Pregnancy and early parenting is a time characterized by high need for health information, high readiness to learn and change, and first-time use of significant health services; a time when both the negative and positive effects of mothers' literacy skills and functional health literacy pass to their children with lifelong consequences. The purpose of this project is to examine the influence - and the mechanisms of influence -of home visitation on maternal functional health literacy, that is, on disadvantaged mothers' progress toward optimal levels of functioning in the health arena. Across the country, established maternal-child health home visitation programs serve vulnerable families who lack resources, social supports and literacy skills to function well in the health arena during pregnancy and early parenting. These home visitation programs could prove to be an effective, efficient channel to promote functional health literacy among the primary health decision makers in growing families at risk. Instruments that can measure the function in functional health literacy are urgently needed to improve understanding of health literacy beyond the current focus on reading ability. This project develops and validates functional health literacy scales to better understand and promote mothers' progress toward higher functioning in the healthcare system and in health contexts at home. ? ? ?