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Leading Journals Publishes Two New Penn Studies

Terri H Lipman, PhD, CRNP, FAAN, the Miriam Stirl Endowed Term Professor of Nutrition, Professor of Nursing of Children and Assistant Dean for Community Engagement, recently had two studies published in Journal of Clinical Pediatrics and Journal of Health Communication. One study involved incorporating the use of Electronic Health Record (EMR) in the clinical assessment of child growth. The other investigated how parent health literacy affected communication between parents and diabetes educators in a clinic.

Journal of Clinical Pediatrics

When clinicians evaluate the growth of children it is important to distinguishing children with an underlying growth problem from those with normal variant genetic short stature. Knowing the heights of the biological parents aids in making that decision. However, obtaining parental height data is often not included in growth assessment. The research team was interested in determining the feasibility and functionality of utilizing an electronic mid-parental height (MPH) auto-calculator in the clinical assessment of growth in pediatric primary care settings to see if those data impacted clinical decision making. The team had clinicians complete growth assessment surveys utilizing recorded parent heights. The MPH tool confirmed clinicians’ initial growth assessment in 79 percent of cases and changed it in four percent; the remainder did not use the tool. Those clinicians who changed assessment were more likely to pursue more comprehensive evaluation. “What this study found was that the MPH tool was a quick, functional resource as a component in an electronic health record and these are the first data to demonstrate that use of an EHR-based MPH calculator affected clinical decision making when assessing the growth of a child,” said Lipman, who served as the study’s prinicipal investigator.

Journal of Health Communication

Low health literacy is associated with poor communication between adults and providers, but little is known about how parents’ health literacy influences communication in pediatric encounters. This study examined how parent health literacy affected communication between parents and diabetes educators in a pediatric diabetes clinic. A mixed-methods study was conducted including a cross-sectional survey of 162 parents and semi-structured interviews with a subsample of 24 parents of a child with type 1 diabetes. Parent and child characteristics, parents’ report of quality of communication, and parent health literacy were assessed. Content analysis showed that low health literate parents were confused by diabetes jargon, preferred hands-on teaching, and wished for information to be communicated in simple language, broken down into key points, and repeated. Parents with adequate health literacy wanted comprehensive information communicated through ongoing dialogue. Lipman, the study’s senior author says, “These findings suggest that it would be advantageous for diabetes educators to understand the level of health literacy of all the parents with whom they interact and to adjust their clinical teaching styles accordingly.”