Relationships among Functional Health Literacy, Asthma Knowledge and the Ability to Care for Asthmatic Children in Rural Dwelling Parents


Purpose: This Orem-based study examined the relationships among functional health literacy, asthma knowledge, the ability to care for asthmatic children and sociodemographic factors among rural parent/guardians.

Method: A descriptive correlation design was used. The convenience sample of 57 parents and one guardian who cared for asthmatic children was recruited from three rural health districts in the eastern United States (Virginia, North Carolina, and upstate New York). Subjects completed the Test of Functional Health Literacy in Adults (TOFHLA) and the Asthma Questionnaire-Parent Survey (AQ-P) and provided additional demographic and health status information.

Findings: The results show that TOFHLA scores were directly related to asthma knowledge (AQ-P scores), p=.04.  Subjects who had not completed high school had significantly lower TOFHLA scores than those who had completed high school, and their children were hospitalized more often (p=.05). Those with higher income also had higher health literacy (TOFHLA scores) (p=.008) and regression analysis revealed that smoking status was also directly associated with functional health literacy (p=.004).

Conclusions: The findings confirm that rural health care providers need to be diligent in assuring that health education materials and verbal instructions are presented in the most simple and easy to read format in order to maximize understanding.


Keywords: Health Literacy, Asthma Knowledge, Orem’s Theory of Dependent Care Agency

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share (for non-commerical purposes) the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).