(280) Association of health literacy with patient-reported outcomes in the perinatal period among low-income individuals

This is a secondary analysis of data from a randomized trial of postpartum patient navigation, in which pregnant people were eligible if they were ≥16 years, English- or Spanish-speaking, and had public insurance. Upon enrollment (≥30 weeks’ gestation through postpartum hospitalization), participants completed the Newest Vital Sign, a validated measure of HL, which was categorized as inadequate versus adequate based on standard scoring. PRO measures, which reflected multiple aspects of health, were collected at enrollment, 4–12 weeks postpartum, and 11–13 months postpartum. The significance of differences in PRO scores by HL adequacy was determined using bivariable tests; multivariable models adjusted for maternal age and education.

Results:
Of 405 participants randomized, 59.3% (N=240) had inadequate HL. Those with inadequate HL were younger and less likely to have a college degree than those with adequate HL. At enrollment, in adjusted analysis, those with inadequate HL reported lower global health status (mental health component) and patient activation, and greater perceived stress (Table 1). At 4-12 weeks postpartum, participants with inadequate HL reported lower global health status (physical health component), patient activation, self-efficacy, and postpartum care satisfaction; they also reported higher perceived stress (Table 2). At 11-13 months postpartum, participants with inadequate HL continued to report lower patient activation (Table 2).

Conclusion:

Among low-income pregnant participants in a prospective study, inadequate HL was common and associated with several indicators of suboptimal perinatal health and healthcare engagement. HL may be an understudied area for interventions to optimize maternal health.