Health literacy profiling of parents in two disadvantaged inner-city areas in the United Kingdom

BACKGROUND: Health literacy refers to the ability to understand, access and use health information and services. Limited parental health literacy is associated with ineffective preventive behaviours and worse child health outcomes. Limited financial and social resources are associated with low health literacy. Profiling the health literacy strengths and limitations of individuals allows the multidimensional nature of health literacy to be considered and highlight patterns of need. This study aims to identify the health literacy profiles of parents using family hubs in two disadvantaged UK regions using the Optimising Health Literacy and Access framework. METHODS: A mixed method study using the Health Literacy Questionnaire Parent (HLQ-Parent) and semi-structured focus groups was conducted among parents attending family hubs or libraries in two cities. Hierarchical cluster analysis was conducted to identify clusters with varying health literacy strengths and needs based on the HLQ-Parent domains. Clusters were translated into health literacy profiles using HLQ-Parent patterns and demographic data. Then, using an explanatory sequential approach, vignettes were created to represent the different health literacy profiles. RESULTS: Participants’ (n = 175, age range 18-59 yrs., mean age 33 yrs., 98% female) lowest mean HLQ-Parent score in city 1 was present in domain 4 “Social support for health” and domain 2 “Having sufficient information to manage my child's health” in city 2. Eight clusters were identified each with unique health literacy profiles. Both cities had one cluster (44% of participants) scoring highly on all domains and one cluster (20% of participants) reported difficulties across all domains. CONCLUSIONS: Eight distinct health literacy profiles were identified among parents attending family hubs. These profiles in vignette format will facilitate the co-design and co-development of parental health literacy interventions. KEY MESSAGES: • This study emphasises the health literacy challenges faced by parents in disadvantaged areas, and the potential barriers they face in navigating and using health services for their children. • The vignettes developed in this study provide an authentic description of the health literacy profiles of parents in this context proving a promising starting point for co-designing interventions.