Evidence map›Paper›PMID 39331337›Full record

ArticleCJEM2025

Low caregiver health literacy is associated with non-urgent pediatric emergency department use.

Katharine V Jensen, Andrea Morrison, Keon Ma, Waleed Alqurashi, Tannis Erickson, Janet Curran, Ran D Goldman, Serge Gouin, April Kam, Naveen Poonai and 8 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in CJEM, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Observational
  2. Article
  3. Health literacy and its sociodemographic and health determinants.Revista da Escola de Enfermagem da U S P · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Katharine V JensenDepartment of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Andrea MorrisonCommunicateMD, Grafton, WI, USA.
Keon MaDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Waleed AlqurashiDepartment of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
Tannis EricksonChildren's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada.
Janet CurranSchool of Nursing, Faculty of Health Professions, Dalhousie University, Halifax, NS, Canada.
Ran D GoldmanThe Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, BC, Canada.
Serge GouinCHU Ste Justine, Montreal, QC, Canada.
April KamDepartment of Pediatrics, McMaster University, Hamilton, ON, Canada.
Naveen PoonaiDepartments of Paediatrics, Internal Medicine, Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Tania PrincipiDepartment of Pediatrics, Hospital for SickKids, Toronto, ON, Canada.
Shannon ScottFaculty of Nursing, University of Alberta, Edmonton, AB, Canada.
Antonia StangDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Patricia CandelariaDepartment of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Kurt SchreinerPEAK Research Team, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Maryna YaskinaWomen & Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada.
Samina AliDepartment of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada. sali@ualberta.ca.ORCID 0000-0002-0595-364X
Pediatric Emergency Research Canada Family Needs Study Group

Funding

Women and Children's Health Research Institute Clinical/Community Research Integration Support Program
6 · The paper itself

Abstract

objectiveCaregivers with low health literacy are more likely to overestimate illness severity and have poor adherence with health-promoting behaviors. Our primary objective was to relate caregiver health literacy to the urgency of emergency department (ED) utilization. The secondary objective was to explore the relationship between social and demographic characteristics, health literacy, and urgency of ED use.

methodsThis sub-study was a descriptive cross-sectional survey with health record review. Data were collected from ten Canadian pediatric EDs. Study variables included demographics, visit details, and the Newest Vital Sign measurement of health literacy. ED visits were classified as urgent or non-urgent based on the resource utilization method.

resultsThe response rate was 97.6% (n = 2005). Mean (SD) caregiver age was 37.0 (7.7) years, 74.3% (n = 1950) were mothers, 72.6% (n = 1953) spoke English as a primary language, 51.0% (n = 1946) had a university degree, and 45.1% (n = 1699) had a household income greater than $100,000. The mean (SD) age of the children was 5.9 (5.0) years and 48.1% (n = 1956) were female. 43.7% (n = 1957) of caregivers had low health literacy. Being a caregiver with a child < 2 years old [aOR 1.83 (1.35, 2.48)] and low health literacy [aOR 1.56 (1.18, 2.05)] were associated with greater non-urgent pediatric ED use. Interprovincial variation was evident: Quebec caregivers were less likely to use the pediatric ED for non-urgent presentations compared to Alberta, while those in Nova Scotia, Manitoba, British Columbia, and Ontario were more likely compared to Alberta.

conclusionAlmost half of caregivers presenting to Canadian pediatric EDs have low health literacy, which may limit their ability to make appropriate healthcare decisions for their children. Low caregiver health literacy is a modifiable factor associated with increased non-urgent ED utilization. Efforts to address this may positively influence ED utilization.

Indexed as

CaregiversEmergency Service, HospitalHealth LiteracyAdultCanadaChildChild, PreschoolCross-Sectional StudiesFemaleHumansMaleRetrospective StudiesCaregiverHealth educationHealth literacyUrgency

Identifiers

PMID39331337

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.