Predictors of Health Literacy and Numeracy Concordance Among Adolescents With Special Health Care Needs and Their Parents

Parent and teen health literacies (HLs) are employed as teens with chronic illnesses transition to health self-management and the adult health system. This study explores the relationships between parent and teen HL. Teens ages 12-18 with chronic conditions and their parents, sampled from a pediatric Medicaid accountable care organization, completed an interview assessing HL and self-reported competence with written and numerical health information. Rates of teen and parent HL, degree of concordance, and the relationship between concordance and teen-reported competence with health materials were measured. Half (52%) of teens had adequate HL, 62% of teens reported competence with written health materials, and 69% reported competence with numerical information. The correlation between parent and teen HL was modest but significant (phi=0.13, p=.03): 47% of parent-teen dyads were concordant for adequate HL, and 10% were concordant for inadequate HL. Adequate teen HL was associated with parental adequate HL and parental education. Discordance was associated with self-reported competence with written material and numerical material. More than half of parent-teen dyads had at least 1 member with less than adequate HL, and parent-teen HL concordance was associated with teen perception of HL. These findings support the consideration of both independent and dyad HL levels in adolescent care.