O2159: Health Literacy and Treatment-Seeking Behaviors: A Prospective Study Comparing Caregivers of Patients with Cerebral Palsy and Patients with Acute Fractures

Background: Health literacy (HL) is the degree to which individuals can comprehend and access information and services to inform health-related decisions and is a strong predictor of health outcomes. This study investigates whether increased exposure to the healthcare system equips caregivers of children with an exemplary chronic disease – cerebral palsy (CP) – with higher baseline HL compared to caregivers of otherwise healthy pediatric patients seeking acute surgical treatment.

Methods: In a prospective study utilizing a single pediatric referral healthcare system over a 15-month period, caregivers of pediatric patients with CP undergoing planned orthopaedic surgery (CP group) and the caregivers of otherwise healthy pediatric patients undergoing planned surgical treatment for acute fractures (fracture group) were recruited. Baseline HL was assessed pre-operatively with the Newest Vital Sign survey; charts were reviewed for no-shows, canceled appointments, and advice-only calls. Mann-Whitney U tests and pair-wise post hoc tests were utilized to compare cohorts.

Results: Ninety patients were included for analysis, of which 37 (41.1%) were in the CP group and 53 (58.9%) were in the fracture group. There was no significant difference in baseline caregiver HL between cohorts (CP: mean 3.76 (SD 1.62); fracture: mean 3.55 (SD 2.09), p = 0.790). However, there were significantly higher “no-show” (CP: mean 0.03 (SD 0.16); fracture: mean 0.49 (SD 1.17), p= 0.008) and more canceled appointments (CP: mean 1.16 (SD 1.69); fracture: mean 1.94 (SD 2.43), p= 0.032) in the fracture group. There were significantly higher advice-only calls in the CP group (CP: mean 2.51 (SD 3.42); fracture: mean 0.06 (SD 0.31), p < 0.001) as seen in Table 1.

Conclusion: Despite more interaction with the healthcare system, caregivers of children with CP do not have measurably higher HL when compared to caregivers of children seeking acute, episodic fracture care. While these two cohorts demonstrate comparable baseline HL levels, their needs, understanding, and utilization of healthcare differ. These findings emphasize the importance of providing education and resources at each visit, ensuring caregiver comprehension regardless of patient status, system familiarity or healthcare utilization rates.