Sickle cell trait knowledge and health literacy in caregivers who receive in-person sickle cell trait education

Susan Creary, Ismahan Adan, Joseph Stanek, Sarah H O'Brien, Deena J Chisolm, Tanica Jeffries, Kristin Zajo, Elizabeth Varga, Susan Creary, Ismahan Adan, Joseph Stanek, Sarah H O'Brien, Deena J Chisolm, Tanica Jeffries, Kristin Zajo, Elizabeth Varga

Abstract

Background: Despite universal screening that detects sickle cell trait (SCT) in infancy, only 16% of Americans with SCT know their status. To increase SCT status awareness, effective education for patients and their families is needed. The objective of this study was to assess caregivers' SCT knowledge before and after an in-person SCT education session.

Methods: A trained educator provides in-person SCT education to caregivers of referred infants with SCT at Nationwide Children's Hospital. From August 2015 to July 2016, primarily English-speaking caregivers of infants with hemoglobin S-trait were recruited and completed a health literacy assessment and a SCT knowledge assessment (SCTKA) before and after receiving education. Caregivers repeated the SCTKA again after ≥6 months, if they could be contacted.

Results: Thirty-eight (38.1%) percent of 113 caregivers had high SCTKA scores (≥75%) before education but 90.3% achieved high scores after education. Caregivers with low SCTKA scores after education had significantly lower health literacy (P = 0.029) and baseline SCTKA scores (P = 0.003) compared to those with higher scores after education. At ≥6 months, caregivers' scores were significantly higher (P = 0.014) than baseline, but only 73.3% scored ≥75%.

Conclusion: Our results suggest that caregivers' baseline SCT knowledge is low, improves with in-person education but may decline with time. Caregivers who do not achieve high SCT knowledge after education had lower health literacy and baseline knowledge. Future studies should determine if adapting in-person education to caregivers' health literacy and knowledge levels results in high and sustained SCT knowledge among all caregivers and more individuals who know their SCT status.

Keywords: Health literacy and knowledge; sickle cell disease; sickle cell trait education.

© 2017 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

Figures

Figure 1
Figure 1
Sickle cell trait knowledge in caregivers who completed pre‐, post‐, and follow‐up assessments.

References

    1. AAP Newborn Screening Task Force . 2000. Elk Grove Village, IL. Serving the family from birth to the medical home. Newborn screening: a blueprint for the future – a call for a national agenda on state newborn screening programs. Pediatrics 106:389–422.
    1. Asnani, M. R. , Quimby K. R., Bennett N. R., and Francis D. K.. 2016. Interventions for patients and caregivers to improve knowledge of sickle cell disease and recognition of its related complications. Cochrane Data. Syst. Rev. 10:CD011175 .
    1. Bernhardt, B. A. , Biesecker B. B., and Mastromarino C. L.. 2000. Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment. Am. J. Med. Genet. 94:189–197.
    1. Centers for Disease Control Data and Statistics : Children with Sickle Cell Disease. Available at . (Accessed 23 February 2017).
    1. Centers for Disease Control and Prevention . 2014. Incidence of sickle cell trait – United States, 2010, 2014. Morb. Mortal. Wkly Rep. 63:1155–1158.
    1. Centers for Disease Control and Prevention : Sickle Cell Trait Toolkit. Available at . (Accessed 18 July 2017).
    1. Centers for Disease Control and Prevention : Sickle Cell Trait. Available at . (Accessed 12 September 2014).
    1. Gallo, A. M. , Wilkie D. J., Wang E., Labotka R. J., Molokie R. E., Stahl C., et al. 2014. Evaluation of the SCKnowIQ tool and reproductive CHOICES intervention among young adults with sickle cell disease or sickle cell trait. Clin. Nurs. Res. 23:421–441.
    1. Gallo, A. M. , Wilkie D. J., Yao Y., Molokie R. E., Stahl C., Hershberger P. E., et al. 2016. Reproductive health CHOICES for young adults with sickle cell disease or trait: randomized controlled trial outcomes over two years. J. Genet. Couns. 25:325–336.
    1. Johnson, K. , Lloyd‐Puryear M. A., Mann M. Y., Ramos L. R., and Therrell B. L.. 2006. Financing state newborn screening programs: sources and uses of funds. Pediatrics 117:S270–S279.
    1. Kavanagh, P. L. , Wang C. J., Therrell B. L., Sprinz P. G., and Bauchner H.. 2008. Communication of positive newborn screening results for sickle cell disease and sickle cell trait: variation across states. Am. J. Med. Genet. C Semin. Med. Genet. 148C:15–22.
    1. Kim, S. H. , and Lee A.. 2016. Health‐literacy‐sensitive diabetes self‐management interventions: a systematic review and meta‐analysis. Worldviews Evid. Based Nurs. 13:324–333.
    1. Kladny, B. , Williams A., Gupta A., Gettig E. A., and Krishnamurti L.. 2011. Genetic counseling following the detection of hemoglobinopathy trait on the newborn screen is well received, improves knowledge, and relieves anxiety. Genet. Med. 13:658–661.
    1. Liem, R. I. , Chan C., Vu T. T., Fornage M., Thompson A. A., Liu K., et al. 2017. Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA. Blood 129:723–728.
    1. Mortality among children with sickle cell disease identified by newborn screening during 1990–94–California, Illinois, and New York. Morb. Mortal. Wkly Rep. 1998;47:169–172.
    1. Moseley, K. L. , Nasr S. Z., Schuette J. L., and Campbell A. D.. 2013. Who counsels parents of newborns who are carriers of sickle cell anemia or cystic fibrosis? J. Genet. Counsel. 22:218–225.
    1. Ohio Department of Health: Sickle Cell Services . 2014. Available at . (Accessed 30 March 2017).
    1. Ohio Department of Medicaid : Medicaid Eligibility Procedure Letter. 2016. Available at . (Accessed 17 July 2017).
    1. Platt, O. , Brambilla D. J., Rosse W. F., Milner P. F., Castro O., Steinberg M. H., et al. 1994. Mortality in sickle cell disease: life expectancy and risk factors for early death. N. Eng. J. Med. 330:1639–1644.
    1. Treadwell, M. J. , McClough L., and Vichinsky E.. 2006. Using qualitative and quantitative strategies to evaluate knowledge and perceptions about sickle cell disease and sickle cell trait. J. Natl Med. Assoc. 98:704–710.
    1. Weiss, B. D. , Mays M. Z., Martz W., Castro K. M., DeWalt D. A., Pignone M. P., et al. 2005. Quick assessment of literacy in primary care: the newest vital sign. Ann. Fam. Med. 3:514–522.

Source: PubMed

3
Abonnere