clinical Outcomes in Juvenile Idiopathic Arthritis with a Health Equity Lens

Background/Objectives: Health literacy (HL) is the ability to obtain, understand, and use information to make health-related decisions. Its impact on rheumatologic outcomes remains unclear. We examined the relationship between parental HL and clinical outcomes of patients with juvenile idiopathic arthritis (JIA) at an ethnically diverse academic center. Methods: In this single-center cross-sectional study, parents of patients with JIA completed a demographic survey and the Newest Vital Sign (NVS), a validated six-item HL assessment. Parental HL was dichotomized into limited HL (NVS score 0–1) and possibly limited/adequate HL (NVS score 2–6). The clinical Juvenile Arthritis Disease Activity Score based on a ten-joint count (cJADAS10) and Patient-Reported Outcomes Measurement Information System (PROMIS) were used to determine clinical outcomes. Clinical characteristics and outcomes were compared, and odds of active disease (cJADAS10 > 1) were estimated. Results: Seventy-five parents participated, 15 (20.0%) had limited HL. Among patients with polyarticular disease, median cJADAS10 was higher in the limited HL group [8.0 (IQR 3.0–11.0), n = 11 vs. 2.2 (IQR 0.0–7.0), n = 28; p = 0.017]. Among patients with oligoarticular disease, PROMIS mobility scores were lower in the limited HL group [35.3 (IQR 27.1–45.4), n = 4 vs. 52.1 (IQR 52.1–52.9), n = 30; p = 0.037]. In an exploratory multivariable model, limited HL was associated with higher adjusted odds of active disease, although the estimate was imprecise (OR 6.96, 95% CI 1.19–40.81; p = 0.031). Conclusions: In this cross-sectional cohort, limited parental HL was associated with higher disease activity in polyarticular JIA and higher adjusted odds of active disease in an exploratory adjusted analysis.