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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Usual Source of Sick Care.

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Strategy. Health Literacy and Parental Engagement

Approach. Promote health literacy and parental engagement at the individual, clinic and community levels through the distribution and promotion of educational resources

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Overview. Childhood experiences as they relate to the caregiving environment are determinants of wellbeing across the life course.[1] Evidence shows that grandparent-led households may benefit from additional support to ensure that grandchildren receive timely health services.[2] Low health literacy is associated with poor health outcomes, while family engagement is critical to fostering positive health outcomes.[3] By promoting health literacy and fostering caregiver engagement, healthcare systems can empower families to actively participate in their child's care, ultimately enhancing access to and quality of sick care services.

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Parent/caregiver health literacy assessments tools
  • Parent program engagement data
  • Parent/caregiver health knowledge surveys

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Community Health Factors.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of organizations partnered with Title V distributing health literacy and parental engagement resources. (Measures dissemination of educational materials)
  • Number of parents receiving health literacy resources through various Title V supported channels. (Assesses access to educational materials)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of organizations partnered with Title V distributing health literacy and parental engagement resources. (Measures dissemination of educational materials)
  • Percent of parents receiving health literacy resources through various Title V supported channels. (Assesses access to educational materials)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of parents demonstrating increased knowledge in managing their child's health after accessing resources. (Measures impact on parental health literacy)
  • Number of clinics experiencing increased parental involvement in care planning after accessing resources. (Shows impact on clinical care process)
  • Number of communities experiencing increased parental activation and improved family well-being outcomes. (Measures population-level impact)
  • Number of healthcare systems integrating evidence-based health literacy strategies into their programming. (Assesses field-level adoption of effective practices)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of parents demonstrating increased knowledge in managing their child's health after accessing resources. (Measures impact on parental health literacy)
  • Percent of clinics experiencing increased parental involvement in care planning after accessing resources. (Shows impact on clinical care process)
  • Percent of communities experiencing increased parental activation and improved family well-being outcomes. (Measures population-level impact)
  • Percent of healthcare systems integrating evidence-based health literacy strategies into their programming. (Assesses field-level adoption of effective practices)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Sadruddin AFA, Ponguta LA, Zonderman AL, Wiley KS, Grimshaw A, Panter-Brick C. How do grandparents influence child health and development? A systematic review. Soc Sci Med. 2019 Oct;239:112476. doi: 10.1016/j.socscimed.2019.112476. Epub 2019 Aug 7. PMID: 31539783.

[2] Joshi DS, Lebrun-Harris LA. Child Health Status and Health Care Use in Grandparent- Versus Parent-Led Households. Pediatrics. 2022 Sep 1;150(3):e2021055291. doi: 10.1542/peds.2021-055291. PMID: 35909145.

[3] Sivanand, B., A. Herman, C. Teutsch, and S. Teutsch. 2017. Building Health Literacy and Family Engagement in Head Start Communities: A Case Study. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. https://doi.org/10.31478/201704c

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.