This application addresses broad Challenge Area (05) Comparative Effectiveness Research and specific Challenge Topic, 05-MD-105: Health Literacy. Limited health literacy affects over 90 million Americans, and is strongly associated with poor health. While limited health literacy affects people of all social, cultural and economic backgrounds, it is especially prevalent in low income households, and among minorities and people with limited English proficiency. Young children have multiple viral URIs a year, especially those in group activities like daycare. Latino parents have been shown to be at high risk for poor health literacy regarding URIs. Limited health literacy, as related to knowledge, attitudes and care practices, among Latino parents can directly affect their ability to care for and treat themselves and their families. This can result in increased costly emergency department visits, and inappropriate antibiotic seeking leading to increased individual and community-wide antibiotic resistance. The CDC recommends community based culturally appropriate interventions to educate families about viral URIs. While previous studies have found a positive impact of educational efforts to increase parental knowledge regarding URIs and antibiotic resistance, they were not developed for minority populations with poor health literacy, and did not include cost-effective analyses. Early Head Start/Head Start (EHS/HS) educational programs for low-income families have been shown to be promising sites for community based health education interventions, but need further evaluation. The purpose of this study is to conduct a randomized controlled trial to comparatively assess the effectiveness of our tailored educational intervention, The Appropriate Care of URI (ACURI) Project, to improve health literacy levels regarding upper respiratory infections (URIs) and to decrease pediatric emergency department (PED) visits, among Latino households in Early Head Start/Head Start. Our intervention builds capacity in the participating EHS/HS, and can be disseminated to other EHS/HS nationally. Funding for this project will allow hiring of three community members, including two community health workers, thereby building community capacity. It will also contribute to the local economy through parental incentives and purchase of supplies from local businesses.

Public Health Relevance

This tailored health literacy intervention regarding URI for Latino Early Head Start/Head Start parents has the potential to not only improve the care of participating minority families, but also may allow for dissemination of this and other health literacy interventions to the nearly 1 million children that attend EHS/HS sites nationally.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
NIH Challenge Grants and Partnerships Program (RC1)
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Special Emphasis Panel (ZRG1-RPHB-A (58))
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Rajapakse, Nishadi
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Columbia University (N.Y.)
Schools of Medicine
New York
United States
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Hofstetter, Annika M; Barrett, Angela; Stockwell, Melissa S (2015) Factors impacting influenza vaccination of urban low-income Latino children under nine years requiring two doses in the 2010-2011 season. J Community Health 40:227-34
Stockwell, Melissa S; Catallozzi, Marina; Larson, Elaine et al. (2014) Effect of a URI-related educational intervention in early head start on ED visits. Pediatrics 133:e1233-40
Dunn-Navarra, Ann-Margaret; Stockwell, Melissa S; Meyer, Dodi et al. (2012) Parental health literacy, knowledge and beliefs regarding upper respiratory infections (URI) in an urban Latino immigrant population. J Urban Health 89:848-60