P2.N269: Caregiver Perspectives on Health Literacy Screening at Time of Cancer Diagnosis

Purpose/Objectives: Evidence demonstrates a critical relationship between healthcare literacy (HL) and healthcare outcomes. Our institution is a large urban tertiary hospital located in Houston, Texas, a city with one of the lowest HL scores in the state and country. There is limited literature describing the HL of caregivers of children with cancer. Healthcare providers tend to overestimate the HL of patients and their caregivers; however, formal screening of HL is not standard of care. As part of a quality improvement project, funded by the AAP SOPT Health Equity grant, we present results from a focus group conducted to evaluate initial perspectives on routine HL assessment for caregivers of children with cancer.

Design/Methods: We recruited nine caregivers from the Cancer Center Family Advisory Council to participate in a focus group. We presented a validated HL screening tool, the Short Assessment of Health Literacy Scale – English (SAHL-E), and then conducted a semi-structured interview with caregivers. Caregiver responses were transcribed for subsequent qualitative thematic analysis.

Results: The focus group participants represented families of patients with leukemia (n=5, 55%), lymphoma (n=2, 22%), solid (n=1, 11%) and brain tumors (n=1, 11%). Caregivers self-reported their race/ethnicity as: Caucasian (n=4, 44%), Hispanic/Latinx (n=3, 33%), African American/Black (n=1, 11%), or Asian (n=1, 11%). All participants were privately insured. Caregivers expressed a favorable view of standardized HL screening being performed at the time of a new cancer diagnosis. We identified three themes: timing and location of HL screening are barriers to participation, HL screening could exacerbate anxiety, and HL screening can be conducted at time of diagnosis if introduced appropriately (Table 1).

Conclusion/Discussion: Informed by these findings, we will implement routine HL screening in caregivers of patients with newly diagnosed leukemia to improve provider-caregiver communication. This work will lay the groundwork for standardized HL screening in other pediatric populations.