Breastfeeding and Health Literacy Among Urban Adolescents In a Midwestern Community

Theoretical Background and research questions/hypothesis:  Low health literacy rates have been associated with lower levels of health knowledge and poor health outcomes. Health literacy has been identified as a critical and modifiable factor for improving preventive care and reducing health disparities. One population where identification of lower health literacy levels may have a positive impact on health outcomes is among adolescent mothers. Birth rates among women aged 15-19 years rose 5% from 2005 to 2007; in 2007 approximately 450,000 women aged 19 years or younger became pregnant.  Due to the higher risk of disease and poor health outcomes among adolescent mothers and their infants, breastfeeding may be especially beneficial for this population.  However, breastfeeding has remained low among teenage mothers even though it has increased among the general population. The aim of this study was to investigate the relationship between breastfeeding outcomes and health literacy among urban Midwestern adolescent mothers.

Methods:  Mothers who were 19 years old or younger participated in a questionnaire assessing attitudes and knowledge about breastfeeding, and three health literacy assessments.  The breastfeeding questionnaire was developed using findings from a previous study by K.A. Wambach (2011). The three health literacy assessments used were the Test of Functional Health Literacy in Adults (TOFHLA), REALM-Teen, and a three question screening tool from a previous study by Chew (2008). Previous studies have validated part of the TOFHLA and the REALM-Teen for use with adolescents. The three question screening tool was tested for validity among adolescents in this study.  A logistic regression will be used to analyze the relationship between adolescent health literacy and breastfeeding knowledge. Breastfeeding knowledge will be assessed based on the knowledge assessment. To calculate breastfeeding knowledge, each item will be scored (correct or incorrect) and the total correct answers will be summed. Scores will be divided into high and low knowledge categories based on the data break points.  A logistic regression will also be used to analyze the relationship between adolescent health literacy and breastfeeding outcomes (i.e., initiation and duration).

Results: Pending

Conclusions: Pending

Implications for research and/or practice:  A health disparity exists among birth outcomes of adolescent and adult mothers. Breastfeeding is a potential strategy to reduce this disparity.  Identification of health literacy levels may indicate a possible direction for future public health interventions and health promotion campaigns.  Not only could such efforts improve the ability of these mothers to understand how to navigate the medical system and better advocate for their health needs, but this could dramatically improve the health of their children and address the disparity in health outcomes between adolescent and adult mothers.