Rural Residence and Family Size, Rather Than Parental Health Literacy, Are Associated With Pediatric Burn Status
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Abstract
Keywords
Abstract
Background: Pediatric burn injuries are largely preventable and arise through a complex interaction of environmental, socioeconomic, and caregiver-related factors. Parental health literacy may theoretically influence injury prevention through risk recognition, supervision, and the ability to understand and apply health information; however, its independent relationship with pediatric burn status remains unclear. This study aimed to determine whether parental health literacy is independently associated with pediatric burn status after accounting for relevant sociodemographic and family-level characteristics.
Methods: This comparative cross-sectional study included parents of 57 children hospitalized with burn injuries and 86 parents of children without a history of burn injury. Parental health literacy was assessed using the validated Turkish version of the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16), with scores transformed to a 0-50 index. Valid HLS-EU-Q16 scores were available for 116 participants (50 burn and 66 control). Sociodemographic and family characteristics were compared between groups. Multivariable binary logistic regression was performed with pediatric burn status as the dependent variable to evaluate the independent associations of health literacy, place of residence, number of siblings, maternal education, family income, and child age.
Results: Mean HLS-EU-Q16 index scores were similar in the burn and control groups (37.28 ± 7.04 vs 37.01 ± 6.51, respectively; p=0.832), and the distribution of health-literacy categories did not differ significantly between groups (p=0.587). In the multivariable model, parental health literacy was not independently associated with pediatric burn status (adjusted odds ratio [aOR] per 1-point increase, 1.01; 95% CI, 0.95-1.08; p=0.744). In contrast, rural/village residence was strongly associated with burn status (aOR, 13.81; 95% CI, 3.62-52.71; p<0.001). Each additional sibling was also associated with higher odds of belonging to the burn group (aOR, 1.47; 95% CI, 1.02-2.13; p=0.040). Maternal education, family income, and child age were not independently associated with burn status.
Conclusions: Pediatric burn status was independently associated with rural residence and larger family size, but not with parental health literacy. These findings suggest that the social and environmental context in which caregiving occurs may be more influential than parents' ability to access and understand general health information alone. Burn-prevention strategies should therefore extend beyond health-literacy education and particularly target rural households and families with greater caregiving demands.
Keywords
pediatric burns; health literacy; parents; rural residence; family size; injury prevention; HLS-EU-Q16
